Luigi Mangione appeared to be living a charmed life.

A beloved son of a storied Baltimore family. Valedictorian at The Gilman School. A decorated scholar at the University of Pennsylvania, where he earned both a bachelor’s and master’s degree. A promising data engineer living and playing among other beautiful people in Hawaii.

But earlier this year, Mangione disengaged. His mother filed a missing person report in San Francisco last month, saying she had not spoken to him since July. Friends pleaded with him to return their messages. “Nobody has heard from you in months, and apparently your family is looking for you,” one person posted on X in October.

Then on Monday, the 26-year-old burst back into view for his alleged role in a high-profile crime that has transfixed the nation. Mangione was arrested in a McDonald’s restaurant in Altoona, Pennsylvania, and charged in last week’s fatal shooting of United Healthcare CEO Brian Thompson in Manhattan. A masked gunman had crept up on Thompson and fired bullets emblazoned with words that signaled frustration with insurance claims: “Deny,” “Delay” and “Depose.”

How did a golden boy from Baltimore transform into a man police have accused with acting like a seasoned assassin? A portrait is beginning to emerge of Mangione’s missing year, a time of turbulence, isolation and pain, both physical and psychological.

The pain, friends said, stemmed from long-running back issues. Mangione’s X profile included a photo of an X-ray of a spine with four large screws and he discussed undergoing back surgery in July 2023 with a friend and on social media posts.

In Reddit posts unearthed by The New York Times, Mangione divulged that he felt pain when sitting, had numbness in his groin and bladder and twitching leg muscles. He also discussed experiencing irritable bowel syndrome and “brain fog,” that made studying challenging.

“It’s absolutely brutal to have such a life-halting issue,” Mangione wrote, according to The Times.

It’s unclear whether Mangione struggled with a health insurance company over his treatment or care. Police reported discovering a three-page handwritten manifesto in which he apologized for any “strife or traumas” but wrote “these parasites simply had it coming,” according to the Associated Press.

In the missing person report she filed Nov. 18 with the San Francisco police, Kathleen Zannino Mangione, said she had last spoken with her son in July, when he told her he was working for a tech company called TrueCar in its offices in that city.

But TrueCar had shuttered its San Francisco office by then. Mangione’s LinkedIn profile indicates he began working at TrueCar, an online automobile marketplace, in November 2020 as a data engineer.

”While we generally don’t comment on personnel matters, we can confirm that Luigi Mangione has not been an employee of our company since 2023,” a TrueCar spokesperson said in an email.

Where Mangione worked in the interim, or even whether he was working, is not known.

His friend and former roommate R. J. Martin told The Times that Mangione was in debilitating pain in due to his spine being “misaligned.”

“His lower vertebrae were almost like a half-inch off, and I think it pinched a nerve,” Martin said.

Martin, the owner of Surfbreak, a “co-living” space in Honolulu tailored to remote workers, met Mangione in 2022 when the Towson native became part of the first cohort of residents to live there.

Martin told CNN that Mangione told him he suffered a back injury and wanted to build strength. “When he first came, he went on a surf lesson with other members and, unfortunately, just a basic surf lesson, he was in bed for about a week,” Martin said.

Martin said Mangione mentioned he had needed surgery, which weighed on him. According to reporting in The Times, the two friends talked about Mangione’s back pain and how it prevented him from being intimate.

“He knew that dating and being physically intimate with his back condition wasn’t possible,” Martin said. “I remember him telling me that, and my heart just breaks.”

After six months of living at Surfbreak, Mangione left to see a doctor on the East Coast, Martin recalled.

Mangione rented another apartment on the 14th floor of a Honolulu building from October 2022 until this past August, according to Hawaii’s KHON2.

But Martin told reporters that he has not communicated with Mangione since August 2023, when he texted him to ask how the back surgery had gone.

“He sent me the X-rays,” Martin said to CNN. “It looked heinous, with just giant screws going into his spine.” Martin told The Times he asked how Mangione was feeling after seeing the photos.

”So, long story,” Mangione replied. “Will fill ya in in person. Back in Hawaii as soon as I can, I have to figure out some spine stuff here first.”

Martin told CNN that Mangione called him once after that exchange, but he didn’t pick up the phone. Martin said he texted Mangione a few times between March and June of 2024 to check in, but Mangione never replied.

Mangione posted on X throughout the first six months of year, sharing posts on mental health and smart phone use, the book The Anxious Generation and cellular agriculture.

It appears that Mangione spent some time in Japan in late February, according to post on X from a Japanese professional poker player, Obara Jun.

“He came in by himself and we talked to him and treated him to a meal and drinks because we wanted him to enjoy Japan,” Jun wrote. “He said he was on vacation from Hawaii and we ate together for about 30 minutes before parting ways.”

In April, Mangione posted a screed on X about Japan’s falling birth rate, saying the country needed to “encourage natural human interaction, sex, physical fitness and spirituality.”

Around the same time, he shared a post about the heroic journey in art in literature in which a young man is faced with a terrifying quest. “In the end, he rises above, he wins, he conquers. He conquers first himself and then he conquers the threat,” the post says.

Mangione’s posts trailed off in mid-summer.

Friends attempted, unsuccessfully, to reach Mangione through the social media platform.

In a series of posts this July on X, a Baltimore friend repeatedly tagged Mangione, asking whether he’d be attending the man’s upcoming wedding. “my guy I need you,” one post reads.

”I don’t know if you are okay or just in a super isolated place and have no service,” he wrote in a separate post. “But I haven’t heard from you in months. Your made commitments to me for my wedding and if you can’t honor them I need to know so I can plan accordingly.”

Despite the appeals, it’s unclear if Mangione ever responded or attended the wedding. The ceremony and reception took place in September at Haysfields Country Club, which the Mangione family owns, according to tagged social media posts.

The couple could not be reached for comment Tuesday, and other attendees either declined to comment or could not be reached.

On the same thread of posts in late November, another X user said, “Thinking of you and prayers everyday in your name. Know you are missed and loved.”

Banner reporters Brenna Smith, Hallie Miller, Hayes Gardner and Cody Boteler contributed to this article.