TOWSON, Md.–Within a few hours of his arrest after the public execution of a health care CEO, a clear picture of 26-year-old Luigi Mangione quickly emerged.

By all accounts, Mangione was a well-educated, brilliant, and physically fit young man who came from a wealthy family in Maryland. He was arrested on Dec. 9, five days after 50-year-old UnitedHealthcare CEO Brian Thompson was gunned down on a New York City sidewalk.

The chain of events and the thought processes that may have pushed the high-achieving young man to allegedly commit such a shocking crime is taking longer to come into focus.

A back injury Mangione suffered and the care he received may have been factors, based on statements from police, people who know Mangione, and the circumstances of Thompson’s slaying, coupled with Mangione’s public post showing an X-ray of his spine with screws implanted in it.

As of Dec. 10, no one has specifically said how the back injury may have culminated in Mangione allegedly committing such a high-profile crime. The case shows the unpredictable nature of alleged criminal behavior, said Steve Meacham, professor of criminal justice at Cedarville University in Ohio.

“The thing about crime, and trying to predict crime and understand why people commit crime, it’s not an exact science. There isn’t one template; there isn’t one formula,” said Meacham, who served as a New York State police officer for 30 years.

It’s rare for a “well-to-do” person like Mangione to face such serious accusations, Meacham said. Preliminary information indicates that Mangione probably “has an ax to grind and retaliated in anger,” he added.

It’s harder to explain why one person may feel he was similarly wronged and wasn’t driven to kill because of it, Meacham told The Epoch Times.

On Dec. 10, a day after Mangione was charged with murder and jailed in Pennsylvania, security guards patrolled entrances at his old Baltimore-area alma mater, the elite Gilman School, and Hayfields Country Club, owned by the Mangione family.

Gilman School in Baltimore on Dec. 10, 2024. (Madalina Vasiliu/The Epoch Times)

A guard at the country club told The Epoch Times that the family needed time; other relatives declined interviews.

A friend, R.J. Martin, gave several media interviews. He said that Mangione told him he wanted to move to Hawaii to improve his strength after suffering from back problems. Mangione and Martin became roommates in the Honolulu area.

Mangione participated in a surfing lesson and “was in bed for about a week” afterward, he told CNN within hours of Mangione’s arrest.

“It weighed on him that he knew there was an impending surgery,” Martin said. He fell out of touch with Mangione sometime after the surgery; the dates were unclear in his interview.

“He was absolutely a not-violent person ... I can make zero sense of it,” Martin said about the allegations Mangione is facing.

Meanwhile, at Mangione’s old stomping grounds in the Baltimore suburb of Towson, the origins and meaning of the local valedictorian’s alleged actions were also unclear.

At a mall there, a shopper, Phyllis Loveland, told The Epoch Times she was close to the Mangione family and wondered about a possible explanation for what is believed to have happened to the family’s scion.

“I can’t guess what was in his mind. It just seems like there was some kind of mental breakdown,” she said.

“It sounded like he needed help, and he didn’t reach out to the people that could have helped him.”

Loveland credited Maryland State Delegate Nino Mangione, a cousin of the accused young man, with helping guide her son through scouting to the Eagle Scout rank.

“They give back to the community constantly,” she said of the Mangione family.

Earlier, Nino Mangione issued a statement on the family’s behalf, saying: “Unfortunately, we cannot comment on news reports regarding Luigi Mangione. We only know what we have read in the media. Our family is shocked and devastated by Luigi’s arrest. We offer our prayers to the family of Brian Thompson, and we ask people to pray for all involved.

“We are devastated by this news.”

The suspect was arrested in Altoona, Pennsylvania, less than 250 miles west of the shooting site where Thompson was killed.

Police said someone at the Altoona McDonald’s thought Mangione looked like the well-publicized photos that were circulating of the “person of interest” in the Thompson slaying.

NYPD police commissioner Jessica Tisch said Mangione was caught with multiple fake ID cards. One of the cards was a New Jersey ID that matched one presented at check-in at a New York City hostel before the shooting, she said.

Police also found “a handwritten document that speaks to his motivation and mindset,” Tisch told reporters. Police didn’t disclose the specifics of that document.