Three question marks

Back to the past, part one. To be continued. The catalogue of questions sent to me by the AOK is too extensive. Well, not really as such, but the topics asked are so multi-layered and complex that I could almost become philosophical when answering them. Besides, even with simple questions that relate to my experiences, how do I best formulate this in a nutshell? Have I had any experience with care in the past seven years? Just say.

Then let's take a look. Experience is always good. Even bad experiences are good. Sounds like a pretty big platitude. I know. It's meant seriously. You can only learn from experience, draw conclusions and do better in the future. If my experiences, written down in detail, then lead to other sufferers also being helped, then the time, effort and countless tablets of Tavor will have been worth it. I wouldn't have been able to write all this down without tranquillisers. My brain works differently somehow. It doesn't repress. It doesn't forget. Experiences? I can reproduce them down to the smallest detail. But I also relive everything, down to the smallest detail.

Experience. Despite the rapid progression of my disease, I've been living pretty well with it for many years. So they say. I think they're right. About two and a half years ago, a team of four doctors specialising in neuromuscular diseases last dared to make a prognosis. If I carry on like this, listening to my body rather than the experts, then I won't live to see next summer. Well, I'm still here. I'm mentally better than I was back then. I even weigh more. I haven't changed anything. Better: I have changed exactly nothing. That's the crux of the matter. I don't give a shit about going for a check-up every three months. I can see for myself what has changed in the past twelve months. The doctors were even regularly too good to even take a look at my file. And a whole chapter in the book I'm writing is not enough to describe what I've experienced in hospitals up to that point and since then.

I form my own opinion based on well-founded measurements and enforce it. If I had listened to doctors and health insurance companies and had done without the 1:1 care I was used to in the hospital of all places, I would have had to undergo an emergency bronchoscopy more than just this one time in order to survive.

Sounds so polemical again. But that's not even my opinion. It can be measured. It's described in countless daily charts and doctors' letters. When you get right down to it, things have even happened to my own carers several times where I could have died. But the probability of something tragic and uncorrectable happening is naturally higher without your own 1:1 carers on board. Nobody disputes that. Not even the nurses in the hospitals themselves.

Well, nobody disputes that, except my health insurance company, AOK Bayern. I couldn't work for a company like that, where I would have to follow unethical instructions that are not compatible with my conscience. Where I would have to send a letter to my customer saying that his experience of fear of death is not worth a penny. If he were to die, the law would be on the side of the health insurance company. So you risk your life in good faith. Dear AOK, you won't get rid of me that easily. You need more glyphosate for that. Luckily for you, the EU has also quietly reversed the stricter rules on the use of pesticides. Like every law on nature conservation. Paris climate agreement? Global warming of no more than 1.5 degrees by 2030? Never heard of it. Can't be, we would have already exceeded it in October 2023. And next we'll be denying climate change.

God forbid that I've got away with a black eye and blue-green bruised hands and arms every time so far. Injecting emergency medication multiple times a day takes its toll. When you only get medication that is injected directly into the blood, when you have a pressurised arterial line that has to be stitched up before discharge, yes, you know the situation is serious. I could have been killed.

I think the decision-makers at the health insurance companies are in deep darkness when it comes to practical experience. Come and see me in hospital for seven days and seven nights in a row. You would be ashamed of some of your so-called individual case decisions. I bet you wouldn't be able to sleep at night. Welcome to the club. Make yourself comfortable. What you decide will stay with you for the rest of your life. The trauma won't go away. I know you didn't realise that. It's a bitter pill, isn't it?

Sure, dear AOK, I'm only making this up because I don't have any other hobbies. Don't. Ha. Ha. Ha. (artistic pause for thought) Haha, we all laughed. Me, with the greatest disappointment. I feel nothing but disappointment and sentimentality for what the AOK has done to me for some time now. Often followed by a question of meaning.

Sentimentality because nobody can afford to fight it legally. Just because I take legal action against it doesn't mean that I can afford it. After all, I run the risk of losing 132,000 euros with my lawsuits from a purely monetary point of view. That's how high my risk of legal costs is. I can't afford it any more than I can afford another trauma. Well, at least the trauma wouldn't be due to care errors and wouldn't be the result of my work as an environmental activist. In that sense, at least it would be something new. Just like the recent behaviour of the health insurance company and its employees. I can only respond to this with disinterest and indifference. Integrity and empathy are suddenly foreign words there. I don't know what happened there. Except that I'm on the hit list because I've become too expensive.

