<\/p>\n\n\n\n
A version of this text, complete with references to the sources used and the corresponding source texts, can be sent upon request.<\/em><\/p>\n\n\n\n Contents<\/p>\n\n\n\n <\/p>\n\n\n\n <\/p>\n\n\n\n Introduction<\/strong><\/p>\n\n\n\n I had fallen into a trap that was not discernible from the outside; by the time I began to suspect it, it was already too late, too late for my entire professional career \u2013 apparently, there is indeed such a thing as fate:<\/p>\n\n\n\n From friendly sources, I was repeatedly, urgently, and insistently advised to actively fight back against a network of polarized interest groups. I was supposed to fight against a power that ultimately proved to be a political-judicial usurper of a system still very new in the country’s history, namely liberal democracy \u2013 looking at the US, some call it now \u201cdespotism of a mislead majority\u201d; my opinion is, that it requires urgent amendment. The political parties, as representatives of social interest groups, fight for power using methods that belie their commitment to a new constitution bycircumventing and undermining it. They preach democratic and rule-of-law principles to citizens, while practicing them for themselves in the backyard of power. The abusive handling of these fundamental values in the administration of their community is only exposed when one gets in the way of these colourful power-players, a risk that regularly threatens citizens in elevated positions, because there, responsibility and power, intertwined, clash.<\/p>\n\n\n\n I must admit that the perpetrators, the villains in this affair, were themselves victims, because without the coincidental interplay of factors on multiple levels of political power struggles, they would not have been able to realize their professional murderous plans.<\/p>\n\n\n\n To avoid repeating the bewildering game by sending the readers of this text on the same years-long search for clues to understand the connections, as happened to me, I tell this story from the perspective of its end, so to speak, as an external, uninvolved observer who was present at all events and therefore understands everything from the outset:<\/p>\n\n\n\n From a retrospective overall view, it is indeed a complex affair that unfolded on multiple levels and had a significant, even crucial, prehistory; however, I only learned about its backgrounds and contents during the legal proceedings or even only in retrospect:<\/p>\n\n\n\n Summary<\/strong><\/p>\n\n\n\n In brief, the doctors of his future department had already threatened beforehand to attack and destroy Prof. Auer, should the University dare to appoint him against their wish. Coincidentally, the state CDU party was looking for a scandal at the time of Auer’s appointment to destabilize and, if possible, to replace the then Prime Minister of Saarland, Lafontaine, and his administration.Additionally, rivalries existed within the faculty, which led to rumors, spread by doctors from Auer’s department soon after he took office. They were forwarded by the University hospital\u2019s administration to the public prosecutor’s office (STA) without prior internal investigation and clarification of rumours, respectively. Furthermore, an overview of the 10-years long legal proceedings suggests that there was a polarization between the CDU-dominated public prosecutor’s office in an SPD-governed federal state and an SPD-subordinate political judiciary. This gave the state-CDU the opportunity to deal with the matter as another scandal, alongside the ongoing anti-Lafontaine affairs of that time, to the highest possible media and legal level, to publicly expose that the Lafontaine-government had lost control over its duties. The unsubstantiated accusation by the STA caused further pressure on the Lafontaine cabinet and thus forced them, in the broad public opinion, to suspend Auer and to allow the criminal incrimination of Prof. Auer. A series of criminal trials against Auer followed, spanning over a decade, beginning with accusations of around 50 medical malpractice cases committed within a few months, suppression of documents, document forgery, billing fraud, and other disciplinary offenses.The repeated suspension and reinstatement of Prof. Auer reflected the government’s uncertainty as to whether it seemed more opportune to support Prof. Auer to demonstrate the control competence of the political party and government, or to sacrifice him as a pawn and thereby demonstrate that justice would prevail regardless.After an initial acquittal, admonitions to the Saarland judiciary by the Federal Court of Justice (BGH), rejection of convictions, dismissal of proceedings in 40 cases, and demands for Auer’s reinstatement to his original position, a grotesque conviction based on assumptions with a minimal penalty of a few daily rates was finally achieved, based on the principle: in doubt against the accused; a conviction for a criminal offense without proof of an act. This conviction, based on the presumption of incomplete patient information, was used by the Saarland disciplinary authority to dismiss Prof. Auer from his civil servant position “under special protection of the state.”This authority was under state sovereignty; the dismissal ruling was not appealable. The media had sufficiently exploited all preliminary convictions, thereby destroying Auer’s professional opportunities as a neurosurgeon and neuroscientist worldwide.<\/p>\n\n\n\n Thus, the “Auer Affair” became a mirror of the zeitgeist: a small band of agitators holds an entire federal state in check by being allowed to act as informers, playing “whistle-blowers” who expose alleged grievances, but in reality are fighting a power struggle against their own faculty because they did not get their preferred candidate as the new head of department. Politics corrupts its own democratic system by fighting in rival groups for the preservation of their respective interests, instead of striving together for the common good.<\/p>\n\n\n\n Chronological Table of Events<\/strong><\/p>\n\n\n\n The Course of Events in Detail<\/p>\n\n\n\n Foregoing Activities<\/p>\n\n\n\n During the appointment process for the succession to the Chair of Neurosurgery after Prof. Loew, a delegation of assistant doctors of the department appeared before the appointment committee and demanded the appointment of their preferred candidate; they would not accept Prof. Auer and, if necessary, would know how to eliminate him, should the university prefer to appoint Auer nonetheless. When Prof. Auer was nevertheless appointed, preparatory steps in line with the threat began; when a misdirected fax correspondence arrived in Prof. Auer’s secretariat in October 1990: it showed that individual doctors had tried to collect material against Auer. In a letter to the external addressee, it stated: “We are now starting the affair!”With the subsequent attacks against Prof. Auer, these assistant doctors then started to carry out their threat and at the same time initiated a power struggle against their own faculty, in which they sought to achieve their goal of elimination by discrediting and incriminating Prof. Auer.