Investigators are piecing together a timeline and motive leading up to the killing of UnitedHealthcare CEO Brian Thompson, but in the meantime, a clearer picture is coming together about the alleged gunman, Luigi Mangione. And it's believed that the 26-year-old suffered from a spinal condition that likely caused him excruciating pain.
In 2019, Mangione detailed in handwritten notes reviewed by Business Insider that he was afflicted with a joint deterioration condition called spondylolisthesis. According to Cleveland Clinic, spondylolisthesis occurs when one of the vertebrae in the spine slips out of position and puts pressure on the vertebra below. This can put pressure on the nerves around the spine, causing back pain and other symptoms.
Not all spondylolisthesis diagnoses require surgery, however patients are more likely to need it if they have high-grade spondylolisthesis or experience severe pain or symptoms that affect their ability to stand, walk, or move. Surgical treatment involves a spinal fusion to realign the vertebrae and strengthen the back area.
Mangione was said to have written about the pain he suffered, as well as what he felt to be an inadequate response by the healthcare system, in dozens of Reddit posts between 2018 and 2024. Though, none of the posts named UnitedHealthcare or Thompson. Blue Cross Blue Shield is the only insurer specifically mentioned in the posts, related to the coverage of a medical test.
However, Dr. Uzma Samadani, a Minnesota neurologist specializing in spine surgery who has not treated Mangione, told Yahoo Life that often, insurance providers will require patients to undergo six to 12 weeks of physical therapy before agreeing to cover surgery, or even imaging tests to diagnose the condition. It's unclear whether this was the case with Mangione, but Samadani says that physical therapy can be "excruciating" for spondylolisthesis patients and isn't guaranteed to help.
"It’s sort of like a torture, a mandatory torture imposed by the insurance company," she explained.
But Samadani also notes that many young patients aren't taken seriously due to their age, and she has personally seen several young patients who were initially turned away by doctors. "In the case of this particular kid, my guess is that he was in massive pain," she added.
Mangione also reportedly described the pain he was suffering online. In a 2022 post he complained of "near-constant burning/twitching in both ankles/calves," and in 2023, said that he had been experiencing "back and genital pain" and numbness in his groin for about a year.
Eventually, Mangione did undergo the spinal fusion surgery later in 2023, in X-ray photos that have been circulating online showing rods and screws in his spine. And while Mangione first seemed to indicate that the surgery was a success, by June 2024 he was blasting his doctors as "basically worthless" on social media.