It has apparently become the norm to do things at work that you consider morally reprehensible. Doing things that you would never even consider doing in your private life. My personal contact, I know her personally. She was already a guest in my home. We got on well. I felt I was being spoken to on an equal footing. Was I so wrong? Had my good judgement of character let me down? Was she really behind the decision not to authorise 1:1 care for me in hospital? I don't want to believe that I was so wrong about her as a person. On the other hand, I wouldn't be able to act contrary to my moral compass in my job. It's called integrity, behaving with integrity. A trait that seems to be disappearing from the modern Western world.

Integrity is very important to me. Integrity is even more important to me than loyalty. Polemics again? Not at all. Let me tell you a little story.

I've already been fired once because of my integrity.

I was offered to forget about it if I complied. I was fired again because of my integrity. Better safe than sorry.

Okay, let's get into the story a little earlier. I didn't make that up either. It's all in the court records, my boss at the time was in custody after the incident. But he's probably free again. The company went bankrupt. You can read about it in the publicly accessible commercial register. And I, well, I was sacked without notice by the managing director of our group of companies at the time himself. First in writing and then again verbally the same afternoon to back it up. The reason, trivial. I had defied what I considered to be his unethical instructions.

I lost my well-paid dream job, in which I had virtually complete freedom. For years, I worked seven days a week and only took two holidays in the entire history of the company. The agreement with my girlfriend was that my laptop would stay switched off from 7am to 7pm. So I worked in the morning before I got up and in the evening when she was in the bathroom (longer than I was) and at night. I ended up sleeping on the beach during the day. I was still green behind the ears.

I was a dork. I really thought it was my dream job. And I had jeopardised this dream job. I gambled high and lost higher. But they couldn't take my integrity away from me. I could look in the mirror every night, if only I could.

When I became unemployed, my long-term girlfriend quickly decided to go behind my back... oh, you can guess. She soon moved out of the 120 square metre ground floor flat we shared, which was connected to the underground and nonetheless had a garden the size of a tennis court complete with grandstand. Left me, the unemployed guy, with a monthly rent of well over 2,000 euros.

Nice anecdote from my life. But hand on heart, no, I can no more do that than I can look in the mirror on my own. You can't really tell if I have a heart from the things I sometimes say. But seriously, it's true that my line manager offered me my job back several times after I was made redundant - on the phone and even in person at my home - that I could have my job back straight away. All I had to do was put aside my excessive sense of justice, he said, because it wasn't the way I felt. Thanks, but no thanks. Integrity and all that.

Unemployed. Wife gone, dog gone. Company car gone, for which I had to wait a proud nine months because of the seat stitching in the colour of my choice and, apart from the black sunroof, which was too ostentatious for me, every item of optional equipment that could be ordered from Audi. The car that I had just picked up in Ingolstadt three months ago with my girlfriend and both families in tow... gone from one day to the next. Flat, practically gone.

Naturally, I accepted the offer and resumed my work. I didn't. To this day, I don't have much love for my former boss and once very good friend. Indifference. Shame for not having realised everything earlier to prevent him from dragging so many more people into his shit, as he did, unfortunately. Deep shame towards my clients at the time, because my own in-house lawyer issued me a written ban on contact with my clients. On the other hand, the company shamelessly did everything in its power to destroy my good reputation. They also didn't know what was going on with Mr Ruppelt and customers were constantly complaining. They were already looking for a replacement, but it was common knowledge that the labour market was not looking rosy. When the employees refused to continue spreading such lies, I was told that I would now be on sick leave for three months. I wasn't allowed to say any more about it, data protection and all that.

They're looking for a replacement for me. Of course. The only new hire I made during this time was not a commercial and technical sales manager who could have replaced me. Nor to a Head of Technology, who had thrown in the towel shortly before my dismissal. Unfortunately, the reason for this drastic decision was completely unknown to me at the time, as he was one of the shareholders and co-founders of the company. What could have motivated him to leave without a soundbite?

I should have known. The answer, trivial. Insurmountable moral differences between him and our two superiors, our managing director. Replacement for him? Why should he have been replaced? Patrick was happy to do two more than full-time jobs at the same time. And fuck me, I was good at it.

Furthermore, the managing director didn't care that my technology was already haemorrhaging when I had started at the company a few years earlier. We're talking about tiny companies here. You notice every missing head immediately.

