As a parent, you want to do your best. You focus on your child, ensuring they're emotionally safe, properly socialized, and academically challenged — anything to set them up for success.

It's hard to fathom a dark outcome: that your child would grow up to assassinate someone, or be accused of doing so.

That's what Luigi Mangione's parents experienced last week, as the 26-year-old accused killer of UnitedHealthcare CEO Brian Thompson was charged with murder as an act of terrorism. And the parents of 15-year-old Natalie Rupnow, who killed two and injured six others at a Wisconsin school before dying of a self-inflicted gunshot, according to police.

Working with parents who've watched their kids sink into dangerous behavior, family therapist Rachel Goldberg said it's very hard for them to heal. She said parents must strive to find self-compassion and "separate their identity from their child's actions," no matter how challenging.

Parents of shooters experience remorse and confusion

In her 2016 memoir, "A Mother's Reckoning," Sue Klebold, the mother of Columbine shooter Dylan Klebold, wrote about struggling to call her son a "monster" after he killed 13 people in 1999. "When I hear about terrorists in the news, I think, 'That's somebody's kid,'" she wrote in the book.

Peter Rodger, the father of Isla Vista killer Elliot Rodger, wrestled with similar confusion and guilt. He remembers sitting in horror, watching his son's retribution video, which he posted on YouTube before stabbing, shooting, and using a car to hit bystanders in 2014. "Elliot was far from evil," Rodger told ABC that year. "Something happened to him. He was the most beautiful, kind, sweetheart of a boy."

Such an event "forces us as parents to contend with our worst fears," Annie Wright, another family therapist, told Business Insider. "The lack of control, at some level, over who they become."

Mangione's family is wealthy and well-known in their community as the owners of a golf club and philanthropists. He attended the Gilman School, a prestigious private school in Baltimore, where he graduated as valedictorian and was described by his peers as "very social" and "very into sports."

Goldberg said that a parent's imagined worst-case scenario is usually that their child would become a lonely, unemployed adult living in their basement. If a child does the unthinkable, recovering as a parent can feel impossible.

Limits to a parent's control

Kids don't need to be out of the house to be mysteries to their parents. In the wake of the Wisconsin shooting, authorities are combing through Rupnow's online activity in search of a motive, finding a version of her life seemingly concealed from others, like her fascination with the Columbine shooters.

Once a child is over 18 and financially independent, parents' control over their lives becomes even more tenuous. In the Mangiones' case, their son stopped responding to messages for months before he was arrested.

For parents watching their adult kids slip into alarming behavior, their options are legally limited, Goldberg said. Often, their best defense is talking to their kid, but "it really depends how much their adult child is willing to let them in."

Wright said that involving third parties can help. Parents can try family therapy or find licensed professionals who can help manage their child's physical or emotional pain. Parents can also call their local authorities in extreme cases, such as when their child is in immediate danger or endangering someone else.

Goldberg said the best thing parents can do is know their child as well as possible and act when something feels off. "Don't wait until it gets really bad if you can possibly intervene earlier," she said.

Even then, sometimes, intervention falls short.

Rodgers, the Isla Vista shooter, was in therapy from the age of 9. Peter Lanza, the father of Sandy Hook shooter Adam Lanza, said his son had been assessed by mental health professionals multiple times.

Pain a parent can't fix

Loneliness and isolation can often be red flags when analyzing a child's behavior. Still, Mangione, who started a gaming club in college and was part of a fraternity, appeared surrounded by people.

This made it harder for him to disappear fully: In July 2024, when he cut off contact with his family, cousins and friends reached out on social media. In November, his mother filed a missing person's report in San Francisco, where Mangione has some relatives.

Despite his seemingly solid network of friends and family, Mangione had spondylolisthesis, a painful spinal condition. He frequented Reddit communities related to back pain, describing his symptoms as "absolutely brutal" and "life-halting." That can be isolating, Goldberg said.

"It is a very lonely place to be in pain all the time because you can't really be present with people," he added.

In 2022, when Mangione lived in a Hawaiian surf community, he experienced sciatica, debilitating nerve pain, in his leg. R.J. Martin, who owned the co-living space, told The New York Times that Mangione "knew that dating and being physically intimate with his back condition wasn't possible."

While parents can do a lot to relate to a child's pain, such as listening and doing their best to understand the nuances of what their child is going through, "empathy alone can't bridge every gap," Wright said.

Parents can still protect themselves

Goldberg's clients, particularly parents of kids with substance abuse issues, struggle to move past their guilt. Acceptance can take a lifetime.

"They live in fear of getting a phone call from the police or hospital; they question everything they have done," she said. "They often feel incredibly helpless and stuck."

Wright said the resulting grief from something like this can be "extraordinarily complex" and "often includes sorrow, not only for the victims and their families but for the loss of the child they thought they knew."

She suggested therapy and, for those with religious affiliations, seeking spiritual leaders they trust. Parents can feel so many conflicting emotions, and it's important to "allow these emotions to coexist without rushing to tidy them up," she said.

This is especially hard for the parents who felt they tried their best.

Upon learning of Mangione's arrest, his family released a statement contrary to the manifesto found with their son during his arrest. "We offer our prayers to the family of Brian Thompson, and we ask people to pray for all involved," they said. "We are devastated by this news."

Some parents try to find meaning in the tragedy. Klebold wrote her memoir and participated in press interviews. Chin Rodger, mother of Elliot, started speaking at threat assessment trainings. She hopes that people will get better at identifying the red flags of someone going through a mental crisis.

Still, some just wish it never happened. Adam Lanza's father blames himself for overlooking the warning signs. "You can't get any more evil," Lanza told the New Yorker in 2014. "How much do I beat up on myself about the fact that he's my son? A lot."

• Luigi Mangione's NY judge is Gregory Carro, described as tough on crime and sympathetic to victims.
• Lawyers call him no-nonsense, and some say he leans pro-prosecution.
• Carro has allowed video and still photography in his courtroom during past high-profile proceedings.

His cases have earned tabloid nicknames, including the "rape cops," a "killer nanny," and a "blowtorch hubby." In 2021, he presided over the moped hit-and-run death of Gone Girl actor Lisa Banes.

New York Supreme Court Justice Gregory Carro has had dozens of sensational — sometimes horrific — cases in his 25 years on the Manhattan criminal bench.

As early as Thursday afternoon, Carro will preside over his most high-profile media case yet, the prosecution of Luigi Mangione, who is accused of the ambush shooting of UnitedHealthcare CEO Brian Thompson.

With Carro on the bench in a likely-packed 13th-floor courtroom, Mangione, 26, will be officially informed of the first-degree murder indictment against him. Manhattan District Attorney Alvin Bragg announced Tuesday that the indictment alleges a top charge of murder as an act of terrorism.

After the charges are read, Mangione will have the chance to enter a plea of not guilty. Carro, who is expected to keep the case, will then set a next court date and order that Mangione be taken to a city jail to await that date.

A former Manhattan narcotics and homicide prosecutor, Carro was appointed to Manhattan's criminal court bench in 1998 by then-Mayor Rudy Giuliani.

Carro is the son of retired Associate Justice John Carro, who in 1979 was the first Puerto Rican appointed as an appellate judge in New York.

A 'tough draw'

The younger Carro is known among defense lawyers at Manhattan Criminal Court as a "tough draw. "

If one lawyer tells another in a courthouse hallway, "I just learned my guy is going to be in front of Carro," another might commiserate, "Wow, that's a tough draw," veteran attorneys in the city told BI.

Prosecutors might say the opposite of Carro: "Good draw."

"Of course, in a case like this, there are no good judges," said longtime Manhattan defense attorney Ron Kuby. "You're not going to find any members of Antifa on the bench."

