This handout mugshot provided by the Pennsylvania Department of Corrections on December 10, 2024 shows Luigi Mangione, accused of gunning down a health insurance executive in New York, after his arrest in Altoona, Pennsylvania, on December 9, 2024. Agence France-Presse

WASHINGTON — On paper, Luigi Mangione had it all: wealth, intellect, athleticism, good looks. But the child of a prominent Maryland family may have spurned it all in a spasm of violence, in a killing that has mesmerized Americans.

The 26-year-old was arrested Monday and charged with the murder of Brian Thompson, a health insurance chief executive and father of two who was gunned down in Manhattan last week by someone who, evidence suggests, has endured his own debilitating health crises and grew angry with the privatized US medical system.

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The cold-blooded killing has laid bare the deep frustration many Americans feel toward the country’s labyrinthine health care system: while many have condemned the shooting, others have praised Mangione as a hero.

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It has also prompted considerable interest in how a young engineer with an Ivy League education could have gone off the rails to commit murder.

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News of his capture at a Pennsylvania McDonald’s triggered an explosion of online activity, with Mangione quickly amassing new followers on social media as citizen sleuths and US media tried to understand who he is.

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As Americans have looked for clues about a political ideology or potential motive, a photo on his X account (formerly Twitter) includes an X-ray of an apparently injured spine.

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Mangione lived in Hawaii in 2022 and, according to his former roommate R.J. Martin, suffered from back pain, and was hoping to strengthen his back.

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After a surfing lesson, Mangione was “in bed for about a week” because of the pain, Martin told CNN.

Earlier this year, Martin said, Mangione confirmed he’d had back surgery and sent him photos of the X-rays.

Police said the suspect carried a hand-written manifesto of grievances in which he slammed America’s “most expensive health care system in the world.”

“He was writing a lot about his disdain for corporate America and in particular the health care industry,” New York police chief detective Joseph Kenny told ABC.

According to CNN, a document recovered when Mangione was arrested included the phrase “these parasites had it coming.”

Meanwhile, memes and jokes proliferated, many riffing on his first name and comparing him to the “Mario Bros.” video game character Luigi.

Many expressed at least partial sympathy, having had their own harrowing experiences with the US health care system.

“Godspeed. Please know that we all hear you,” wrote one user on Facebook.

Standout student

Mangione hails from the Baltimore area. His wealthy Italian-American family owns local businesses, including the Hayfields Country Club, according to local outlet the Baltimore Banner, and cousin Nino Mangione is a Maryland state delegate.

A standout student, Luigi graduated at the top of his high school class in 2016. A former student who knew Mangione at the elite Gilman School told AFP the suspect struck him as “a normal guy, nice kid.”

“There was nothing about him that was off, at least from my perception,” the person said.

Mangione attended the prestigious University of Pennsylvania, where he completed both a bachelor’s and master’s degree in computer science by 2020, according to a university spokesperson.

While at Penn, Mangione co-led a group of 60 undergraduates who collaborated on video game projects, as noted in a now-deleted university webpage.

On Instagram Mangione shared snapshots of his travels, and shirtless images of himself flaunting a six-pack.

X users have scoured Mangione’s posts for potential motives. His header photo includes an X-ray of a spine with bolts attached.

Finding a political ideology that fits neatly onto the right-left divide has proved elusive, though he had written a review of Ted Kaczynski’s manifesto on online site Goodreads, calling it “prescient.”

Kaczynski, known as the Unabomber, carried out multiple bombings in the United States from 1978 to 1995, in a campaign he said was aimed at halting the advance of modern society and technology.

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Mangione has also linked approvingly to posts criticizing secularism as a harmful consequence of Christianity’s declinegkbet, and retweeted posts on the impact mobile phones and social media have on mental health.

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