<\/p>\n\n\n\n However, they were not the only warring parties in this “affair”:<\/p>\n\n\n\n The Local Intermezzo of Conflicting and Cooperating Parties<\/strong><\/p>\n\n\n\n Before Prof. Auer took office, the Dept. of Neurosurgery and of the University\u2019s Medical Faculty, it was divided into two sections: General Neurosurgery and Stereotactic Neurosurgery. The stereotactic specialist, Dr. Ostertag, senior physician and C3 professor, had been trying for years to expand his power base and instrumentalized several employees for this purpose. Rooms had been occupied in the manner of the ’68 movement, when hippies carried out squatting. Reports and letters about these fights, activities and formal disputes filled several file folders. An employee informed Prof. Auer that his predecessor, Prof. Loew, had not taken care proper of his department in recent years, with the exception of the fight against Ostertag; “The department widely belonged to senior assistants.” Prof. Schnabel, a member of the Faculty, reported as a witness in court about these years-long power struggles. But let’s go back a step and look at the situation, before Prof. Auer took office:<\/p>\n\n\n\n Auer’s predecessor on this Chair of Neurosurgery at Homburg \/Saar, Friedrich Loew, as editor of the Neurosurgical journal “Acta Neurochirurgica,” had followed and accompanied Auer\u2019s professional development with special interest and goodwill: his habilitation thesis and a number of other publications had thus appeared in “his,” Loew’s, journal or with Springer-Verlag. When it was time for Loew to retire, he proposed Auer as his successor. Representatives of the appointment committee came to the hospital in Hannover, where Auer was working at that time, interviewed staff members there and watched his operations. However, when the committee later placed him as number 1 on the appointment list, Loew announced that he had changed his mind, and now wanted to propose his former senior assistant Prof. Herrmann, who had since become head in Hamburg, arguing that his staff members preferred Herrmann over Auer.The members of the committee felt fooled and insisted on keeping Auer in first place. As a result, the next power struggle within the faculty erupted: it was fought between Loew, who until then had been considered the doyen and spiritual leader of the hospital, and the Medical Faculty and its committee, respectively: the question was, whether Loew would be able to exert his power over this committee, or whether the members of the committee could prevail. The dispute was therefore no longer about the individuals on the appointment list. For the first time in many years, however, Loew lost a power game: Auer was ultimately appointed against his will. Considering the usual uncertainty and fear of staff on occasion of a change of leadership, Prof. Auer undertook it to instruct a company for professional career counselling \u2013 Auer obviously unaware of the actual staff\u2019s decidedness and plan to do everything possible to get him removed as soon as possible. That these attempts could only make the staff even more restless and nervous, since they were pursuing their intention. Accordingly, the psychological management consultant, equally uninformed about the actual situation, was puzzled about staff\u2019s strange behaviour. The Minister of Science Breitenbach, to whom Auer had communicated his plan in advance, was first enthusiastic, however, he later never mentioned this project and Auer\u2019s intent again. <\/strong>In addition to the active activity of searching for actionable content to eliminate Auer, the doctors also engaged in further subversive passive resistance and also subversively refused the consultant\u2019s attempts and efforts. <\/strong>According to the available documents, the most active participant in the campaign was a disciplinary case: Dr.Caspar. However, the political environment turned this “Caspar case” into an “Auer affair” through skillful media activity, which could no longer be stopped, but became even further heated precisely by the party-political interest mentioned above. As a consequence, Minister Breitenbach came to the hospital on October 21, 1990 to reprimand and warn the doctors, threatening to initiate disciplinary action in case they would keep their passive and even active resistance. However, the doctors remained with their original plan and also sought to denounce their director, Auer, at the medical association. When their continued strike-like and subversive activity did not bear fruit, they feigned cooperative behavior for a short time, in which they were in truth collecting the case documentations for a criminal complaint, which they then implemented as a surprise at the beginning of the month of February 1991, again accompanied by scandal press and letters to the minister. Some aspects of the abnormal behavior and prejudices against Auer can be seen not only from the testimonies in court, but also from the interrogation protocols of the ministry in the spring of 1991. At the level of the department itself, there was also a jealousy-laden competition between Prof. Auer’s predecessor, Prof. Loew, who dominated the faculty operations by virtue of his political machinations, and the general surgeon Prof. Feifel, who was at a disadvantage, although his field was the much more extensive one. Therefore, Feifel’s first endeavour after the start of the campaign was to at least make himself the acting director of neurosurgery and to pursue the removal of Prof. Auer before any objective examination of allegations; for this purpose, he convened a conference of heads of departments of the hospital to get the support of the other directors. Later, he was accused by the faculty of having misled the colleagues somewhat by misleading statements, whereas he had wanted to have Prof. Auer removed on his own authority from the outset and temporarily replace Auer by himself, because he had declared Auer incapable of leading his department in writing to other colleagues outside his own faculty and even to the Saarland Minister of Science Breitenbach, contrary to the findings of the appointment committee of his faculty. After that, he supported the revolting doctors by waving through their efforts, even the demand for autonomous treatment of private patients, and further strike-like destabilization of neurosurgical operations; in acting in this way, Feifel had never involved or even informed the director of neurosurgery, Prof. Auer. Ultimately, Feifel also covered up numerous civil service offenses and irregularities of assistant doctors from neurosurgery: he did not check any of the sick leave certificates or certificates of incapacity to work, thus covering up the realization of the destruction action against Prof. Auer previously announced by the doctors \u2013 and Feifel was informed and aware of the assistants\u2019 intention, very much in contrast to Auer. This included the assistants\u2019 demand, according to which the hospital management agreed without involving the employer, the minister. Had the minister been informed, he could have ordered a corresponding examination of the contradictory sick leave certificates and the illegal agreement between Feifel as the hospital director and the assistant neurosurgeons, the minister could have filed disciplinary action against the assistants. This illegal activity included the fact that Feifel covered up the refusal of the doctors to continue work in the department\u2019s outpatient clinic. Feifel as medical director of the clinic also did not contradict Caspar’s report against Auer for allegedly missing KV approval. According to the memorandum, Auer was temporarily the only surgeon at his department during the doctors’ strike; at the same time, the offer forwarded by him from several other hospitals such as Freiburg, Munich, Mainz and Cologne to send neurosurgeons as replacement to ensure that scheduled operations could be performed, was rejected by Feifel.Prof. Auer also recorded that Feifel left him in the dark about complaints about himself and refused to answer his inquiries in this regard. It would also have been in Feifel\u2019s responsibility to report to the minister, that these neurosurgery assistants on strike had forced the department\u2019s secretaries to join their strike action. Moreover, the minister did not take any steps from November of 1990 on on, when Auer reported to him directly by hand him out a memorandum.