Just because three or later five companies are labelled as a group of companies managed by the holding company doesn't make it any bigger than it is on paper. You can count the employees of the entire group of companies at that time on one hand. And that's not counting those who were only employed for the purpose of tax relief. Or maybe they were? Of course it never happened. I must have imagined it. Just like the bogus company that was used to procure drugs with a street value of 240,000 euros under the guise of my company and at the expense of the employees entrusted to my care. With the aim of selling it, of course, what else? And to satisfy my own addictive behaviour, okay, but not in that quantity. The quality was good. But not in this quantity.

I have no problem with either. An enlightened open drug policy works in every country that has tried it. It completely eliminates one of the biggest branches of crime. Crime decreases and users of intoxicating substances can do this decriminalised in a controlled society or at home, so they don't bother anyone who has a problem with it. And the consumers also pay taxes on the intoxicants. I mean, seriously, for the Minister of Finance it's like 40 years of birthdays, Christmas and confirmation or communion or Schnibbeldischnapp parts off the willy at once. Be that as it may, as contrary to human rights as I consider the latter to be, I don't care that someone is selling or consuming drugs. This was only about ketamine anyway, it wasn't even BTM. So fuck it.

But he dragged my employees into it. Suddenly my people had to go to the CID and make a statement. And everyone knew who was behind it. That, that is out of the question for me. The fact that the honourable gentleman accused denied everything and served up my employees to the wolves on a silver platter was the icing on the cake and prompted me to take action. Integrity, and all that.

I asked him to stop lying to me. Then I would find a solution to get us out of this cleanly. Without involving my employees. He insisted that he was just as shocked as I was. He didn't know why someone was sending him kilos of ketamine personally (and my employees unsuspectingly acknowledged receipt - and thus became known to the records through no fault of their own), nor could he make sense of where all the licences for Siemens telephone systems worth a quarter of a million had come from. Electronic licences that weren't there yesterday when we had to file for insolvency. Licences that were suddenly there today. Licences that were sold personally by the management without the knowledge of the sales manager and the head of technology. Me. All I was told was that they had a plan and that I shouldn't worry.

So insolvency was averted. Nice. Averted at the same time as two of the most bizarre events I've ever experienced in my professional life. Could we please sweep it neatly under the carpet so that none of my employees ever unknowingly take drugs for you again? I would also prefer never again to be officially invited by the head of the Compliance and Internal Affairs department of Siemens Enterprise - something like an internal criminal prosecution. On the way to this appointment, I was still completely unaware of why I had been invited. I assumed they were hoping for our great expertise in the market to help with some kind of internal investigation. Who would have thought that I would be so right. And that the object of desire was, well, my own employer. Not me, not on my life.

You or me? I put the knife to my boss's chest. He continued to deny everything. I asked him if he was joking. He insisted he didn't know anything. I stabbed him. If that was the case, then he had nothing to fear from a self-report against unknown employees. So, you or me? If you don't go to the police, I will. He remained steadfast. He didn't know anything and there was nothing to tell the police. So I turned the knife round, stuck it in his chest and left. Left. In other words, I made my three-and-a-half-hour statement to the police and was fired for it. Extraordinary, without notice. Means no salary and no unemployment benefit. Yes, that's how it is. It's legal. If you're dismissed without notice, everything sucks. My integrity was worth it to me.

Beautiful story. But history. Just as detailed as this trip into my head to where memory cells store experiences on the subject of integrity, I would be happy to tell you a true story about every single... fucking shitty day of my life that I had to spend in some fucking clinic. The last few years, on top of that, my stay there was vital. Hospital or death. Which one will it be?

Dear AOK, when you read this, and you will read it, think about the following sentence in a quiet minute. You're acting as if I chose this shit. I waited until the last possible moment and four days longer to have a tracheostomy tube fitted. I hate that thing like the plague. I described why, why and why in detail a year or more ago. I was labelled inexperienced and unprofessional. What the heck, there are worse things.

For example, that I was right on all points and am reminded of this a hundred times over. Day after day. Every day. Day in, day out. Did you sceptics hear that? I was right. Next time you see a patient, be careful with statements about things you have neither knowledge nor experience of. Not everyone can deal with broken hopes. No offence intended. At the end of the day, it's ... my personal problem. But it doesn't help if the alternative to the clinic is death. That's not an alternative. That would be an alternative for the Alternative for Germany. No joke. Anyone who has spent the last 10+ years absorbing every basic and party programme of the AfD and the Hitler Youth alternative, including the comments of renowned political institutes, and - granted - is severely disabled, but a bright guy in the head, can't get over it without thinking. Yes, dear AOK, my life is a walk in the park and I really like the way you feed me. You're out of your minds. The helicopter with the paramedic from the clinic where I ended up practically landed in my front garden.

