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On the fifth of December 2024, a major newspaper published the front-page story “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 killer who then calmly departed the scene”. The murder in broad daylight was truly chilling and disturbing. But numerous US citizens had a different response: for those who had been denied health insurance or faced exorbitant healthcare costs, the news felt cathartic. Online platforms erupted. One comment stated: “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, twenty-six-year-old University of Pennsylvania graduate with a master’s in computer science, was arrested at a McDonald’s in Altoona, Pennsylvania. He faces court proceedings on criminal counts of murder, with the district attorney seeking the death penalty. So what is his background? And what might have motivated the accused offense? These are the questions John H Richardson attempts to answer in an inquiry that explores broader themes, too.

The Making of a Subject

A writer for a major publication, Richardson devoted considerable time to studying the groups that lurk in the dark corners of the internet, writing stories about people “plagued by genuine concerns about an apocalyptic future”. To uncover “the making” of his subject, Richardson first examines Mangione’s wide-ranging book list. We learn that “[when] he was arrested, Luigi had a list of 295 books on a reading platform”. Their content covered climate change to masculinity, along with a “focus on his own personal growth, both physical and mental”. Additionally, Richardson analyzes his communications with influencers and authors as well as his many updates on digital networks. These primary sources, meant to paint a portrait of Mangione, instead render him an amorphous figure. Richardson tries to justify this by proposing that “Luigi’s mystery, in fact, is what gives him a little of that old deceiver’s charm”. Throughout the book, Richardson attempts to cast his subject in archetypal terms.

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

The Meaning Behind the Crime

As for “the meaning” of the title, Richardson uses as a clue three words – “delay”, “refuse” and “remove”, engraved on the ammunition left behind at the crime scene. These are the terms occasionally employed by health insurance companies to deny coverage. He looks at the evidence Mangione had 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 existential anxiety about the world around him, one where “everything is accelerating whether we like it or not, sliding faster and faster to the edge”; a world where the consensus seems to be that AI is going to eventually either dominate, or destroy us, or both.

Gaps in the Narrative

Notably missing from the book are interviews with the principal actors. Richardson asked, of course, but never expected access to Mangione himself. And his relatives made it clear that they had decided against speaking to the press in advance of the trial. Another glaring gap is any detailed data about the victim, Thompson, though we learn that under his leadership, from the early 2020s, UHC profits rose significantly.

Unclear Conclusions

By the conclusion, the reader has no clear understanding of Mangione’s personality or what could have driven his accused actions. More troubling, Richardson’s obvious sympathy for him gives the reader the uncomfortable impression of having been privy to a veiled endorsement of an targeted killing. In the book’s closing remarks, Richardson delivers his fairytale assessment: “We’ve entered a era of stories, the insane ruler, the monster in the maze and the emperor without clothes.” In that fable “outlaw heroes come with a beautiful promise … They arrive in times of social turmoil, when the people are suffering and everything is confusing anymore.”

One thing is certain: as Mangione’s defence team works to have accusations that could lead to the ultimate sentence dismissed, any mention of myths, Robin Hoods, champions or monsters will not be allowed in court in defence of this handsome young man with a “jawline … and lips … out of a Caravaggio painting” soon to be on trial for murder.