<\/p>\n\n\n\n At that time, the political wind had already turned, and now, the minister threatened Auer with disciplinary proceedings, however, not his assistants on strike. Probably, Feifel had already informed the minister of his opinion, backed by the other hospital\u2019s directors of departments, who had been misinformed by Feifel. Feifel went on with this policy by reporting in this sense to the state parliament. Moreover, a supplemented memorandum from 05 March 1991, which Auer had written at the beginning of his leave of absence from mid-February and sent to the minister, remained without any consequences; there, Prof. Auer described unacceptable and partially even catastrophic medical and administrative deficiencies, but neither the hospital nor the minister nor the STA wsaw any interest in following Auer\u2019s warnings; the only interest from now was to incriminate Auer himself despite the fact that the committee of the German Society of Neurosurgery had reported that there were no malpractice cases to be found in the allegation paper launched by the revolting assistants (e.g. postoperative infection rates over 10% in cases operated before Auer took office, e.g. unacceptable shortages in intensive care quality, e.g. a delay of correspondence to patients\u2019 general practitioners after patients had returned home after surgery; e.g. a serious disciplinary misconduct of Dr. Caspar, who had not been available while on duty, when an emergency case was coming in and later dying). Instead, the STA insisted on further pursuing allegations of fraud, of document forgery and medical malpractice against Auer, as initiated by Feifel. Feifel also attempted to have Auer replaced by a place-holder on Auer\u2019s chair, of the name of Steudel, and proposed a senior assistant of Prof.Lorenz, the then chairman of Frankfurt Neurosurgery and president of the German society of Neurosurgery. Allegedly, Feifel asked Lorenz to review and turn around the committee\u2019s medical expert report, and promised to place Steudel into Auer\u2019s position in return. Both Feifel from the hospital side and the STA from the legal side blocked Prof. Roosen\u2019s report, forwarded by Prof.Auer, that Caspar used a surgical method not accepted by the vast majority of experts in the field. <\/p>\n\n\n\n As a remark aside, Dr. Caspar was described in the regional newspapers during the media campaign against Prof. Auer, as a world-famous surgeon, while he waw not even invited to this annual conference of the professional association on the expert area of his allegedly outstanding qualification. Prof. Mittelmeier, the director of orthopaedic surgery, Prof. Larsen, the director of anaesthesiology also opposed these trick games of neurosurgical assistants and Feifel; the director of haematology, Prof. Wenzel, even attacked Feifel very directly for his inappropriate behaviour and refused to accept his actions, and others published a letter indicating that the campaign against Auer was a catastrophic and embarrassing signal from the Homburg faculty. Science and Justice in a partisan dilemma in an atmosphere of politicized justice <\/strong><\/p>\n\n\n\n The administration of Prime Minister Lafontaine cabinet was already under heavy fire, partly due to the scandals and lawsuits involving Finance Minister Kasper’s employee, Erich M\u00fcller. By coincidence, political interests \u2013 specifically the struggle between the ruling SPD and the opposing CDU – took the affair onto a higher political and public level, and thereby played into the hands of the revolting neurosurgical assistants on strike, who pretended to be whistle blowers. One reason was, that the CDU-party in opposition had already managed before the Auer-scandal, to launch two other scandals, thus offering a chance to undermine Prime Minister Lafontaine’s administration. This new affair Auer exposed theMinistry of Science to criticism, added to the ongoing affairs against two other Ministries. Prof. Auer was very well suited to be a scapegoat due to the strong public interest in health-issues and the fact that, as a recently arrived foreigner, he was not part of any power game and structure in Saarland.The Minister of Science, himself attacked from within his own party, had already indicated in April 1991, that he considered a protracted avalanche of lawsuits against Auer to be the most viable way to keep himself, the party, the government, and the University Hospital, safe from CDU attacks; this recommendation was proposed to the Minister of Justice, Walter. The strategy was to delay and protract upcoming trials “ad infinitum.”[1] This strategy was then systematically practiced by the courts: a multitude of court dates served merely for brief, seconds-to-minutes-long administrative pretexts such as jury vacation planning, acknowledging a document without deliberation, etc. Thus, a scenario of grotesque politicized justice developed, in which the public prosecutor’s office pushed for convictions to expose the government’s inability to place competent people in key positions. The courts, on the other hand, allowed the charges but also let the trials drag on for years. The a priori intention to publicly denounce Prof. Auer as a victim was not deterred even by SPD interjections during the CDU MP’s speech in the state parliament, such as “Pre-judgment campaign!” As the culmination of efforts at the level of politicized justice, Auer was later offered by Justice Minister Walter in a meeting at the ministry that all proceedings against him would be dropped if he were willing to voluntarily leave his position (see also below). The development to the 1st Suspension<\/strong><\/p>\n\n\n\n The final destruction campaign was initiated, as announced by the whistle-blowing assistant doctors on strike, by leaking rumors to the Saarbr\u00fccker Zeitung (SZ) about catastrophic conditions in the Homburg Neurosurgery Department, for which the newly appointed Prof. Auer was allegedly responsible, even though he had only been managing the department for a few months. The Minister of Science came under pressure, as expected by the political party \u201cCDU\u201d in opposition, when he began to objectively investigate the accusations. The doctors increased the pressure by going on strike, which