Kuby called Carro "harsh but not crazy," as Manhattan criminal judges go.

Five Manhattan defense lawyers interviewed by Business Insider said the judge leans pro-prosecution. None would say so on the record, because they may have cases before him in the future.

The most common descriptor among lawyers reached by BI? "No nonsense."

"He's a tough judge," said a former fellow jurist, Charles Solomon, a state Supreme Court Justice in Manhattan who retired in 2017.

"Very firm, very fair, and well-respected by his colleagues," Solomon said of Carro.

Judges are assigned at random

Solomon said that Carro would have been assigned as Mangione's judge through a strictly random process.

What likely happened was that on December 4, the day of Thompson's shooting, Mangione's lead prosecutor, Joel Seidemann, happened to be on call to "catch" new homicides.

Seidemann's team of prosecutors feeds all of its new cases into one of only two assigned courtrooms, and one of them was Carro's.

"This is the typical way a case gets assigned," agreed another retired state Supreme Court justice, Michael Obus, who served as a supervising judge in Manhattan Criminal Court from 2009 to 2017.

"He's a solid guy," Obus said. "He's a very good trial judge. In general, lawyers could do a lot worse than Judge Carro."

Law, order, and victims

At sentencings, Carro is an emphatic advocate for law, order, and victims, his many news clippings show.

"I can only imagine what memories are haunting the victim in this case and his significant other," he said last year at a recent high-profile sentencing, for the random, attempted slashing murder of a French tourist.

In 2011, Carro presided over the trial of an NYPD officer accused of raping a young fashion executive — a woman he'd been dispatched to help when she was too intoxicated to get out of her taxi.

A jury cleared the officer of rape and convicted him of official misconduct for the three caught-on-video visits he made to the woman's apartment during his shift that night.

Police misconduct offenses "rip at that fabric that holds us all together," Carro told the former officer, Kenneth Moreno, before sentencing him to a year at Rikers Island jail.

"You, sir, ripped a gaping hole in that fabric in committing those crimes."

It was Carro's biggest media case until now.

Moreno's lawyer, Joe Tacopina, was one of the lawyers to call Carro "no nonsense."

"Not easy on defendants or defense lawyers, for that matter," Tacopina said.

"Honestly, it doesn't matter what judge has this case," the former criminal attorney for President-elect Donald Trump, added. "There is such overwhelming evidence of guilt here. It is not a 'Who done it.' It is a 'Was he sane when he did it' case."

In his most high-profile murder — dubbed the "killer nanny" case by city tabloids — Carro allowed a jury to hear the insanity defense of Yoselyn Ortega, who in 2012 fatally stabbed two young children in her care.

Defense lawyers called two psychiatrists to the stand to testify that Ortega heard voices — including Satan's — urging her to kill the children. Jurors also heard that when the mother returned home to witness the carnage in her Upper West Side bathroom, Ortega was nearby, slashing into her own throat with the murder weapon.

The jury rejected the defense.

Carro called Ortega "pure evil" at her 2018 sentencing.

Then he sentenced Ortega to life without parole for first-degree murder, the same maximum penalty Mangione faces for the same top charge in his indictment.

Last month, the New York Times reported Carro sentenced a Long Island, New York man who admitted planning to "shoot up a synagogue" to ten years prison on a plea to possessing a weapon as a crime of terrorism.

• Luigi Mangione is on track for a late Thursday murder arraignment in Manhattan, BI has learned.
• Barring a last-minute change of heart, he plans to waive extradition in PA earlier Thursday.
• His fate will be in the hands of Justice Gregory Carro, a veteran of the NY criminal bench.

Luigi Mangione is expected to be brought before a Manhattan judge on Thursday for arraignment on a first-degree murder charge that could keep him imprisoned for life, Business Insider has learned.

The 26-year-old suspect has agreed to formally waive extradition at a hearing Thursday morning in Blair County, Pennsylvania, a law enforcement source told BI, speaking on the condition of anonymity due to their connection to the case.

Barring any last-minute change of heart by Mangione — who has previously been fighting extradition — he would be immediately transferred to the custody of NYPD officers. The officers would then transport him to New York from Pennsylvania, where he has been held since his arrest 9 days ago in the December 4 shooting of UnitedHealthcare CEO Brian Thompson.

"We have indications that the defendant may waive" extradition, Manhattan District Attorney Alvin Bragg said in announcing Mangione's indictment on Tuesday, without naming an arraignment date.

Once in Manhattan, Mangione would be brought directly to the Midtown North police precinct, home base for the Thompson murder investigation, said a second law enforcement source who also spoke on condition of anonymity.

After some preliminary processing, he will then be escorted out of the precinct.

"They want to do a perp walk for the media," in front of Midtown North, the second source said.

The precinct is in the same neighborhood where Thompson, a father of two sons from Minnesota, was ambushed outside a Hilton hotel, where he had been scheduled to speak at an investor meeting for the nation's largest healthcare insurer.

Police say Mangione is linked to the shooting by ballistic, DNA, and fingerprint evidence, in addition to writings recovered from him on his arrest.

Law enforcement is planning for an afternoon or early evening arraignment on Thursday, again barring any last-minute hitches that could push the timing into Friday.

Mangione's Pennsylvania hearing is scheduled for 9 a.m. Thursday.

New York Supreme Court Justice Gregory Carro, a more than 20-year veteran of the Manhattan criminal bench, will preside over the arraignment and be Mangione's judge going forward, according to court and law-enforcement sources.

Carro's last high-profile case was the electric-scooter death of movie and television actor Lisa Banes, who appeared in "Cocktail," "Gone Girl," and "Masters of Sex."

Mangione's New York attorney, Karen Friedman Agnifilo, did not immediately respond to a request for comment. A spokesperson for Bragg declined comment.

• Luigi Mangione has waived extradition in Pennsylvania, meaning he will come to New York voluntarily.
• Former Manhattan prosecutors say it's a good move for him to abandon his weeklong extradition fight.
• They said Mangione wouldn't benefit from a losing battle and needed to be close to his lawyer.

At a court hearing in Pennsylvania on Thursday, Luigi Mangione abandoned his fight against extradition and agreed to let New York police fly him to Manhattan.

Mangione will now face federal charges of stalking, murder through the use of a firearm, and a related gun charge, according to the federal complaint.

A representative for the federal court in Manhattan said a hearing was scheduled for 2 p.m. before US Magistrate Judge Katharine Parker.

Mangione is also expected to be arraigned on the state murder charges before Justice Gregory Carro of the New York Supreme Court — a tough judge described as pro-prosecution by some lawyers — at a later time.

Former Manhattan prosecutors told Business Insider his leaving Pennsylvania willingly — to face arraignment on first-degree-murder charges in the December 4 killing of UnitedHealthcare CEO Brian Thompson — was a smart move.

Fighting extradition, a process that could take months, makes no sense in this case, they said, and could only hurt the 26-year-old former Ivy League student.

"I think Karen realizes fighting is a waste of time," Michael Bachner, a lawyer and former Manhattan prosecutor, told BI earlier this week, referring to Mangione's new defense lawyer, Karen Friedman Agnifilo.

Friedman Agnifilo, a former chief assistant attorney at the Manhattan district attorney's office, is married to Marc Agnifilo, the attorney for Sean "Diddy" Combs in the rapper's federal sex-trafficking case. Their Manhattan law firm, Agnifilo Intrater, is set to defend in both high-profile cases.

"She's probably thought to herself, the evidence against my client is more than sufficient to lose an extradition hearing," Bachner said. "So what is the benefit of having one?"

