Chronic Pain Can Cause a Kind of Madness. I Know This Personally.

Luigi Mangione’s evolution from valedictorian to vigilante may never be fully understood. But his bleak inner reality seems to have been forged in part by his losing battle with unbearable pain.’

-  MELANIE THERNSTROM

T his pain is driving me mad. The phrase comes to mind whenever I catch myself responding angrily or stupidly to some challenge or threat. Who would I be without pain? Would I have acted this way, misremembered that thing or viewed a situation so darkly? Would I be so upset about the complete absurdity of our healthcare system? With the fact that the pain clinic where I was getting treatment stopped taking my insurance and sent me a bill for five 45-minute physical therapy sessions at $1,150 apiece? The path by which Luigi Mangione transformed from a 26-year-old Ivy League tech bro to a violent vigilante crusading against a capitalist healthcare system may never be fully understood. But his bleak inner reality seems to have been forged in part by chronic pain.

For eight years Mangione posted on Reddit about his struggles with "unbearable pain" and brain fog. Social media has been swooning over his dashing looks and jacked physique, but by age 23 he didn't even want to date because his back pain made sex impossible.

"We don't know his story, but we do know that relentless chronic pain is destabilizing," says Dr. Scott Fishman, a pain specialist at the University of California, Davis, who founded its Center for Advancing Pain Relief, a rare center that focuses on both the treatment and prevention of pain.