significantly hampered the department\u2019s function, especially scheduled surgical procedures. At the same time, the medical director of the University Hospital, Prof. Feifel, who was also the director of the department of general surgery at that time, prohibited the transfer of patients to surrounding hospitals, which Prof. Auer had proposed and requested. When the doctors finally took their next step and presented accusations of medical malpractice involving about 50 patients within a few months to the Minister of Science, Prof. Feifel immediately forwarded the matter to the public prosecutor’s office, without initiating an investigation or review from a medical perspective himself \u2013 he claimed he could not professionally assess the accusations, even though he had widely disseminated his opinion regarding Auer’s incompetence months earlier. Feifel even concealed towards Auer on March 11, 1991, that an expert opinion requested by the Minister of Science had found no medical malpractice, but rather indicated internal disputes; the report had been prepared by the President of the German Society for Neurosurgery, Prof. Lorenz, and an expert committee assembled by him, on request by the Minister of Science. However, when Prof. Feifel confidentially offered the expert the prospect of appointing his senior assistant as interim director of Homburg Neurosurgery \u2013 and possibly later as a new full professor \u2013 Prof. Lorenz wrote a new expert opinion, in which he now saw medical malpractice where the expert committee had previously found none. Lorenz was criticized for this by colleagues of the German Association, not only by Prof. Seeger but also by Prof. Gaab, who wrote: “The matter in question (referring to ‘Case Auer’) was handled by Mr. R. Lorenz, as the then 1st Chairman, illegally, embarrassingly for his own benefit, endangering the society, and finally with false statements before the extended board.” End of the 1st Suspension<\/strong><\/p>\n\n\n\n “After an expert commission of the German Society for Neurosurgery had unanimously concluded at the end of February that the ‘accusation of medical malpractice against Prof. Auer cannot essentially be upheld,’ the interim investigations by the public prosecutor’s office and the Ministry of Science and Culture have also not yet led to findings that would justify a continuation of Prof. Auer’s suspension,” the ministry informed the press; the fact that the presumption of innocence should have applied from the outset, especially after the initial commission’s expert opinion, is not even mentioned here. The intention to implement Justice Minister Walter’s plan for a politicized justice solution is even publicly hinted at here (details see above).<\/p>\n\n\n\n When the suspension had to be terminated, and the newly structured department was to be staffed with new medical personnel, the press and the Ministry again held Prof. Auer responsible for the fact that, due to the media’s destructive campaigns, it had become impossible to recruit sufficient staff for this new department, while all \u201cwhistle-blowers\u201d of Auer\u2019s original department were now working for Prof. Lorenz\u2019s \u201cboy\u201d on Auer\u2019s chair as provisional director. By the way: This \u201cboy\u201d, Steudel, attempted to assist the \u201cwhistle-blowers\u201d for a further criminal accusation against Prof. Auer: he accused Auer of having pretended to have removed a pituitary adenoma in a female patient, while in reality he had left it behind. Apparently, Steudel was inexperienced in this field of neurosurgery, as apparently also the Neuroradiology-Section, because both had taken a mass in the postoperative tumour cavity as the left-behind tumour, while it was a fibrin sponge, which Auer put into the cavity to secure it from becoming the source of leakage of cerebrospinal fluid. Steudel even recommended the patient to have \u201cthe tumour\u201d removed in a second operation: he operated upon the patient, but removed the pituitary gland in the erroneous opinion to remove the tumour. Postoperatively, the patient had the unavoidable hormone deficiency and needed life-long hormone-replacement medication. When the STA became informed bout these real circumstances, they dropped the new attempt to raise yet another affair against Auer, however, they also did nothing to hold Steudel liable for his medical malpractice.<\/p>\n\n\n\n The 2nd Suspension<\/strong><\/p>\n\n\n\n Politicized justice had suffered a minor setback: The operation of Auer’s new department had to begin after the end of the “research semester” on November 1, 1991, but it lasted only 10 days, because after just 7 days, the criminal indictment, widely announced in the press, followed on November 7, 1991:The initial accusation of Prof. Auer with respect to approximately 40 cases of medical malpractice had to be dropped due to any lack of evidence \u2013 the accusations, however, had been announced and widely discussed in the newspapers before any legal actions had started. Now, the public prosecutor’s office (STA) finally filed charges to Court, and the courts admitted the accusations to be dealt with: the represented three remaining issues \u2013 because the fourth accusation, then considered criminally relevant by Feifel, namely the suppression of document files, had also to be dropped, [2] and without any assignment of guilt. Here are the three trials summarized:<\/p>\n\n\n\n Trial on Suspicion of Document Forgery<\/strong><\/p>\n\n\n\n The start of the trial had been announced with great fanfare by the media; however, the proceedings, with sensationalist press coverage and television broadcast vans outside the courthouse, then led to a “first-class” acquittal in the second instance, because, again, there was no evidence whatsoever, behind the whistle-blowers\u2019 disseminated rumours.<\/p>\n\n\n\n Trial for Intentional Bodily Harm in 8 Cases (“Surgibone Trial”)<\/strong><\/p>\n\n\n\n In the trial concerning the allegedly experimental use of a new interposition material in cervical spine surgeries, it turned out that the complaint and indictment were void because the material had been in use for years in at least 20 countries; although it was not yet approved in Germany, the hospital\u2019s pharmacy had ordered and supplied it without informing Prof. Auer (as no longer expected otherwise, no action was taken against the pharmacy afterwards). Regardless of all this, the public prosecutor’s office (STA) and the court had allowed the trial, even though preliminary expert opinions, initiated by the STA, had clearly shown that the alternative to the interposition material used by Auer, namely autologous bone from the iliac crest, would result in significant discomfort for patients. In the middle of the trial \u2013 it was now the Justice Minister Walter’s decision to delay trials for as long as possible \u2013 the proceedings were interrupted with the argument that no trial dates were available, only to announce later, in August 1993, that the court did not intend to further prosecute Prof. Auer either for lack of clarification or for his surgical technique. Nevertheless, a conviction followed; but the Federal Court of Justice (BGH) overturned the verdict and referred it back to Saarbr\u00fccken courts. Saarbr\u00fccken resumed the trial, and on March 9, 1994, a new conviction was issued. This time, the BGH responded on June 29, 1995, with another referral back and a request to the Higher Regional Court (OLG) Saarbr\u00fccken to drop the proceedings, as 76 days of investigations and hearings spread over 4 years had not been sufficient to secure a legally flawless conviction. From mid-1996, the OLG Saarbr\u00fccken also began to signal the termination of the proceedings. Finally, in the course of 1997, the civil lawsuit in this matter by the plaintiffs against Auer was also dismissed, with reference to the unlikelihood of a criminal conviction by the BGH. Both proceedings were ultimately and definitively closed without any convictions. Instead, Saarland was ordered by the Supreme Court to re-institute Prof. Auer into his former position.