Whether I could prove bad experiences. Erm. Yes. I thought that was the point here. I honestly keep asking myself why the AOK forced me to pull two all-nighters to answer their questions when the rejection letter says that my bad experiences are irrelevant to the assessment. But hey, I was happy to do it. What do I know? I'm not an expert.

The second procedure didn't even require any justification. I had only made a formal legal application for the costs to be covered to be on the safe side. The blanket rejection came earlier than I was in hospital. So it was complete nonsense what I had been told for four weeks beforehand. I should have been told immediately at the initial consultation that it would be better if I took my sister with me. Because I would have to pay €50,000 for my own nursing service myself this time, why should anyone believe that I would have given my consent with this knowledge. I can't follow some trains of thought. I just can't. I'm too stupid. Never mind. The court will explain it to me if I'm wrong.

Have I had any bad experiences? Well, yes, you have. But what does it matter? I don't understand the question. The medical service of the sick ... your own medical service says in the last report that, due to several factors, there is no way around 24/7/365 toujours 1:1 care for me, even with the IPReG #noIPReG #noRISG law reform, which will not come into effect in practice until the end of 2024. I don't see anything that says that this doesn't apply in hospitals. In hospital, of all places, where I'm particularly unwell. Bad, by which I mean physiologically measurably bad. Bad in the way that the emergency doctor and lung specialist lands outside your living room window in the rescue helicopter. The kind of bad, the kind I mean.

At the end of the day, the questionnaire asks about topics that I don't even know where to stop. It's all important if you have a serious interest in what's going on in the patient. For example, my health insurance company wants to know what problems I had during my last hospitalisation with regard to basic care and treatment care. As usual, my answer is brief.

In your very first question, you touch on a topic that I could write a book about. I would like to start with three examples.

During one of my last stays in hospital without my own nursing service, I was not allowed to use the lift for the entire three-day stay. The hospital staff were not familiar with how to operate the lift and the hoist straps I needed due to my muscle weakness.

Second example. During my privately financed stay in hospital to have a PEG fitted, my carer and speech computer were initially not allowed onto the ward because of formalities. They put me in bed without a humidifier out of incompetence and put the bell in my completely paralysed right hand. And left.

It took 35 minutes for my carer to enter the room. 35 minutes in which he didn't check on me once, 35 minutes in which I just lay there and waited to choke on my own saliva. In regions without 1:1 care, this is one of the most common causes of death in ALS patients. I use the word death advisedly. Nevertheless, I cannot spare you from reading it more often today. The threat of death is my constant companion. I wish those 35 minutes had been the longest 35 minutes of my life. They weren't.

Stop for a moment. Imagine for a moment that I'm not talking rubbish. Dear readers, you know the consequences I have suffered in the past for telling the truth. Dismissal by the employer. Termination by the care service. I'm not lying. I was scared to death.

Imagine for a moment that you are lying on your back at night with all four extremities stuck to the junction at Stachus and a mobile phone with voice recognition deactivated is placed next to your head. You know that the helping pedestrian is sure to come. Whether you are still alive or whether you have been hit by the car is uncertain.

I find this metaphorical comparison marvellous. It brings home to you how unimaginably awful a lack of 1:1 care is for a patient like me. The comparison with you as an involuntary air conditioner is almost perfect. Almost. It has one small catch. In contrast to yours, my death would not even have been noticed. Of course, a patient in my condition should always be monitored. But who knows if help will arrive in time, and well, the specialist hospital where this happened, which prides itself on its ALS research worldwide, doesn't even have monitoring in the rooms. Think about that before we move on to the third and final example.

Same patient. Other clinic. No nursing staff of my own. I am admitted to the emergency department with blue lights, two emergency doctors and four paramedics. I have choked and am in danger of suffocating. Hours pass without communication until I am transferred to the intensive care unit at 5.30 the next morning. A bronchoscopy is to be performed. Go into the lungs with a camera and aspirator, suck out the mucus directly in the lungs. That's the plan. It will be many hours before that happens. Many hours in which I am forbidden to use the emergency spray I brought with me in my own trouser pocket in case of breathing difficulties. Because they couldn't find the instructions, my patient folder was still in the emergency department. Too many hours in which I can't use the vital cough aid. Because, well, nobody knows how to use my device and because, well, the clinic doesn't have its own cough machine. Maybe that's why nobody can operate my standard device. There are only two buttons. "Power" to switch it on and "Therapy" to start the therapy. The clinic staff remain steadfast. They haven't been trained to use it, the cough aid doesn't work until they operate my own carers at home.