Attorneys want to be near their clients, not shuttling back and forth — as an extradition battle drags on — between New York and central Pennsylvania, where Mangione is being held without bail.

"You don't want to be doing this from outside the jurisdiction," without easy access to your colleagues and law office, Jeremy Saland, a former prosecutor now in private practice, said.

Friedman Agnifilo did not respond to multiple requests for comment on her client's charges or extradition.

For some defendants, there are good reasons to fight being dragged across state lines to face charges, former prosecutors told BI.

"The benefit could be that you make them show their hand," Ikiesha Al-Shabazz, a defense attorney, said. At an extradition hearing, prosecutors are asked to demonstrate probable cause that the person being extradited committed the crime.

"You get to see some of the evidence," the former prosecutor said. "But this is the type of case where we pretty much know, from media reports, what the evidence will be."

New York Police Department officials say that evidence includes a 9 mm 3D printed "ghost gun" that matches the shooting ballistics and a spiral notebook of his writings. Both the gun and the notebook were recovered from his backpack when he was arrested last week at an Altoona, Pennsylvania, McDonald's following a five-day manhunt, police have said.

"What do you do? You wack the CEO at the annual parasitic bean-counter convention," the handwritten note from the spiral notebook says, law-enforcement officials told The New York Times.

Thompson was fatally shot on the sidewalk outside a Hilton hotel in midtown Manhattan, where he was to speak at an investor meeting.

If Mangione had family in Pennsylvania, an extradition delay could have value, Al-Shabazz added — but that's not the case, either. Mangione's family is in Maryland, where they own a resort and country club.

"There's no humanitarian issue, either, where you don't want to be extradited to someplace where you won't get a fair trial," she said.

"These are the issues that you fight extradition over, but they're not prevalent in this case," she added. "So to fight extradition would only be to further delay the inevitable."

Fighting for the sake of fighting could work against his interests down the road, as Mangione seeks favorable treatment from his judge and prosecutors, Al-Shabazz said.

"You want to cooperate," Al-Shabazz, an adjunct law professor at St. John's University School of Law, said. "You don't want to make it harder for them to do their job for no reason if you're going to turn around and ask them for a plea deal, right?"

The allegations against Mangione are now playing out in three different courts.

In New York state court, if convicted of the top charge of first-degree murder, Mangione faces a mandatory minimum sentence of 25 years to life in prison. The top sentence under New York law would be life in prison without parole.

December 19, 2024: This story was updated to include information about Mangione's federal charges and extradition.

"I've unfortunately had a lot of experience navigating the healthcare industry," the designer told Gizmodo.

• Luigi Mangione was charged last week over the shooting of UnitedHealthcare CEO Brian Thompson.
• The race is on to be the first to make a true crime show about him.
• Two documentaries and two TV specials have been announced so far.

True Crime has a new protagonist: Luigi Mangione.

Since Mangione was arrested and charged with murder last week over the shooting of UnitedHealthcare CEO Brian Thompson, the media and public have been mining information about his past, including by scouring his social media accounts, to learn every detail about his life.

This week, news outlets reported that four documentaries about the 26-year-old and the shooting were in the works.

Thompson was shot and killed by a masked person outside a Manhattan hotel on December 4. Mangione was arrested on December 9 after being found in a McDonald's in Altoona, Pennsylvania, and later faced local gun and forgery charges alongside the murder charge.

The shooting has had a huge cultural impact, sparking conversations about what is seen as the normalization of violence in the US and the state of the healthcare system. It seemed inevitable that true crime shows would follow at a time when the genre's popularity is at its height.

After pictures of Mangione emerged following the shooting, some X users joked that Ryan Murphy, who is behind true crime dramas including "Monsters: The Lyle and Erik Menendez Story," would make a show about him. Others speculated which actors should portray Mangione.

Here's what we know about the upcoming projects.

Advocates told ProPublica the insurer’s strategy may be violating federal law.

• Manhattan DA Alvin Bragg has tapped Joel Seidemann to lead the Luigi Mangione prosecution.
• His 40-year career includes prosecuting the Etan Patz murder and Brooke Astor swindle cases.
• Colleagues say he's tenacious and detail-obsessed, with an expertise in fighting psych defenses.

Former colleagues say he's detail-obsessed and relentless. One calls him "a firecracker." And they're hard-pressed to name anyone in the district attorney's office more capable of crushing a psych defense in a murder case.

Joel Seidemann is the veteran assistant district attorney who will be helming the Manhattan prosecution of 26-year-old Luigi Mangione, charged in last week's ambush shooting of UnitedHealthcare CEO Brian Thompson.

Seidemann has been prosecuting high-stakes, high-profile crimes, including homicides, for 42 years.

"I think a great deal of Joel," said Cyrus Vance, Manhattan District Attorney during Seidemann's two biggest trial wins, in the Etan Patz murder and Brook Astor swindle cases.

"He's probably tried more cases than anybody in the DA's office," said attorney Daniel Bibb, hired as a prosecutor six months after Seidemann and now in private practice.

"It's a sign, certainly, that the Manhattan DA's office is giving this their very highest priority," said veteran defense lawyer Ron Kuby.

An author and former adjunct law professor at Pace University, Seidemann does not wilt under the national spotlight that has found him and his cases over the decades.

In addressing judges and juries, he readily turns the dry language of police and medical reports into vivid sound bites.

"They didn't call for an ambulance. They didn't call for help. Rather, they stood on the street corner and laughed," he told a judge of the teen suspects in the fatal 2006 mugging of an NYU student.

"She had her hair done while her husband lay in surgery," he told another judge in 2008, arguing against bail for Barbara Kogan, dubbed the Black Widow for her pricey dark attire. (Kogan soon after pleaded guilty to her husband's 1990 contract killing.)

More than one former colleague said with affection that Seidemann lands his best lines with seeming self-awareness, sometimes peeking over his shoulder to check the courtroom audience's reaction.

Meanwhile, defense lawyers described him as a relentless adversary.

One of the few high-profile trials Seidemann has lost was the 2007 acquittal of David Lemus in a fatal 1990 shooting at the Palladium nightclub. The case was featured in a recent NBC documentary, The Sing Sing Chronicles.

Both of Lemus's lawyers called Seidemann tough but fair.

"Joel tried the best case he could, but David Lemus was innocent," attorney Jonathan P. Bach told Business Insider.

"He was a consummate professional, extraordinarily talented," agreed co-counsel Daniel J. Horwitz. "But we had the two actual killers taking the stand, and confessing to pulling the trigger."

A spokesperson for the Manhattan DA's office declined to comment on this story. Mangione's attorney in Pennsylvania, where he is fighting extradition, did not respond to repeated requests for comment. Neither did his New York attorney, Karen Agnifilo.

Mangione has been denied bail and remains held in a central Pennsylvania jail as he awaits a yet-scheduled extradition hearing.

The Etan Patz case

"Joel is fabulous — he's as experienced in that office as they go, and I don't have a bad thing to say about him," said former prosecutor Joan Illuzzi, also now in private practice.

In 2017, Seidemann and Illuzzi won a kidnapping and murder conviction in a case that held national attention for decades, 1979 disappearance of six-year-old Etan Patz.

"He's especially skilled at psych cases," said Illuzzi, noting that the Patz conviction required jurors to believe former bodega worker Pedro Hernandez had confessed to killing Patz because he was guilty, not because he was mentally unsound.

The Mangione case, should it go to trial, may also hinge on a psych defense. Longtime Manhattan attorneys told BI this week that his best hope may be going to trial on what's called an extreme emotional disturbance defense.

The Brooke Astor swindle

In 2009, Seidemann tried what may be his most high-profile case until now — the $60 million swindling of wealthy philanthropist Brooke Astor by her own son — and he called former Secretary of State Henry Kissinger to the witness stand.