<\/p>\n\n\n\n Trial on Suspicion of Negligent Homicide (Mathis Trial)<\/strong><\/p>\n\n\n\n In this trial, it was disregarded that it was a very rare central brain tumour in an extremely rare location, namely an “ectopic” giant tumour of the pituitary gland outside and above the pituitary gland and below the diencephalon; when the case was presented to Prof. Auer, the preoperative findings had virtually ruled out this diagnosis (see neuroradiological finding); only Prof. Auer himself had expressed the suspicion that it could be such a type of tumour, and ordered additional examinations. The result of these requested examinations came by telephone between Christmas and New Year 1990\/91: a hormone-active pituitary tumour had been ruled out. For this reason, only surgery remained as a therapy.<\/p>\n\n\n\n Regarding the clarification, Auer’s assistant, Dr. Deinsberger, testified that Prof. Auer had discussed a possible drug therapy with the patient, but that this was not possible due to the low prolactin level, and therefore only surgery was an option. Both Auer and Deinsberger were accused of lying or untruthfulness in the judgment, and Auer was accused of the patient not having undergone surgery if treatment with Bromocriptine had been possible \u2013 however, the public prosecutor’s office (STA) and the court failed to provide proof for this, and thus could not convict him for insufficient clarification (see explanations under “Trial for Intentional Bodily Harm”).<\/p>\n\n\n\n Two weeks after this operation, Prof. Auer received the news that this telephone message had been incorrect; further investigations had since been carried out, and it was now determined that it had indeed been a prolactin-producing tumour.<\/p>\n\n\n\n Gradually, in the criminal trial concerning the accusation of faulty surgical technique, medical errors were initially alleged, which, however, proved to be void over the course of the years-long trial: Only when Prof. Auer pointed out to the court expert \u2013 surprisingly Prof. Lorenz – that he himself had recommended the method used by Prof. Auer in one of his publications, which he was now accusing Prof. Auer of as an error, was this accusation dropped, and a new possibility was sought by courts and politics to bring this case to a conviction.<\/p>\n\n\n\n The Public Prosecutor’s Office now aimed to convict Prof. Auer of surgical zeal, alleging he ignored his doctors’ warnings. However, during the holidays and vacation days between Christmas and New Year 1990-91, a temporary lab technician, unfamiliar with the methods, was on duty in the endocrinology lab. He telephoned the on-call neurosurgery doctor with incorrect information, stating that the final value of the hormone, crucial in this context, was at a normal level, and, in any case, ruled out a hormone-active tumour. As a witness in court, the laboratory\u2019s director came under severe pressure due to the alleged negligence and transmission errors. He asserted that, since the incident, he had fundamentally changed and organized the procedures in his lab. The court remained silent, but the prosecution did not: they continued to insist that Prof. Auer should have recognized the lab’s error and adjusted his plans accordingly, and that Prof. Auer, not the lab technician or the lab director, was to blame for the technician’s error. The court remained silent on this point as well.<\/p>\n\n\n\n Expert opinions from renowned international experts, such as Prof. Symon from Queen’s Square Hospital, London, Prof. Patterson from New York, and Prof. Landolt from Zurich, exonerated Prof. Auer by explaining that, and why, no medical malpractice had occurred. These foreign-language expert opinions, translated into German, were completely disregarded by court.<\/p>\n\n\n\n As a last resort for a conviction, only unproven assumptions remained, based on the legal principle: in doubt against the accused (not in dubio pro reo but rather the opposite: in dubio contra reum). In order to achieve this goal, the unsubstantiated accusation of inadequate informed consent was abused, which could be alleged, because the patient was no longer alive and could not be questioned. Accordingly, the court convicted Prof. Auer of negligent homicide.<\/p>\n\n\n\n The Federal Court of Justice also overturned this third conviction from Saarbr\u00fccken and remanded the case; again, for the fourth time, criminal proceedings were initiated against Auer, though this time under a new name.<\/p>\n\n\n\n However, in the meantime \u2013 and with this, the report on this trial is interrupted and resumed under new auspices \u2013 a question had re-emerged due to concurrent proceedings in the Federal Administrative Court:<\/p>\n\n\n\n End of the 2nd Suspension \u2013 Rehabilitation?<\/strong><\/p>\n\n\n\n With its decision of September 9, 1994, the Federal Administrative Court found a violation of Prof. Auer’s fundamental rights regarding Article 3, Paragraph 1 and Article 12, Paragraph 1. However, his dismissal from service remained upheld.<\/p>\n\n\n\n The official lifting of the second suspension from November 15, 1991, was carried out by the Administrative Court of Saarland on November 21, 1994, with the words: ‘Thus, the criminal misconduct… does not appear to be particularly serious, and consequently, it cannot be assumed that in formal disciplinary proceedings… the most severe disciplinary measure, namely his removal from service (\u00a76, Para. 1, SDO), will be imposed. Therefore, the respondent must, according to the decision of the Federal Constitutional Court, provide him with the opportunity for surgical activity.’ Prof. Auer was thus allowed to operate again, but not at his own department.