Mangione’s arrest has stunned his friends and family, most of whom appeared to have lost touch with him in the past six months.
Police believe Mangione had an animosity towards the US health insurance system.Credit: nna\josh.hohne
“We all condemn violence of any kind,” said Josiah Ryan, a spokesman for Surfbreak HNL, a co-living community in Honolulu where Mangione lived for six months in 2022. He added: “There’s sadness because he was a person who was well-loved and no one saw this coming.”
Ryan said Mangione’s back pain was well-known within the Surfbreak community. “It was a real problem for him, and he had to think about that in a way that most 24-year-old young men living in Hawaii would not have to worry about their health,” Ryan said.
Mangione’s struggles with his back pain offer a glimpse into the interior life of a man who outwardly lived a charmed existence – the scion of a wealthy family in Maryland who was valedictorian of his prestigious private school in Baltimore and earned degrees in computer science from the University of Pennsylvania.
In archived Reddit comments, Mangione doesn’t express anger toward UnitedHealthcare or other health insurers. But the posts chronicle his struggle over the years to deal with back pain that became increasingly debilitating.
“From childhood until age 23, my back would always ache if I stood too long, but it wasn’t too bad,” he wrote in February. But as he entered his mid-20s, the pain began to disrupt his life. He once described the sensation of an unstable spine as being able to “feel the bones moving/grinding”.
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He also struggled with cognitive issues, according to his posts. In a Reddit group focused on brain fog, he wrote, “The people around you probably won’t understand your symptoms – they certainly don’t for me.”
By January 2022, Mangione was living at Surfbreak in Hawaii, where a surfing accident exacerbated his spinal condition, according to his Reddit posts and interviews with friends. He had a spinal fusion surgery – a procedure that stabilises the spine with surgical screws – in July 2023, according to his Reddit posts, and he seemed pleased with the results for months afterward.
“Haven’t had a bad day since,” he wrote in November 2023.
Mangione’s discussion of surgery aligns with an image of an X-ray prominently displayed on his profile for the social media platform X. An orthopedic surgeon who reviewed the image for the Post described it as a “lumbar spine with posterior spinal instrumentation, possible fusion”. It’s a common procedure for people with spondylolisthesis, a condition where a vertebra shifts forward and can cause excruciating pain in the lower back.
United Healthcare chief executive Brian Thompson.Credit: AP
He found a community on Reddit dedicated to spondylolisthesis, which he described as “my injury” in handwritten notes uploaded to his profile on the book-review site Goodreads in 2019.
Mangione regularly offered advice to others, sometimes with an edge of bitterness about the reluctance of the medical profession to provide the care he considered necessary. To persuade doctors reluctant to perform surgery, he suggested an extreme option would be to “fake a foot drop” (difficulty lifting the front part of the foot) “or piss yourself. This is the absolute nuclear option, but there comes a point where it’s just ridiculous that people won’t operate on your broken spine.”
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His struggles drew empathy from people close to him. Surfbreak’s owner R.J. Martin told The New York Times that Mangione “knew that dating and being physically intimate with his back condition wasn’t possible”. In a text message to the Post, Martin said he was overwhelmed and exhausted and deferred comment to Ryan, his spokesman.
Martin found Mangione “to be a really special person”, Ryan said. “He expected to have a lifelong friendship with him.” Mangione’s arrest “was pretty devastating for him”.
Marc McCoy, 59, owner of Moped Garage, a store near Surfbreak, said that he sold Mangione a moped and that they had multiple conversations. The Maryland native was eager to talk to McCoy, who has lived in Hawaii for half a century, about how to fit in and respect the local culture and not be an ugly American stereotype, McCoy said. “He was well-spoken, intelligent, conscientious,” he said. “I’m in complete shock.”
Mangione spent some time in Japan this year. A picture posted to X in late February by Japanese professional poker player Jun Obara shows him appearing to enjoy a meal at a Tokyo restaurant with a smiling Mangione and others.
“He came in by himself and we talked to him and treated him to a meal and drinks because we wanted him to enjoy Japan,” Obara wrote in a subsequent post this week. “He said he was on vacation from Hawaii.”
Most friends and family appear to have lost touch with Mangione since May. That appears to be when he last posted to his accounts on Goodreads and Reddit, where he linked to a video shared by another user in a group for discussing Ted Kaczynski, the Unabomber.
His apparently last post on X, formerly Twitter, was a retweet of a podcast episode on how smartphones and social media impact mental health on June 10.
June 10 also was the last time Gurwinder Bhogal, a UK-based writer, said he received a message from Mangione, who was seeking advice about curating his social media feeds.
The two had struck up a correspondence in April after Mangione subscribed to his Substack publication. They discussed politics, said Bhogal, who recalled him complaining “about how expensive health care in the U.S. was.”
In comments circulated to reporters, Bhogal wrote, “Overall, the impression I got of him, besides his curiosity and kindness, was a deep concern for the future of humanity, and a determination to improve himself and the world.”
New York police crime scene unit members photograph bullets on the footpath in the hours after the shooting.Credit: AP
He added, “He was so polite and thoughtful it was hard to conceive of him murdering someone.”
Mangione’s movements in the summer and autumn are still not clear. Mangione’s mother, Kathleen Mangione, called the San Francisco police on November 18 and said her son had not been heard from since July, according to local media reports. A source familiar with the matter confirmed to the Post that a missing-person report was filed.
The San Francisco Police Department declined to comment on the case and referred questions to New York police. An NYPD spokesperson declined to comment on the missing-person report.
The Washington Post
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