The case hinged on Astor's competency to sign repeated changes to her will. Under Seidemann's questioning, Kissinger recalled to jurors how Astor, on the brink of turning 100 years old, had been so impacted by Alzheimer's that she could no longer recognize her dear friend Kofi Annan.

The then-UN Secretary General was sitting beside Astor at a 2002 dinner party at her Park Avenue co-op.

"Who is the black fellow who is sitting on the other side of me?" Kissinger recounted Astor turning to him and asking.

Seventy prosecution witnesses testified at the seven-month trial, including journalist and editor Graydon Carter, socialite Annette de la Renta, and author Louis Auchincloss. Barbara Walters teared up on the stand as she recalled Brooke's mental decline.

"He's brilliant," said former Manhattan elder-abuse prosecutor Elizabeth Lowey, who teamed up with him to win the case. "He's a firecracker."

Seidemann synthesized stacks of financial documents and scores of witness accounts, remembered Lowey, now at the fraud prevention company EverSafe.

Then he'd pluck out the richest details to create a persuasive narrative for the jury, she said.

Among those details: the son, Anthony Marshall, sailed a teak-decked yacht. Meanwhile, he was ignoring requests by his mother's nurses for no-skid socks and a stairway safety gate.

"The yacht for $920,000? He wasn't too frugal for that," Seidemann told jurors at closing arguments. "But the safety gate for two grand? Not going to happen."

Astor's nurses called Marshall's wife, Charlene, "Miss Piggy" behind her back, Lowey remembered, and Seidemann made a point of letting jurors hear that.

"I would tell Joel we can't call her Miss Piggy, even if it's in the nurses' notes, and he would say, 'Oh yes we can," Lowey said, laughing.

"He's not afraid to call it what it is," she added. "If there's anyone who can make people understand that even if you have issues with the insurance industry, you can't be a vigilante, it's Joel."

Philip C. Marshall filed the 2006 guardianship petition that led to his father's prosecution. He told Business Insider that Seidemann kept a box of Kleenex on hand for him during interviews and trial prep.

"I just remember his ability to engage and listen — his calm and intentional nature throughout this ordeal," said Marshall, founder of the Beyond Brooke campaign against elder abuse.

More than one person interviewed by Business Insider mentioned Seidemann's height, one saying, "he still has a damn good courtroom presence." Marshall noted he is not a tall man.

"But any opponent will be dwarfed by the stack of documents and evidence that he'll bring to this case," Marshall quipped.

• UnitedHealth Group's CEO eulogized his slain colleague, Brian Thompson, in a New York Times op-ed.
• Thompson's shooting sparked a nationwide debate about the state of the health insurance industry.
• Witty's op-ed faced fierce online criticism from people who said it didn't offer solutions.

The head of UnitedHealth Group, the parent company of UnitedHealthcare, is responding to the "vitriol" that's been lodged — both on- and offline — against the health insurance industry and its workers.

In an op-ed published in The New York Times on Friday, UnitedHealth Group CEO Andrew Witty expressed his grief over the fatal shooting of UnitedHealthcare CEO Brian Thompson last week, as well as his appreciation for the "outpouring of support" for Thompson. He then condemned the mounting rhetoric that he said has glorified violence against health insurance workers.

"We also are struggling to make sense of this unconscionable act and the vitriol that has been directed at our colleagues who have been barraged by threats," Witty wrote.

"No employees — be they the people who answer customer calls or nurses who visit patients in their homes — should have to fear for their and their loved ones' safety," he wrote.

Witty acknowledged growing criticism that the healthcare industry is flawed and defended his company's place within it.

"We know the health system does not work as well as it should, and we understand people's frustrations with it," Witty wrote, adding that his company's mission is to build a system that works better for everyone.

And Thompson, he added, advocated for ideas "aimed at making health care more affordable, more transparent, more intuitive, more compassionate — and more human."

The fatal shooting of Thompson outside a midtown Manhattan hotel last week sparked a nationwide conversation about the state of the US health insurance industry, with many criticizing the system's ability to provide lifesaving care.

Social media has been inundated with memes mocking Thompson's death, praising the shooting suspect, and calling out other healthcare CEOs. Some executives have sought out greater security over fears for their safety, though the suspect has been arrested and charged in connection with Thompson's murder.

Witty's op-ed in the Times had received more than 2,400 comments as of Friday afternoon, many of which ridiculed his statement and condemned what they said were UnitedHealth Group's practices of denying insurance claims.

A number of commenters called out Witty for saying the system is flawed without providing any tangible solutions to fix it. Others criticized the for-profit health insurance system as a whole, with some acknowledging that businesses are meant to make a profit and others advocating for nonprofit healthcare.

UnitedHealth didn't respond to a request for comment from Business Insider.

Optum's AI chatbot was found exposed online at a time when the healthcare giant faces scrutiny for its use of AI to allegedly deny patient claims.

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• Luigi Mangione was arrested in the killing of UnitedHealthcare CEO Brian Thompson.
• Rewards from NYPD Crime Stoppers and the FBI depend on Mangione's conviction, which may take time.
• The 911 caller and the restaurant patron who recognized Mangione may both be eligible.

After a densely eyebrowed man was caught on camera shooting UnitedHealthcare CEO Brian Thompson, authorities put a bounty on his head.

The New York Police Department's Crime Stoppers program offered a $10,000 reward for information that could lead to the killer's arrest or conviction. The Federal Bureau of Investigation followed suit, touting a $50,000 reward.

But the tipster who called 911 on Luigi Mangione needs Mangione, who was arrested Monday and accused of the killing, to be convicted before they get the money.

An ordinary Crime Stoppers reward is under $3,500. In those cases, tipsters can be paid upon arrest and indictment.

But when a reward is raised to exceed that amount, the money isn't disbursed until a conviction, either at trial or through a guilty plea, according to a spokesperson for the New York City Police Foundation, which administers the funds.

Officers in Altoona, Pennsylvania, arrested Mangione at a McDonald's restaurant, on charges that he lied about his identity and illegally carried a ghost gun police said was assembled from 3D-printed parts.

Mangione will likely be extradited to New York, where a warrant indicates he will be charged with murder, among other crimes. Mangione has not made any public statements since his arrest and has not yet entered a plea for the charges against him.

Thomas Dickey, an Altoona-based defense attorney representing Mangione on his Pennsylvania charges, didn't immediately return a request for comment from Business Insider.

According to New York Police Department officials, the 911 caller was a fast-food worker who was tipped off about Mangione by a restaurant patron.

Even though that person didn't call Crime Stoppers directly, they can still potentially receive the reward, according to the foundation spokesperson.

"The individual in Pennsylvania, who called in a tip, is eligible to receive the reward," the spokesperson told Business Insider.

More than one person could collect rewards

Crime Stoppers doesn't always pay out the maximum amount of their rewards. The total is determined by a board overseen by the foundation, which acts upon the recommendation of the commanding officer of the NYPD's Crime Stoppers unit.

Given the high profile of Thompson's killing, it's likely the tipster will be eligible for the full amount, Joe Giacalone, a former New York police officer who oversaw the unit, said.

"Since this was a national manhunt, I would assume they would ask for the highest amount of award," said Giacalone, now an adjunct professor at John Jay College of Criminal Justice.

The board would also decide whether the reward would go to either the restaurant patron, who first apparently recognized Mangione, or the employee who called 911, or both. Those details "would be ironed out between Crime Stoppers and the police foundation," the foundation spokesperson said.

"In the past, on other cases, sometimes they both get their reward," the spokesperson said. "Sometimes the reward is split half-and-half."