<\/p>\n\n\n\n However, now that the repeated termination of the suspension and reinstatement to his position was supposed to take place, movements in both directions began:<\/p>\n\n\n\n In January 1995, Prof. Schnabel, the chairman of the appointment committee for Prof. Auer\u2019s position, informed the Dean of the Medical Faculty, referring to his duty of confidentiality, that he had received a court summons to testify about the doctors’ threat should Prof. Auer be appointed. Schnabel\u2019s report to court was ignored the same as all the other foregoing informations in favour of Auer.Prof. Sitte, the previous University\u2019s president, continued to provide special support, engaging in repeated discussions with the faculty, the hospital, and the Minister of Science, to ensure that the cessation of proceedings and reintegration of Prof. Auer into professional life, as ordered by the Federal Court of Justice in 1994, was initiated in an orderly and realistic manner \u2013 he ultimately remained unsuccessful, unfortunately, because it was already clear from the political side that the series of affairs in Saarland could best be managed by making Prof. Auer a scapegoat, even if he could have been allowed to slip away through the back door, like Socrates back then. For now, an interlude of politicized justice began, as mentioned before: to get the affair out of the media, the Minister of Justice, Walter, negotiated with Prof. Auer in a meeting between himself, his State Secretary, Prof. Auer, and his lawyer; he proposed that Auer voluntarily vacate his position; in return, he would have all criminal proceedings against him dropped. A corresponding declaration of honour was prepared. However, the plan failed because Prof. Auer rejected the proposal. He apparently still believed in the rule of law in a democratic constitutional state, which would ultimately grant him justice. Above all, he acted with the knowledge that he would no longer find employment in his profession anywhere else, meaning he would have to live without income, as the ministries had rejected any compensation to accompany the declaration of honour.<\/p>\n\n\n\n In the first half of 1995, Prof. Auer applied for various positions in an effort to leave Homburg. Simultaneously, lawyer Dr. Oppermann \u2013 working pro bono for Auer \u2013 fought with the Ministry for the actual implementation of the demand for Prof. Auer’s reinstatement to his position. Lawyer Holtschmit \u2013 also largely pro bono \u2013 pursued a civil lawsuit against the whistle-blowing doctors.Meanwhile, another person had also started working for Prof. Auer without charge: his tax advisor, who was increasingly occupied by the Public Prosecutor’s Office; for the Public Prosecutor’s Officealso tried by all means to criminally prosecute Prof. Auer on the grounds of tax irregularities. The methods of the Public Prosecutor’s Office had so incensed the tax advisor that he, on his own initiative, began to combat these machinations and prove that Prof. Auer had acted legally correctly, whereas many incorrect declarations had gone through for his predecessor, Loew. On this occasion, it should also be mentioned that as early as summer 1990, a Medical Technical Assistant at the department informed Prof. Auer, that the professors of neurology and neurosurgery had double-billed their private laboratory services by sending invoices for reimbursement to both the hospital and private insurance companies \u2013 meanwhile, nobody will be surprised any more to learn, that Prof.Auer\u2019s report to Ministries and STA in this context remained without any consequences.<\/p>\n\n\n\n While the Dean and the Medical Faculty kept a low profile, indicating that the Minister would decide everything alone, the hospital\u2019s board vehemently opposed Prof. Auer’s reinstatement, using all available slanders from the neurosurgery staff, bringing forth all rumors and accusations, including psychiatrically suggestive remarks. The Hospital, the Faculty, and the Ministry, circulated the matters for months; the Saarland Ministry of Justice, urged by the Federal Constitutional Court to reinstate Prof. Auer, demonstrated what can happen when the State commands itself, the State: nothing. Only the prohibition of clinical activity in Homburg was emphasized. When Prof. Auer sued the denouncing doctors for their false accusations, which the majority of experts had deemed void and which had not even been taken up by the Public Prosecutor’s Office, all efforts for adequate legal judgment remained unsuccessful; all counter-suits were dismissed, as were counter-suits against Feifel and Lorenz.<\/p>\n\n\n\n Efforts in Prof. Auer’s interest were soon thwarted again, for now politicized justice reappeared as the mastermind, with the Minister of Justice and his original concept of a protracted avalanche of lawsuits. The trial concerning the accusation of negligent homicide \u2013 the verdict had been overturned by the Federal Court of Justice \u2013 soon continued with a new panel, aiming for even much worse accusations:<\/p>\n\n\n\n Trial for Intentional Bodily Harm (Mathis II Trial)<\/strong><\/p>\n\n\n\n Based on the assertion, contrary to reason, witness testimonies, and Prof. Auer’s relevant scientific anamnesis, as detailed below, a conviction for intentional bodily harm resulting in death was now constructed, justified by incomplete disclosure, and accompanied in the written judgment by the even more cynical assertion ‘and intended it so.’ The court repeatedly accused Prof. Auer of lying because he argued in his defense that he had indeed discussed treatment alternatives with the patient, but that this had merely not been clearly documented in writing; Prof. Auer described in detail when and where in the hospital building this conversation with the patient had taken place; his assistant doctor, Dr. Deinsberger, when he confirmed this as a witness, was also again accused of lying and was now himself pursued by the Public Prosecutor’s Office with a criminal complaint and threat of legal action, as further detailed below.<\/p>\n\n\n\n Prof. Auer was accused of operating out of surgical zeal, against the patient’s interests. For an attentive and objective medical professional, the absurdity of this accusation would have been evident from the outset, as they would have recognized that it was Prof. Auer himself who, contrary to the existing findings \u2013 e.g., the radiological suspected diagnosis \u2013 considered the possibility of a pituitary tumour and medical instead of surgical therapy, and initiated corresponding further diagnostics: the radiological finding had falsely ruled out a pituitary tumour. Prof. Auer, however, ordered hormone tests to rule out a pituitary tumour, because a so-called ectopic pituitary tumour could not be excluded. Furthermore, in the case of a prolactinoma, medical therapy could be performed. As a precaution, he instructed Dr. Deinsberger to obtain information by telephone from the Erlangen University Department regarding the currently recommended dosage. The employee, Dr. Deinsberger, who was heard as a witness, was repeatedly dismissed by the court as biased and a liar, and his testimony was ignored; he was even pressured again by the Public Prosecutor’s Office with various accusations to silence him. The Public Prosecutor’s Office had already been emphatically pointed out by letter dated May 27, 1991, by the Ministry of Science, that Prof. Auer had already made the identical statement there, referring to Dr. Deinsberger, namely, that ‘inquiries by ward physician Dr. Deinsberger were said to have revealed merely a functional hyperprolactinemia of 3,400 \u00b5g\/ml.’