These days I decide that I will never go to hospital alone again. I'd rather broadcast live on YouTube how I'm travelling to Switzerland and publicly pillorying the Ministry of Health... But it won't come to that. Sending me to hospital without 1:1 care is not only unreasonable, it is also rightly against German law. You know that as well as I do. Don't you? It was finally clarified by the highest court in case B 3 KR 15/20 R "inpatient hospitalisation". Unfortunately, I didn't bother to do any research during my penultimate hospitalisation and paid almost €8,000 out of my own pocket. I thought in good faith that if my health insurance company said I had to pay the hospital costs myself, then that would be the right thing to do. Nobody could have guessed that I had made such a big mistake. And so be it, my medical records are reason enough for the costs to be covered, you asked for it and who am I not to comply with your request. After all, I'm not a specialist.

Well. This is what it looks like when I'm asked a (supposedly) simple question.

I'm sure you've noticed that I've suddenly switched to "you". For reasons. What you've just read is practically my application as I sent it to the AOK. I've removed the personal details and that's all the changes. Not only because I didn't want to keep the original. Also because I'm lazy. I also believe that as a guest of my blog, you are "on my side". And so I think it's good to make it clear when I'm talking to whom. In some places, I've thought three times about whether I'm really writing it like that or whether it's politically correct to overlook it.

But as with my previous complaints against the health insurance company and the medical service, it's the same here. Someone has to speak out about how the health insurance companies exploit a shitty legal situation to save costs. Acting economically, as the legislator supposedly demands, is the jargon. No, dear AOK Die Gesundheitskasse, I see it differently. Shitty legislators, no problem. Of course, they are mainly responsible for what I consider to be bad politicians and, in my personal opinion, bad people Spahn and Lauterbach. Anyone who takes offence at this statement should first read my thoughts on the abolition of 1:1 care, which these two people personally demanded and legally initiated (read here), before failing to get an injunction against me. Then we'll talk further. In my opinion, they are bad people. What they are causing is not only unnecessary, but also anti-social and lacks any justification. A person with common sense would never come up with such crooked ideas. All too often I wish that humans had just a little bit more of an orca's brain. No kidding. Parts of the brain responsible for social behaviour are four times bigger in an orca than in a human. That's why you'll never see a single stranded orca. Orcas always stay together. The weakest member of the group determines the speed of the group. The sick and injured are never left behind. Thirty whales would rather die together in the lightning ice than leave behind a single young animal that cannot dive long enough to reach the open sea. No, our current legal situation does not favour the weak and sick. It is based on the principle of "the weakest will fly" and that is anti-social.

But what my health insurance company makes of this, how it deals with the legal situation and its customers and how it interprets laws exclusively in its own favour in order to maximise its billions in profits, is the sole responsibility of the health insurance company. I should have known. It's already in the company name that they only look after healthy customers.

As much as I would like to leave the last sentence alone, I have two more. Before the next lawsuits come, it's easy to prove the billions in profits, regardless of the official figures. Just take a closer look at lobbying. Economic activity only affects the patient. The extortionate prices paid to large providers, for example, are illegal. The concept of usury is also regulated by law. I'll write something about this topic when I can muster the energy. In any case, that would be one way in which the health insurance funds could save billions every year. The figures are available to legislators. But they just don't want to start there, because we're all such good friends. Well, everyone except the patient, of course. So, only on the debit side. Having is always good. My contribution of 12,531.84 euros p.a. is always welcome. But don't let the severely disabled person with the highest care level end up in hospital because otherwise he'll die. Nah, that's where the friendship ends.

As much as I would like to let this last sentence stand on its own, I promised you one more. Before the next lawsuits come, I wasn't joking about the injunction. Off the top of my head, I can think of four lawyers who tried to silence me because of my publications. It didn't work. If you still haven't had enough of my writing, you can take a look at two particularly exciting cases that made quite a splash at the time.

The first case involved the managing director of Melango. I had scrutinised his illegal rip-off methods, to which tens of thousands had already fallen victim at the time. I had tried to become his customer myself. After the first publication of his machinations, I received a hail of threatening letters and letters from lawyers. How sweet.

Go to the article "The Melango rip-off" here.