It's less clear whether the caller can get a piece of the FBI's $50,000 award anytime soon.

The language on the FBI poster offered money for "information leading to the arrest and conviction of the individual responsible for this crime," also indicating it wouldn't pay out unless a conviction is reached.

An FBI representative said tips from the public are among the agency's "best tools in preventing, detecting, and deterring crime." It did not answer questions about the Mangione tipster or its reward process.

"The FBI maintains longstanding policy not to confirm the identity of individuals who assist the FBI by providing tips or information," the representative said in an email. "Additionally, the FBI will not comment on whether reward money has been paid and to whom. The FBI takes this position for privacy protection, and to ensure the public's continued cooperation and incentivization with any future assistance."

Reward funds can help ease the financial burden of potential informants, whose lives may be transformed if they become cooperating witnesses or ultimately testify at trial. Former prosecutor Opher Shweiki said they were helpful in capturing and building the case against Ahmed Abu Khatallah, who was involved in the 2012 Benghazi terrorist attack. The case was featured as one of the "Success Stories" from Rewards for Justice, a law enforcement program that works with the FBI to offer rewards.

"They're sometimes upending their lives," said Shweiki, now a national security partner at Akin Gump. "And so there's a lot that goes into that equation."

A conviction in the Thompson killing could take a long time if it happens at all. As Business Insider's Laura Italiano reported, a savvy lawyer could delay the Pennsylvania-to-New York extradition for years — and that would be before Mangione would be arraigned on murder charges, kicking off the formal process for the criminal case.

Mangione's folk hero status has led to a cascade of online threats against the employee who called 911, whose name has not been publicly disclosed. The fast food restaurant location where Mangione was arrested has beefed up security, Newsweek reported.

The ordinary NYPD Crime Stoppers procedure is designed to be completely anonymous to protect tipsters. Callers are given ID numbers, and their identities are not even known to police officers — even when they collect the reward.

Given the threats and heightened emotions surrounding the case, Giacalone said NYPD officials were wrong to disclose identifying information about the tipsters, including the restaurant where the call was made.

A spokesperson for the NYPD didn't immediately return a request for comment on the disclosure.

"It was a mistake," Giacalone said. "Because, if you're watching what people are saying online about this person, they're in danger. And so is their family."

Brian Thompson was being sued for alleged insider trading, but there's no evidence Pelosi is involved.

• Luigi Mangione remains held in Pennsylvania and charged with the murder of Brian Thompson.
• Former Manhattan prosecutors predict the extradition process could take months.
• Once in New York, he'll stay in the city's most notorious jail and could pursue a psych defense.

Since his arrest on Monday in the Manhattan killing of UnitedHealthcare CEO Brian Thompson, Luigi Mangione has been held in Pennsylvania's oldest jail.

The State Correctional Institution at Huntington, a sprawling red brick structure on the edge of the Allegheny Mountains, opened in 1889 as a reformatory for delinquent boys, and still features its original Queen Anne-style architecture.

Mangione will remain at that maximum-security jail as he fights extradition — a process that Manhattan defense lawyers and former prosecutors predict will take months.

"Whatever it is, it's going to be better than Rikers, and he'll be in no hurry to leave," veteran New York defense lawyer Ron Kuby told Business Insider, referencing Mangione's likely next placement, the city's notorious Rikers Island. Two weeks ago, a federal judge complained that court-ordered safety and use-of-force reforms at Rikers have proceeded at a "glacial pace."

Here's what longtime Manhattan attorneys predict will happen behind the scenes as Mangione, a 26-year-old Ivy League graduate from a wealthy Maryland real estate family, waits for his case to proceed from indictment to extradition and beyond.

First, a grand jury

Mangione is being held without bail on two felony complaints.

The first was drafted by police and prosecutors in Pennsylvania's Blair County. It alleges that on Monday, after being recognized by an employee at an Altoona McDonalds, he gave cops a fake ID and possessed in his backpack an unlicensed firearm — a part-metal, part 3-D-printed weapon described as a possible "ghost" gun.

The second complaint, drafted soon afterward by the NYPD and Manhattan prosecutors, also charges him with possession of a false ID and weapons possession but adds the top charge of second-degree murder.

Longtime Manhattan attorneys say a secret grand jury is likely already hearing evidence in Lower Manhattan on those charges.

Manhattan prosecutors will likely conclude their grand jury presentation against Mangione by the end of the week or by early next week at the latest, they said, estimating based on their own previous murder cases.

"They won't have full DNA and ballistic results yet," said one longtime defense attorney. The attorney asked to speak anonymously because they said they are under consideration to represent Mangione at his New York arraignment and in future proceedings.

At this early stage, prosecutors may not know for sure if the bullets fired at Thompson match the gun possessed by Mangione when he was arrested, the attorney said.

"But so far, they appear to have a ton of at least circumstantial evidence," they said. "But prosecutors only need to present a minimal amount of evidence" at this stage, to show that there is reasonable cause to believe Mangione committed the murder, they added.

Any indictment would remain sealed until Mangione faces a judge at his Manhattan arraignment.

A spokesperson for Manhattan District Attorney Alvin Bragg declined to confirm if a grand jury is hearing evidence or to comment on this story.

Next, an extradition battle

Meanwhile, Mangione is fighting extradition to New York, a process that will spool out over the course of many weeks, the legal experts predict.

On Tuesday, a Blair County judge got the ball rolling.

He gave local prosecutors 30 days to obtain what's called a governor's warrant, in which New York Gov. Kathy Hochul would request Mangione's return to New York.

"Once the indictment is voted, which could be very soon, they'll ship that paperwork up to the governor's office, where I"m sure it will be expeditiously processed and sent to Pennsylvania," said Daniel Bibb, a former Manhattan homicide prosecutor now in private practice.

"There has to be an indictment for there to be an extradition," Bibb said.

Hours after Mangione's arrest, Pennsylvania Gov. Josh Shapiro said Monday that the Commonwealth will cooperate in Mangione's extradition, and Blair County District Attorney Peter Weeks told reporters that he recognized New York's murder case takes precedence over his own forgery and gun-possession case.

Mangione's Pennsylvania attorney, Thomas Dickey, told Good Morning America on Wednesday that he will demand an extradition hearing so that Manhattan prosecutors will be required to begin divulging their evidence.

Dickey has repeatedly maintained his client's innocence in statements to reporters this week. He did not immediately respond to requests for comment on this story.

A formal extradition hearing, which has not yet been scheduled, will not focus on whether Mangione committed the murder, Bibb said.

"The issue in Pennsylvania will be whether the person named in the New York indictment is him. And that's pretty much the only inquiry," he said.

"I pretty much guarantee that you'll be seeing Mr. Mangione in New York within the next couple of months," Bibb predicted, depending on how much delay the Blair County judge is willing to tolerate.

An extradition battle could take months

Kuby, who has practiced criminal law in New York for more than 40 years, said that a creative defense lawyer could use appeals to drag an extradition battle on for many months.

"You hold the extradition hearing. You lose? You appeal to Pennsylvania's intermediate appellate court," he said. "You lose that, and you apply to the Supreme Court of Pennsylvania to hear the case."

In the early 1990s, Kuby and his partner, William Kunstler, were able to delay the New York-to-Florida extradition of Frank Strahan — a Harlem man arrested in the cold-case, 1946 shooting death of Miami's first black police officer — for nearly two years.

A defense lawyer can try to appeal an extradition all the way up to the US Supreme Court, Kuby said.

A potential psych defense

Once brought back to New York, Mangione would be quickly arraigned. The ensuing prosecution, however, could extend years if he decides to use a psychiatric defense and fights the charges at trial, experts said.