<\/p>\n\n\n\n Similarly, Prof. Mittelmeier, the Full Professor of Orthopaedics in Homburg, who, out of indignation over the unprofessional handling of medical accusations, took Prof. Auer’s side as an expert witness in court, was pursued by the tax authorities at the behest of the Public Prosecutor’s Office, again with the expectation of silencing him. The court categorically rejected foreign experts from overseas. The expert opinion of Prof. Seeger, Full Professor of Neurosurgery at Freiburg University Hospital, was ignored, as was the expert opinion of the Zurich specialist for pituitary surgery, Prof. Landolt; the latter complained to the court and the Public Prosecutor’s Office that his expert testimony in the written judgment was reversed into its opposite, and this opposing argument was used as part of the reasoning for the judgment. Expert opinions from prominent representatives in this specialized field, such as Prof. Laws from the University of Virginia, Prof. Ebersold from the Mayo Clinic, Rochester, Prof. Miller from the University of Edinburgh, Prof. Teasdale from the University of Glasgow, Prof. Kanno from Fujita University, Japan, Prof. Patterson from Cornell Medical Center, New York, Prof. Symon from Queen’s Square, London, and other doctors, were simply ignored without comment or outright rejected along with a multitude of motions for evidence.<\/p>\n\n\n\n Only Prof. Landolt was allowed to testify as an expert witness in court, and his testimony was misrepresented in the reasoning for the judgment, as mentioned above, by turning Landolt\u2019s statement into its contrary. Prof. Landolt, after learning of the conviction and reading the written judgment, complained to the court in a written statement, pointing at the distortion of his statement into its opposite; however, this was again disregarded. Likewise, another letter to the court remained unconsidered, in which a key witness, the endocrinologist Prof. Leicht, after learning of the conviction, wrote to the court that he now wished to correct his testimony, as he could no longer reconcile his previous statement in court with his conscience: he had telephoned Dr. Deinsberger, and Dr. Deinsberger could indeed have misunderstood his words, in the sense of his statements in court and to the Ministry of Science, to mean that it was the final prolactin value.<\/p>\n\n\n\n Successful ‘Loophole Verdict’ without Burden of Proof<\/strong><\/p>\n\n\n\n Prof. Mittelmeier called the accusation of intent to harm the patient ‘a malicious insinuation’ by the Public Prosecutor’s Office and the courts. However, he could not have known that it was precisely this insinuation that had made the conviction possible: because there was no way to criminally convict a surgeon for lack of informed consent. Therefore, in the appeal process, it had to be alleged that Prof. Auer had willfully failed to inform the patient about an alternative treatment option, thus deliberately deceiving the patient in order to operate \u2013 in the verdict text, this legal maneuver is reflected in the words: ‘…and intended it so.’ The plan for a criminal conviction, and the avoidance of judicial embarrassment through another cessation of proceedings, could thus only be realized through this insinuation of intentional patient deception. Prof. Auer had repeatedly stated during the trial that the patient had been irritable during his informed consent discussion because, as a patient at the Neurology Department, he had had to wait a long time for the transfer to neurosurgery and now finally wanted to be operated on \u2013 an extremely authentic-sounding statement indicating that such a conversation had indeed taken place and was not falsely invented by Prof. Auer and Dr. Deinsberger together.<\/p>\n\n\n\n Ultimately, the conviction was achieved based on an unproven, assumed lack of patient informed consent, despite contradictory witness testimonies \u2013 this is what remained as the legal justification at the end of the ‘Auer Affair’.<\/p>\n\n\n\n The reasoning for the judgment indicates \u2013 even more strongly compared to the first written judgment \u2013 that any presentation of facts and circumstances for which no clear evidence existed was used against Prof. Auer, even if alternative possibilities existed, and that all statements by Auer or witnesses who spoke in his favour were either judged as lies, ignored, or twisted into their logical opposite.<\/p>\n\n\n\n This final verdict was recognized as valid by the Federal Court of Justice.<\/p>\n\n\n\n The final conviction was also flawed on the part of the Federal Court of Justice this time: for in the appeal judgment concerning the ‘Surgibone trial,’ it had been explained in detail that in criminal proceedings, unlike civil proceedings, a doctor’s criminal liability would only exist if the patient had not consented to the procedure if properly informed. However, since the patient had died and could no longer be questioned, a ‘hypothetical non-consent’ was assumed. In criminal law, however, unlike civil law, the doctor must prove the patient’s actual refusal. The conviction, however, was made with the note that ‘the accused grossly disregarded the patient’s right to self-determination.’ In medical criminal law, it states: ‘In criminal law, an error-induced belief in the existence of a justification ground leads to a mistake of fact regarding a justifying circumstance. Such a mistake of fact regarding a justifying circumstance excludes intent (analogous to \u00a7 16 German Criminal Code), which then also precludes punishment for an intentional offense.’ That the Federal Court of Justice, with its rejection of a third appeal on October 12, 1995, made this procedural error is difficult to explain as a ‘mistake,’ as Judges Steindorf, Tolksdorf, and Kuffer had dismissed the conviction in the ‘Surgibone’ trial on July 20, 1995, with precisely this argument and with reference to the relevant specialized literature.<\/p>\n\n\n\n Furthermore, the court announced verbally and in writing that all experts had agreed that the patient would certainly have survived his actual day of death without surgery: for this had originally been another point of criticism from the Federal Court of Justice: namely, that ‘near certainty’ was not sufficient as a justification. However, the experts had by no means unanimously advocated such nonsense \u2013 that the patient would certainly have survived without surgery \u2013 nor could they have: they had not advocated it because they pointed out, and had to point out as a widely recognized empirical fact, that these tumours also tend to spontaneous haemorrhages, which can subsequently be fatal; and they could not have advocated it from the outset, because one cannot claim this of any person, and certainly not of someone with a large centrally located brain tumour.<\/p>\n\n\n\n Finally, and perhaps crucially, there is also the following insight: even the carbon copy of the laboratory report sheet from December 29, 1990, from the Endocrine Lab, attached to the Ministry of Science’s letter of May 29, 1991, to the Public Prosecutor’s Office, raises the question of whether the “>” sign, to which so much importance is attached in the judgment, was not inserted retrospectively after laboratory assistant Heugel had made a mistake, because the thickness of this sign’s font differs significantly from the actual lab value, even on this multiple copy. Even if it had ultimately turned out that this difference was irrelevant, the circumstance still indicates that it was not about clarifying the facts, but about collecting seemingly plausible accusations against Prof. Auer. After all, the situation was no different in the trial concerning document suppression: there, Prof. Auer was “prima facie” designated as the only possible perpetrator without further investigation, even though a multitude of other individuals could have been considered for removing the incriminated single-page document and returning it after a complaint was filed (apart from the fact that the accusation itself spoke against such an absurd perpetration by Prof. Auer, as it mentioned that copies of the original already existed).