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On the fifth of December 2024, a leading publication ran the headline “Insurance CEO Gunned Down In Manhattan”. The article went on to state that Brian Thompson was “shot in the back in Midtown Manhattan by a assailant who then calmly departed the scene”. The murder in broad daylight was indeed both cold and shocking. But numerous US citizens had a different response: for those who had been denied health insurance or faced exorbitant healthcare costs, the news felt like a release. Social media blew up. One post read: “All jokes aside … no one here is the judge of who deserves to live or die. That’s the job of the artificial intelligence system the insurance company designed to increase earnings on your health.”

Less than a week after, Luigi Mangione, a handsome, 26-year-old University of Pennsylvania alumnus with a master’s in computer science, was arrested at a fast-food restaurant in Altoona, Pennsylvania. He faces court proceedings on federal and state charges of murder, with prosecutors seeking the death penalty. So what is his background? And what might have motivated the alleged crime? These are the issues John H Richardson attempts to answer in an inquiry that delves into wider topics, too.

The Making of a Subject

A writer for a major publication, Richardson devoted considerable time to studying the communities that exist in the hidden parts of the internet, producing articles about people “plagued by genuine concerns about an end-times scenario”. To reveal “the making” of his subject, Richardson first reviews Mangione’s extensive reading. We learn that “[when] he was taken into custody, Luigi had a list of nearly three hundred titles on Goodreads”. Their content covered climate change to masculinity, along with a “focus on his own personal growth, both body and mind”. Furthermore, Richardson sifts through his correspondence with influencers and authors as well as his many posts on social media. These primary sources, meant to paint a portrait of Mangione, instead render him an unclear character. Richardson tries to justify this by proposing that “Luigi’s elusiveness, in fact, is what gives him a little of that old deceiver’s charm”. Here, as elsewhere, Richardson attempts to cast his subject in symbolic roles.

Mangione is profoundly worried about the world around him, one where ‘everything is accelerating whether we like it or not’

The Meaning Behind the Crime

As for “the meaning” of the title, Richardson takes as his lead three words – “delay”, “deny” and “remove”, etched on the bullets left behind at the crime scene. These are the terms sometimes used by health insurance companies to deny coverage. He examines the evidence Mangione suffered from a chronic back condition, which could have been a reason for an attack, but finds no proof; instead, what significance there is seems to lie in Mangione’s philosophical dread about the world around him, one where “the pace is quickening whether we like it or not, sliding faster and faster to the edge”; a world where the general belief seems to be that AI is going to ultimately either take control, or eliminate humanity, or both.

Missing Pieces

Conspicuous by their absence from the book are interviews with the key individuals. Richardson asked, of course, but did not anticipate time with Mangione himself. And his family made it clear that they had chosen not to talk to the press in advance of the trial. Another flashing-yellow omission is any detailed data about the deceased, Thompson, though we learn that under his leadership, from 2021 to 2023, UHC profits rose significantly.

Ambiguous Findings

By the conclusion, the reader has little insight of Mangione’s personality or what might have motivated his accused actions. Worse still, Richardson’s apparent empathy for him gives the reader the disturbing feeling of having been privy to a veiled endorsement of an targeted killing. In the book’s closing remarks, Richardson presents his fairytale assessment: “We’ve entered a time of fables, the insane ruler, the beast in the labyrinth and the emperor without clothes.” In that fable “outlaw heroes come with a appealing vow … They arrive in periods of unrest, when the people are suffering and everything is confusing anymore.”

One thing is clear: as Mangione’s legal representatives continues in its attempts have charges that could lead to the ultimate sentence dismissed, any reference of fables, folk heroes, heroes or monsters will not be allowed in court in support for this attractive individual with a “features reminiscent of classical art” soon to be on trial for murder.