Given what investigators have described as the evidence implicating him in the shooting — including extensive surveillance video footage and what the NYPD Commissioner Jessica Tisch described as "anti-corporatist sentiment" in a hand-written document recovered at his arrest — Mangione's best chances at trial may be what's called an extreme emotional disturbance defense, they said.

Thompson, a 50-year-old father of two sons from Minnesota, was fatally shot on the sidewalk outside a UnitedHealthcare shareholders meeting, where he'd been set to speak.

In his online posts, Mangione, the scion of a wealthy and prominent Baltimore family, had complained about his chronic back pain and the healthcare system.

A so-called EED defense would ask jurors to find Mangione guilty of a lesser charge of manslaughter, arguing he was so emotionally disturbed at the time that he believed he had to kill Thompson.

"It might be a long shot," said the attorney who requested anonymity due to their potential connection to the case.

"But by all accounts, he went off the grid six months ago, and that was uncharacteristic of him, as was any act of violence," they said.

"He may well have had a psychotic break."

• Luigi Mangione, charged with killing the CEO of UnitedHealthcare, had a lower back condition.
• Spondylolisthesis occurs when one vertebra in your spine slips out of alignment.
• Mangione seemingly frequented a subreddit for the condition and wrote about symptoms.

Luigi Mangione, the 26-year-old man charged with killing UnitedHealthcare CEO Brian Thompson, suffered from a spinal condition.

Mangione's social media accounts included several references to back pain. On X, Mangione's banner included an X-ray image of a spine after a spinal fusion.

On his Reddit account, he posted in a subreddit for spondylolisthesis, a lower back condition most often caused by joint deterioration. Mangione also mentioned he had spondylolisthesis in handwritten notes from 2019 reviewed by Business Insider.

Spondylolisthesis can cause pain and stiffness

According to Cleveland Clinic, spondylolisthesis is usually caused by aging (as the discs holding the vertebrae weaken) or injuries.

It is a condition when one of the bones in the spine falls out of alignment and "presses down" on the vertebra below it. That pressure on nearby nerves can cause lower back pain.

Other symptoms include sciatica (nerve pain that runs down from the lower back to the legs), back stiffness, numbness, and difficulty walking.

Not everyone needs spinal fusion surgery to realign their vertebrae; depending on the severity of the symptoms, rest, physical therapy, and wearing a brace can help reduce pain, as can taking over-the-counter medications when symptoms flare up.

Mangione had sciatica, a common symptom

In 2022, Mangione moved to a co-living space in Honolulu called Surfbreak. According to a Reddit post, he experienced sciatica, nerve pain that runs down from the lower back to the legs, for the first time after a surf session. "A few weeks later I slipped on a piece of paper and my right glute locked and right leg shut down for a week," he wrote in 2022. "Couldn't support any weight on it."

Prior to his back surgery in 2023, Mangione also described having "near-constant burning/twitching in both ankles/calves" and "back and genital pain" on Reddit — symptoms of sciatica.

R.J. Martin, who owns Surfbreak, told the New York Times that shortly after moving in, Mangione experienced such debilitating pain from a group surfing lesson that he needed Martin to switch out his mattress.

Mangione also told Martin that his condition prevented him from being in a romantic relationship.

"He knew that dating and being physically intimate with his back condition wasn't possible," Martin said. "I remember him telling me that, and my heart just breaks."

At first, the back surgery seemed to improve Mangione's symptoms — he posted in 2023 that it was a "success." But by June 2024, he started criticizing doctors online and eventually lost touch with friends and family.

According to Mayo Clinic, spinal fusion surgeries for spondylolisthesis "can have very good outcomes when performed well and for the right reasons."

Another piece of potential evidence has been brought forward by authorities.

• Retail sites like Amazon are taking action against Luigi Mangione-inspired merchandise.
• eBay prohibits items that glorify violence, but it doesn't ban the phrase "Deny. Defend. Depose."
• Mangione has emerged as a folk hero of sorts in certain corners of the internet.

Retail platforms like Amazon, Etsy, and eBay are slapping down merch listings that glorify Luigi Mangione — the suspect in the killing of UnitedHealthcare CEO Brian Thompson.

In the wake of Thompson's murder, some people on social media were unsympathetic, given their grievances with the American healthcare system. And after Mangione was arrested, he emerged as something of a folk hero — and heartthrob — in certain corners of the internet.

That sentiment soon made its way into the merch space. On Etsy, products were being offered with Mangione's likeness and the phrase "Deny, Defend, Depose," BI sister site Morning Brew reported.

Those words were etched onto bullet shell casings found at the scene of the killing, police said — and are similar to a 2010 book scrutinizing the insurance industry titled "Delay Deny Defend."

Many of the Mangione-themed items offered for sale came from drop shippers, Morning Brew reported — or sellers who print products on-demand after they're ordered. Some of the items included cups, sweatshirts, and hats, The Washington Post said.

Morning Brew reported that similar items were for sale on sites like RedBubble and TikTok Shop, while Amazon and Etsy were taking down many listings that referenced Mangione or the shooting.

An Amazon spokesperson told Business Insider that the products in question were removed because they violated Amazon's rules against offensive and controversial items.

An eBay spokesperson told BI that items that "glorify or incite violence" are prohibited from its marketplace. That includes items that celebrate the murder of the UnitedHealthcare CEO, the eBay spokesperson said. The company doesn't prohibit the sale of items with the phrase "Deny, Defend, Depose," the spokesperson said.

It appeared some of the platforms were playing a game of cat and mouse with sellers — with various listings still live as of Wednesday.

The eBay spokesperson said the company is "continuing to sweep the marketplace for other prohibited items," including one listing that was still live as of Wednesday — which the spokesperson said was being removed because it featured an image of a gun.

A Redbubble spokesperson told Business Insider in a statement that its "strict community guidelines prohibit, among other things, the glorification or promotion of violence, while still allowing legitimate discussion of current events."

Every design includes a reporting function so that potential violations can be flagged by the community, the spokesperson added.

Etsy and TikTok Shop didn't immediately respond to requests for comment from BI.

For years before he was accused of killing the CEO of one of America's largest health-insurance companies, Luigi Mangione suffered from debilitating pain that doctors didn't seem able to fix.

He detailed the pain, and what he felt to be the healthcare system's inadequate response, in dozens of posts on Reddit between 2018 and 2024.

None of them, though, mention UnitedHealthcare or its CEO, Brian Thompson, whom he's now accused of killing. And none of the posts blame UnitedHealthcare — or Thompson — for his health issues. The only insurer mentioned is Blue Cross Blue Shield, in a brief post describing how it covered a medical test.

But his posts paint a portrait of someone whose pain and recovery led him to put "my life on hold in my 20s." And the experience appears to represent a significant — and excruciating — engagement with the American healthcare system. Like most young Americans, if Mangione was covered by his parents' health-insurance plan, he likely would have aged out when he turned 26 in May, under rules set by the Affordable Care Act.

In handwritten notes from 2019 reviewed by Business Insider, Mangione wrote that he had spondylolisthesis — severe slippage of parts of the spine due to joint deterioration.

In 2022, he described "near-constant burning/twitching in both ankles/calves." By 2023, he wrote on Reddit, he'd been experiencing "back and genital pain" on and off for a year, including numbness in his groin. (Details shared by the Reddit account match biographical details about Mangione sourced from public documents.)

He underwent surgery later that year. An X-ray image Mangione posted on social media depicted a spinal fusion, with rods and screws reinforcing the position of his bones. At first, he appeared jubilant — his pain was gone. But by June this year, he was castigating doctors as "basically worthless" on X.

