The man charged with killing UnitedHealthcare CEO Brian Thompson posted online in recent years about undergoing spinal surgery and struggling with chronic back pain, numbness and restless sleep, according to what appears to be an archived version of his deleted Reddit account.
Luigi Mangione, 26, was charged Monday in New York with one count of murder, three counts of criminal possession of a weapon and one count of possession of a forged instrument. Thompson’s murder, which occurred last week outside a hotel in New York City, has captured national attention, spurring conversations about gun violence, corporate America and the health care industry.
Mangione’s attorney has said that he intends to plead not guilty to all charges.
The archived Reddit posts may shed light on Mangione’s interests and mental state over the last eight years. He appears to have been active on the platform since 2016 under the username “Mister_Cactus,” posting most frequently about spine health, travel and gaming.
Although the account has been suspended, NBC News reviewed an archive of its deleted posts and comments spanning several years. The activity appears to match up with known events in Mangione’s life. NBC News also spoke to several of his friends who said that although they weren’t able to confirm that the Reddit account was Mangione’s, some of the posts aligned with Mangione and his life events.
A Reddit spokesperson said the platform’s policy is to suspend accounts that may be related to suspects in high-profile criminal investigations, a common practice among tech companies to avoid impersonation or interference in such cases.
The activity on the “Mister_Cactus” account included posts on a subreddit focused on spondylolisthesis, a condition in which a bone in the spine slips out of alignment and puts pressure on the lower vertebrae and the nerves around the spine.
In comments exchanged with another user on the subreddit in April, “Mister_Cactus” wrote that his condition “went bad to the point where I felt it every day.”
A post sharing advice with other spondylolisthesis patients in October 2023 reads: “Constant pain means something is wrong.”
Yoni Ashar, an expert in pain science and an assistant professor at the University of Colorado’s Anschutz Medical Campus, said back pain can lock patients in a “vicious cycle” that affects sleep, mental health and other aspects of their well-being.
“It could be the endless agony from the moment you wake up to the moment you manage to fall asleep, if you’re able to sleep,” Ashar said. “It’s just nonstop, always there, always hurting.”
On a separate subreddit, the “Mister_Cactus” account solicited guidance in 2018 about “restless sleep,” describing waking up frequently throughout the night and feeling “unrefreshed no matter how much sleep I get.”
Reddit posts from last year suggest that the back problems flared up after the user went surfing. The movement aggravated back pain that he said he had dealt with since childhood, according to a post in July 2023. After the surfing incident, the post continued, “I slipped on a piece of paper and my right glute locked and right leg shut down for a week.”
“Mister_Cactus” wrote at the time that he had been experiencing issues with his right hip for the past year and a half. He felt pain while sitting, he said, and he had twitching in his leg muscles and sometimes numbness and tingling in his groin
The Reddit posts suggest that the account holder underwent spinal fusion surgery in 2023 and that he grappled with the decision beforehand.
Spinal fusion surgery involves inserting bone or a bonelike material into the space between two spinal bones, then connecting the grafts and the bones with metal plates, screws or rods. The goal is to fuse the bones to relieve pressure on the vertebrae and reinforce the spine’s shape and stability.
That type of back surgery can reduce pain significantly, though recovery can take up to a year as bone grafts fuse with the vertebrae. A 2022 study found that out of around 100 patients who underwent the surgery, around 85% to 90% reported satisfaction.
In the post from July 2023, “Mister_Cactus” told another Reddit user that his operation was scheduled for two weeks later, “and I keep wondering why I was so afraid of it.”
In the same exchange about the surgery, he said that “it’s not worth being so afraid of more pain/fusions down the line that you don’t live your life now.”
The posts the next month suggest he saw positive results after the operation — he wrote that after a week, he “was on literally zero pain meds” and was able to sit, walk and stand.
“When my spondy went bad on me last year (23M) it was completely devastating as a young athletic person,” “Mister_Cactus” wrote in a separate post in August 2023, referring to spondylolisthesis. He included a list of athletes with “success stories” following spinal fusion surgery.
“This is not to encourage surgery per se, but just to provide reassurance that athletic life is totally normal after fusion if/when the surgery is necessary,” he wrote.
The Reddit posts correspond with the activity of accounts that seem to be linked to Mangione on other social media platforms. An account that appears to be Mangione’s on the book review site Goodreads has on its “read” list books about chronic back pain and dieting, as well as “Industrial Society and Its Future,” the so-called Unabomber Manifesto written by domestic terrorist Ted Kaczynski. The account gave it four out of five stars. The profile, which went private Wednesday, uses a photo of Mangione that matches others available of him, and it has activity dating to at least 2017.
On X, meanwhile, header photos on an account under Mangione’s name show an X-ray image of a spine with what appear to be four rods or screws inserted. (Posts on the X account date to 2016 and appear to align with Mangione’s life events, such as a reference to a speech he gave as a high school senior.)
Two people who were in touch with Mangione in recent years told NBC News that he talked to them about either his back pain or his concerns about the U.S. health care system.
Gurwinder Bhogal, a British freelance writer who publishes a Substack newsletter called “The Prism,” said he corresponded with Mangione from April to June.
“We briefly touched on the differences between the U.K. and U.S. health care systems,” Bhogal said. “Luigi complained about how expensive health care in the U.S. was and expressed envy at the U.K.’s nationalized health system.”
R.J. Martin, the founder of a co-living space in Hawaii called Surfbreak, where Mangione lived for six months in 2022, said Tuesday on “NBC Nightly News” that the two had talked at the time about Mangione’s spinal condition.
“I knew it was something that constantly weighed on him,” Martin said. “It was something that impeded him from doing many things.”
Martin described Mangione’s time at Surfbreak as “a bit of a roller coaster,” adding that Mangione had stayed in Hawaii to “take care of himself” but “had his ups and downs.”