For the second case, I looked for a superior opponent. Who could be better suited than the Federal Bar Association itself, which was responsible for a licence fraud worth millions. After discovering it, I had originally only pointed it out in a friendly manner. Instead of correcting the mistake, they preferred to blame me for false licence information. That kind of thing makes me foxy. Instead of discontinuing my reporting as the Federal Bar Association would have liked, I regularly reported on my latest findings from then on. Until the Federal Bar Association caved in, reached an agreement with the manufacturer of the stolen software (Adobe) and completely reprogrammed its own software called beA - which every lawyer in Germany is obliged to use - and replaced the stolen software with third-party software that could be used free of charge. A terrible patchwork quilt, but at least clean in terms of licence rights from then on.

The original articles from my first publication in the specialised press back then were viewed tens of thousands of times. They are linked. You can find the short summary in my blog post "Bundesrechtsanwaltskammer gesteht: beA Nutzer verwenden Raubkopien", which you can read at here find.

I hope you have a lot of fun with the last two recommendations. It's a little taster of what's to come. I've roughly estimated my risk of legal costs at 79 thousand euros. So if I lose, I'll have to add another 79,000 to the 53,000 or so for care, especially for court and legal fees. My parents' hearts sink when they read the last line. My carer asks me, after noting that over 130,000 euros is really a lot of money, but really a lot of money, whether it's worth it at all. Of course it's not. The initial situation would have to be much better for it to be worth it. Yes, but...

I have a very strong sense of justice and I highly respect not only the freedom we enjoy in Germany, but also the courts that allow us to effectively enforce our legal rights on a daily basis. And in the proceedings I have described, we have a pile of unjust laws, some of which, in my opinion, are not only unjust, but unjust on top of that (note the difference between unjust and unjust). The insurance companies exploit this out of pure greed for profit against defenceless seriously ill patients. David against Goliath, as Jesus himself could not have written better. And that makes me sick to my stomach. It's so mean, nasty, sneaky and anti-social. Someone has to do something about it. And who should it be if not me? It's like seriously caring about animal and nature conservation. You won't win a flower pot with it, let alone a lawsuit. Not even if you're in the right and you're right to have the law on your side. The work costs an incredible amount of money, time and even more nerves. I also don't believe that animal welfare work is mentally healthy. Your friends laugh at you, your own family think you're crazy, face the ambivalence of loving what you do, but think you're too busy with it because it makes you sick in the head. Which I don't deny at all. But I only know black or white. Either you are an animal rights activist and stand up for animals with all available means, or you continue to have your milk and eggs for breakfast, your schnitzel at lunchtime and a fat sausage and cheese platter on the table in the evening. No, that doesn't work in my world. I don't differentiate between animals that I like and animals that I like to eat. And again, I've lost 40% of my readers. Even those who are still with me think a little less provocative would be okay. Don't they?

Let's get back to the topic. Animal welfare and nature conservation are expensive, unhealthy and unfair. Suing your own health insurance fund is expensive, unhealthy and unfair. But, I'm happy to repeat myself, who else is going to do it but me? Someone has to do it. The legal situation is becoming more unfair with every legislative period and the health insurance companies are becoming increasingly brazen. The absurdities that are being rejected are becoming more and more abhorrent. Recently, I even have to pay for the syringes supplied by the pharmacy to administer the medication supplied by the same pharmacy. Not covered by health insurance. The same applies to sterile gloves, sufficient quantities of disinfectant wipes to treat the stoma and bandages in general. Opinions vary widely, from you just have to submit an application to the health insurance company. The fact is, after four weeks in the intensive care unit, I can't read up on who could write a written request and where, so that I don't get two packs of sterile gloves but three of them. I don't have the nerve for that. What's more, three isn't enough and four isn't enough. We use five to six packs of them. I still have to fight my own carers to get sterile suction at all. That would be so much more important to me than the question of who pays for these fucking things. Plastic with bonded coated paper. It all ends up in the residual waste. Together with 50 nappies, several plastic tubes, 20 packs of wet wipes and 1,400 disposable plastic catheters in packaging made of... drum roll... plastic inseparably bonded with paper. Nature conservation has never been easy. As an ALS patient, it is made particularly difficult for you, as is so often the case.

So, this time I didn't end up at animal welfare but at nature conservation. The same rubbish in green. Everything sucks. All expensive and unhealthy. I know all about that, expensive and unhealthy. So fuck it. Let's get on with it. As a - I almost said clever man - ... well, as a... man who was not stupid, but not always consistent in his actions and thinking, once so aptly expressed, from time to time, the tree of liberty must be refreshed with the blood of patriots and tyrants. It is its natural manure. Or like this.