Public records, social-media posts, and interviews indicate that Mangione cut off contact with family and friends earlier this year. Months later, police say Mangione murdered Thompson on a Manhattan sidewalk, wielding a gun assembled from 3D printed parts.

The scion of a prominent Baltimore family, Mangione was educated at elite schools. Friends say they're now hard-pressed to recognize the kind, unassuming, and whip-smart person they know.

A classmate who led a student group at the University of Pennsylvania with Mangione in 2016 and 2017 said she recalled him as humble, helpful, and immensely driven. She asked not to be named given the intense focus on Mangione, but BI has confirmed her identity.

"I would set my sister or friend up with him," she said. "Just knowing his personality, I would completely trust him. Even knowing what I know now, if he 100% did it, I would feel completely safe being alone in a room with him."

A privileged youth

Mangione grew up in Towson, Maryland, about 10 miles outside Baltimore. His grandfather, Nick Mangione Sr., was a self-made multimillionaire, The Baltimore Banner reported. The elder Mangione, who died in 2008, owned and operated a sprawling portfolio of country clubs, nursing homes, and local radio stations. The younger Mangione is one of 37 grandchildren, part of a large family whose ranks also include a Maryland lawmaker.

Mangione's parents and immediate family did not respond to requests for comment.

Thomas J. Maronick Jr., an attorney and longtime host at one of the family's radio stations, told BI that the family was "very influential" in the local community, which was reeling from the news of Mangione's arrest.

"When you think of the Mangione family, you think of an esteemed family that has done a lot for the community," Maronick said on a phone call. "When I first heard the name, I thought it had to be a different family. It was very out of character for anything I've ever known about the family."

Mangione appeared well positioned to carry on the family's name.

He attended the Gilman School, a prestigious Baltimore-area all-boys school where tuition runs over $37,000 a year. There, he cofounded AppRoar Studios, a company that released a phone game; was in the school's robotics club; and graduated as valedictorian of the class of 2016.

Mangione was "very into sports" and "very social," a high-school classmate told BI. The classmate asked not to be named, but BI has verified their identity. "He was easily one of the smartest in our class. I never would have thought he would have been a part of this," the classmate added.

He went on to the University of Pennsylvania, graduating in four years with both a bachelor's and a master's degree in computer science, a university spokesperson said. He cofounded a video-game-design club and was inducted into the computer-engineering department's Eta Kappa Nu society for students at the top of their class, according to blog posts and the society's website.

He appeared active in his fraternity, photos posted on Instagram show.

Still, his health appeared to drag him down. In posts on Reddit, he described experiencing "brain fog." His "cognitive decline" started after he contracted Lyme disease at 13, he wrote, and worsened after his "very tame" but sleepless fraternity initiation. The fraternity did not respond to a request for comment.

He considered dropping out of college, he wrote, and felt that his condition restricted him to "what feels like 10% of a college experience."

"My symptoms were very minor at first and I was able to excel in high school, but the symptoms worsened exponentially last year," he wrote in 2018. "It's absolutely brutal to have such a life-halting issue."

In 2019, Mangione spent three months as a counselor for a Stanford summer program for high schoolers. He left a positive impression on the students, one of them said in posts on Instagram.

After college, he got a job as a data engineer at TrueCar, an online vehicle-purchase platform, and was regularly promoted, according to his LinkedIn profile and a former colleague.

By early 2022, he had moved to a coliving space in Hawaii called Surfbreak, according to photos posted on Instagram. R.J. Martin, the founder of Surfbreak, told Honolulu Civil Beat that Mangione founded a book club at the residence. On Martin's suggestion, one of the books discussed by the club was the Unabomber Ted Kaczynski's manifesto, Martin said.

Kaczynski, a Harvard-trained mathematician, lived in the wilderness and conducted a 17-year mail-bombing campaign against people he blamed for advancing technology at the expense of the natural environment.

Mangione gave the book four out of five stars on his Goodreads account.

"While these actions tend to be characterized as those of a crazy luddite, however, they are more accurately seen as those of an extreme political revolutionary," Mangione wrote in his review of the book.

The book club dissolved shortly thereafter, Martin told Civil Beat, amid discomfort with the manifesto.

Mangione detailed his back-pain journey on social media

In Hawaii, Mangione experienced another health setback. He'd had mild back pain since he was a child, but while surfing in early 2022, he "experienced sciatica for the first time," he wrote on Reddit. "A few weeks later I slipped on a piece of paper and my right glute locked and right leg shut down for a week. Couldn't support any weight on it."

Mangione, writing under the username Mister_Cactus, was a frequent poster in the spondylolisthesis subreddit. He exchanged notes with other people dealing with the condition and advised one poster how to persuade medical professionals to take symptoms seriously in the face of some doctors whose perspectives he decried as "nonsense."

"Tell them you are 'unable to work'/do your job. We live in a capitalist society," he wrote. "I've found that the medical industry responds to these key words far more urgently than you describing unbearable pain and how it's impacting your quality of life."

Martin told Honolulu Civil Beat that Mangione struggled with back pain throughout his time living at Surfbreak in 2022. In a separate interview, with The New York Times, Martin said that Mangione told him the lower vertebrae of his spine were nearly "a half-inch off" and had impeded his romantic life.

But by the next year, Mangione wrote that surgery had helped resolve his pain, at least for a time.

In one post, dated October 2023, he said back-fusion surgery had been "a success." After a week, he had no use for pain medication, he wrote.

"The surgery wasn't nearly as scary as I made it out to be in my head, and I knew it was the right decision within a week, and that I won't have to bother with injections or future surgery for many years," he wrote.

Mangione went dark earlier this year

In 2023, Mangione stopped working at TrueCar. The company laid off more than 100 employees that year. BI was unable to confirm the circumstances under which he left the company.

He appeared to spend early 2024 traveling around Asia, according to Reddit posts. In April, he emailed the author of a Substack he followed to say he would be in Japan through the beginning of May, according to a screenshot of the email the blogger shared on X.

His final Reddit post, in May, was to the Kaczynski subreddit; he shared a video lambasting Chinese social-media culture. On X, his final posts, on July 8, revealed a disenchantment with both the Democratic and the Republican political parties and support for Robert F. Kennedy Jr. The previous month, he'd reposted another user's skepticism with doctors.

"My experience with the medical profession — and yours is probably similar — is that doctors are basically worthless unless you carefully manage them, and 2/3 of them are worthless even in that case," the post said.

Afterward, both accounts went dark.

Maronick, the family friend, told BI that there had "been some rumblings" that Mangione hadn't been in touch with his family in "quite some time."

In July, an apparent friend posted on X suggesting that Mangione hadn't responded to messages in months.

"You made commitments to me for my wedding and if you can't honor them I need to know so I can plan accordingly," the user wrote to Mangione. (The user could not be reached for comment.)

In recent months, one of Mangione's cousins began reaching out to Mangione's friends to ask whether anyone had heard from him, his high-school classmate told BI. The classmate texted Mangione but never heard back.

Mangione's mother filed a missing-persons report in San Francisco on November 18, writing that she hadn't seen her son since July, according to the San Francisco Standard. In a statement released on Monday, a group of Mangione's cousins wrote they were "shocked and devastated by Luigi's arrest."

"We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved," the statement said.

Thompson was shot and killed on December 4 ahead of an annual investors meeting for UnitedHealth Group. Police say the bullet casings found on the scene had the words "delay," "deny," and "depose" written on them — which some have taken to be a reference to a book, "Delay, Deny, Defend," which details how insurance companies avoid paying medical bills.

Pennsylvania police, acting on a call from a McDonald's employee, found Mangione eating at a franchise location in Altoona. They say he had in his backpack a gun and a handwritten document expressing "ill will toward corporate America," with the phrase "these parasites had it coming."

