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On the fifth of December 2024, a leading publication ran the headline “Insurance CEO Gunned Down In Manhattan”. The report 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 truly chilling and disturbing. But numerous US citizens reacted differently: 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 stated: “All jokes aside … no one here is the judge of who should live or perish. That’s the job of the artificial intelligence system the insurance company created to maximize profits on your health.”

Less than a week after, Luigi Mangione, a good-looking, 26-year-old University of Pennsylvania alumnus with a graduate degree in computing, was arrested at a McDonald’s in Altoona, Pennsylvania. He awaits trial on federal and state charges of murder, with the district attorney seeking the death penalty. So what is his background? And what drove the accused offense? These are the issues John H Richardson seeks to resolve in an inquiry that explores broader themes, too.

Understanding the Person

A writer for a major publication, Richardson devoted considerable time to studying the groups that exist in the hidden parts of the internet, writing stories about people “cursed with realistic fears about an apocalyptic future”. To uncover “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 a reading platform”. Their subject matter ranged from climate change to masculinity, along with a “focus on his own personal growth, both physical and mental”. Furthermore, Richardson analyzes his communications with influencers and authors as well as his many updates on social media. These original materials, intended to depict a picture of Mangione, instead present him as an amorphous figure. Richardson attempts to explain this by proposing that “Luigi’s elusiveness, in fact, is what gives him a little of that old deceiver’s charm”. Throughout the book, Richardson tries to frame his subject in symbolic roles.

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

Interpreting the Incident

As for “the meaning” of the title, Richardson takes as his lead three words – “postpone”, “refuse” and “depose”, etched on the bullets left behind at the crime scene. These are the phrases sometimes used by health insurance companies to deny coverage. He looks at the evidence Mangione suffered from a chronic back condition, which might have provided motive for an attack, but discovers no confirmation; instead, what significance there is seems to rest in Mangione’s philosophical dread about the world around him, one where “the pace is quickening whether we like it or not, moving rapidly to the edge”; a world where the consensus seems to be that AI is going to eventually either take control, or eliminate humanity, or both.

Missing Pieces

Conspicuous by their absence from the book are conversations with the key individuals. Richardson made requests, but never expected access to Mangione himself. And his family stated explicitly that they had decided against speaking to the media in advance of the trial. Another flashing-yellow omission is any significant information about the victim, Thompson, though we learn that under his guidance, from the early 2020s, UHC profits rose significantly.

Ambiguous Findings

By the conclusion, the reader has no clear understanding of Mangione’s character or what could have driven his accused actions. More troubling, Richardson’s apparent empathy for him creates the disturbing feeling of having been exposed to a subtle approval of an targeted killing. In the book’s final lines, Richardson presents his fairytale assessment: “We’ve entered a time of fables, the mad king, the beast in the labyrinth and the emperor without clothes.” In that tale “outlaw heroes come with a beautiful promise … They arrive in periods of unrest, when the population is in pain and everything is confusing anymore.”

One thing is certain: as Mangione’s defence team continues in its attempts have accusations that could lead to the death penalty thrown out, any reference of myths, folk heroes, heroes or monsters will not be allowed in court in support for this attractive individual with a “jawline … and lips … out of a Caravaggio painting” soon to be on trial for murder.