Police arrested Mangione on forgery and gun charges. He is fighting extradition to New York, where he is expected to be charged with second-degree murder, a warrant obtained by BI shows. He has not formally entered a plea.

Thomas Dickey, an attorney representing Mangione, said in an interview on Tuesday that he had not seen "any evidence yet" that would implicate Mangione.

"I don't even know if this is him or whatever," he said. "So we're going to test those waters and give the government a chance to bring some evidence forward." Dickey did not immediately respond to a request for comment.

Mangione's high-school classmate said that nobody they knew recognized Mangione from the photos police released before his arrest. After law enforcement named Mangione as a suspect, though, "the eyebrows made sense," the classmate said.

At his initial court appearance Monday, a judge asked Mangione whether he was in touch with his family, multiple reports from outlets present at the arraignment said.

"Until recently," he responded.

Ana Altchek, Laura Italiano, and Natalie Musumeci contributed reporting.

It used to be that when a killer emerged in America, we found out who the man was before we began to enshroud him in myth. But with Luigi Mangione, the lead suspect in the killing of UnitedHealthcare CEO Brian Thompson, that process was reversed. The internet assumed it already knew everything about Thompson's killer before a suspect had even been identified, let alone arrested.

Within hours of the shooting, social media was churning out a mythologized version of the masked man. In his anonymity, he became an instant folk hero, portrayed as a crusader for universal healthcare, a martyr willing to risk it all to send a message to America's insurance giants with "the first shots fired in a class war." A Reddit forum offered up dozens of laudatory nicknames to crystalize his mythology: the Readjuster, the Denier, the People's Debt Collector, Modern-Day Robin Hood. "I actually feel safer with him at large," one tweet a day after the shooting said; it received 172,000 likes. A surveillance image of the suspect moved some to comment that he was "too hot to convict" and prompted comparisons to Jake Gyllenhaal and Timothée Chalamet. In New York City, a "CEO-shooter look-alike competition" was held in Washington Square Park. Surely, the internet assumed, the suspect shared left-wing ideas about the cruelties of privatized healthcare.

Then the man himself appeared — and he didn't fit into any of the neat categories that had already been created to describe him. On X, he followed the liberal columnist Ezra Klein and the conservative podcaster Joe Rogan. He respected Alexandria Ocasio-Cortez and retweeted a video of Peter Thiel maligning "woke"-ism. He took issue with both Donald Trump and Joe Biden. He played the cartoon video game "Among Us," posted shirtless thirst traps, quoted Charli XCX on Instagram, and had the Goodreads account of an angsty, heterodox-curious teenage boy: self-help, bro-y nonfiction, Ayn Rand, "The Lorax," and "Infinite Jest." Yes, he seemed to admire the Unabomber. But mostly, this guy — a former prep-school valedictorian with an Ivy League education and a spate of tech jobs — was exceedingly centrist and boring. A normie's normie. He wasn't an obvious lefty, but he wasn't steeped in the right-wing manosphere either. His posted beliefs don't fit neatly into any preestablished bucket. In his 261-word manifesto, which surfaced online, he downplayed his own qualifications to critique the system. "I do not pretend," he wrote, "to be the most qualified person to lay out the full argument."

In the attention economy, patience is a vice.

That didn't stop the denizens of social media from pretending to be the most qualified people to lay out exactly who Mangione is. He's "fundamentally anti-capitalist" and "just another leftist nut job." Or he's "a vaguely right-wing ivy league tech bro." Or he was invented by the CIA, or maybe Mossad, as a "psyop." The reality of Mangione — his messy, sometimes contradictory impulses — allowed everyone to cherry-pick the aspects of his personality that confirmed their original suspicions. In the attention economy, patience is a vice.

The rush to romanticize killers is nothing new. A quarter century ago, we cast the Columbine shooters as undone by unfettered access either to guns or to the satanic influences of Marilyn Manson and Rammstein. A decade ago, we debated the glamorization of the Boston Marathon bomber, gussied up like a rock star on the cover of Rolling Stone. But social media has sped up the assumption cycle to the point where we put the killer into a category before police have found the killer. Perhaps there's a "great rewiring" of our brains that has diminished our capacity to understand each other, as the social psychologist Jonathan Haidt suggests in "The Anxious Generation" — a book Mangione had retweeted a glowing review of.

Mythmaking is easier, of course, when it's unencumbered by reality. The less we know about a killer, the more room there is to turn him into something he's not. From what we have learned so far, Mangione is a troubled Gen Zer who won the privilege lottery at birth and ascribed to a mishmash of interests and beliefs. We will surely learn more about him in the coming days, weeks, and months. But now that we know who he is, it will be hard, if not impossible, to let go of our initial assumptions. Instead, we'll selectively focus on the details that fit tidily into the myths we've already created. In the digital-age version of "The Man Who Shot Liberty Valance," the legend was already printed by the time the facts came along.

---

Scott Nover is a freelance writer in Washington, DC. He is a contributing writer at Slate and was previously a staff writer at Quartz and Adweek covering media and technology.

"Evidently I am the first to face it with such brutal honesty," the manifesto reads.

• Police said they found a "ghost gun" on the UnitedHealthcare CEO shooting suspect.
• Ghost guns are untraceable firearms that can be assembled at home, raising safety concerns.
• Elected officials are cracking down on the sale of such weapons to curb their accessibility.

Police say a weapon they found on UnitedHealthcare CEO shooting suspect Luigi Mangione could be a 3D printed ghost gun.

Ghost guns are firearms assembled at home using parts that were purchased individually. Sometimes, those components are made using a 3D printer. It's legal to buy the parts and use them to make your own gun, but laws prohibit the sale or transfer of ghost guns to another person.

Mangione "was in possession of a ghost gun that had the capability of firing a 9mm round," Joe Kenny, the New York Police Department's chief of detectives, told reporters on Monday.

He added that it "may have been made on a 3D printer"; there's no confirmation that it was the same gun used to kill Brian Thompson.

Mangione is being held without bail, and a lawyer for him has not yet been publicly identified.

Both authorities and gun safety groups have raised concerns about ghost guns, which are accessible online in kits. More than 25,000 privately made firearms were recovered by US law enforcement agencies in 2022, according to the DOJ.

In 2022, New York City officials filed a lawsuit against five ghost gun retailers over their sales to residents. Mayor Eric Adams eventually came to an agreement with at least four of the companies that would stop the sale of ghost guns in NYC.

It's unclear if the firearm Pennsylvania police say they recovered from Mangione is technically a ghost gun, said Kris Brown, the president of the gun safety group Brady.

They'll know for sure once investigators examine the weapon to see if any of its component parts have serial numbers. Only if there are no serial numbers is it a ghost gun, meaning entirely unregulated and untraceable, Brown told Business Insider.

Mangione may have printed the plastic portions of his gun, but he likely purchased the metal components, she said. Under current law, if you buy these components as part of a kit, you need a background check, Brown said.

These include the slide, the thread for the barrel, and the trigger mechanism; all are easily acquired through mail-order companies that advertise online.

Currently, some states require serial numbers for separately sold metal components, and some do not, Brown said.

Brady advocates for gun-control legislation, including the 2022 rule issued by the Biden-Harris administration regulating the sale of ghost gun kits."That bill has been very effective," she said. "Without it, it would have been lawful for a shooter to buy a kit and assemble an entire gun in minutes." In 2023, there was a drop in ghost gun recoveries by police nationwide, Mark Collins, Brady's director of federal policy, said.

Brady is pushing next for passage of the Ghost Guns and Untraceable Firearms Act, which would set a federal standard requiring background checks and the serialization of build-it-yourself gun parts.