<\/p>\n\n\n\n The judgment text contains no mention that Prof. Auer had been particularly active scientifically in the field of this type of tumours and their treatment, had held an international congress on the subject, and had established a working group at his home university in Graz, involving endocrinology, gynaecology, pathology, and neurosurgery, whose goal was not to operate on every patient, but to make the indication for surgical or conservative therapy dependent on various factors in an interdisciplinary discussion.<\/p>\n\n\n\n Likewise, the pre-planned smear campaign remained completely unmentioned, even though the faculty and many other institutions had persuaded Prof. Schnabel to give a very mitigated statement in court regarding his testimony. Similarly, there was no interest in the fact that, according to meta-research data, Prof. Auer ranked number 1 among German neurosurgeons with his scientific profile. The Full Professor of Neurosurgery, Prof. Seeger, wrote to Mr. Auer on the occasion of the final judgment text that “this text reminds him of times long thought to be past.” He also wrote to the chairman of the professional society, Prof. Herrmann: “We have experienced the same pattern four times: New head, older employees, generational conflicts, involvement of the press… Attacks against the head of the department, involvement of the courts.”<\/p>\n\n\n\n In contrast to all these omissions and errors by the courts, Auer\u2019s \u201cwhistle-blowing\u201d assistant doctors were given ample opportunity in the trials for self-promotion and, above all, for disparaging Prof. Auer, who was allowed to be ridiculed to the amusement of those present: thus, Dr. Caspar was allowed to further distinguish himself there with remarks like “Don-Auer,” a nickname he had given Dr. Donauer as long as he remained loyal to Prof. Auer, until he was finally convinced to cooperate in the revolt. Furthermore, he garnered laughter instead of criticism for making fun of Prof. Auer in the operating room with the nickname “tutti frutti \u2013 Auer”: this referred to a popular TV show at the time where participants had to gradually undress if they couldn’t answer questions. Prof. Auer had demanded that the improper practice of surgical nurses entering the operating room and approaching the operating table in long-sleeved undershirts be stopped, because this made the required surgical hand and forearm disinfection impossible \u2013 the unusually high postoperative infection rate was obviously a consequence of insufficient hygiene measures; Prof. Auer had therefore sent the head surgical nurse for further training at Prof. Samii’s department at his, Auer’s, private expense.<\/p>\n\n\n\n The End of a Professional Career<\/strong><\/p>\n\n\n\n During the 10-year litigation avalanche, Prof. Auer was suspended twice; this suspension was lifted twice (May 18, 1991), most recently by order of the Federal Administrative Court. Ultimately, however, the legal shortcut described above was achieved through unproven assumptions and allegations, which in the judgment documents became “opinions of the court.”<\/p>\n\n\n\n The scandal thrived on rumors of alleged malpractice in about 50 cases within half a year, as well as allegations of document suppression, forgery, and billing fraud. For months, the case was front-page news in the regional press and featured in television talk shows. From this, the public prosecutor’s office initiated four parallel criminal proceedings. The billing fraud proved to be real \u2013 but it became apparent, that other heads of departments had practiced this fraud for years, while Auer refused to continue the same fraudulent practices \u2013 it did not interest the press, though, because Auer had to be accused by the newspapers, not those others. The attempt at document suppression was refuted by the judiciary and police through a house search. In both cases, the slanderers or actual billing fraudsters were not further prosecuted. In the case of forgery, Prof. Auer was acquitted on appeal in the presence of a bitterly disappointed press, including ZDF television vans.<\/p>\n\n\n\n The judgments of the Saarland Higher Regional Court were also dismissed by the Federal Court of Justice in the two criminal proceedings concerning allegations of malpractice. Accordingly, the state of Saarland was ordered to reinstate the unlawfully suspended Prof. Auer. When the public prosecutor’s office reopened one of the criminal charges and again secured a conviction, the Federal Court of Justice reprimanded the Saarland judiciary, stating that it was unable to substantiate the conviction with concrete criminal offenses, and ordered the final cessation of proceedings.<\/p>\n\n\n\n Another interlude could not divert the fatal course, even when the case was widely discussed in the national press as a sensational result of new Federal Court of Justice jurisprudence.<\/p>\n\n\n\n However, by then, political interest was already fixed in the opposite direction, and the Lafontaine administration was sufficiently safe again, as it seemed to be able to demonstrate to the public that it could ensure order on its own initiative by removing Prof. Auer as a scapegoat. Before that, as explained above, an attempt had been made to get rid of him through the method of politicized justice.<\/p>\n\n\n\n Accordingly, the Saarland government and its judiciary ignored the judgments of the federal courts. Prof. Auer was not reinstated in his work area. Instead, the last lost criminal case was reopened and successfully brought to a positive conclusion with the help of unproven accusations: after all allegations of malpractice had been refuted, the accusation remained that Prof. Auer had not sufficiently informed a patient about treatment options. To do this, the court had to dismiss all contradictory witness statements as lies, reverse medical expert opinions, and attribute the causes of a complicated course of events to Prof. Auer instead of the actual perpetrators. This judgment, arbitrarily built on false claims, which the court had reached not based on evidence but on so-called “findings,” was ultimately approved by the Federal Court of Justice after another five-year trial. The approval was based on a recommendation from the Federal Public Prosecutor General, i.e., the political authority. Prof. Auer was finally legally convicted, and the political goal was achieved.<\/p>\n\n\n\n Ultimately, therefore, the dismissal was based on a false conviction in one of approximately 50 malpractice allegations, and this was based on the court’s assumption \u2013 contrary to all witness statements and expert opinions regarding the plausibility of such an assumption given Prof. Auer’s medical history and research profile \u2013 that he had not informed a patient about the possibility of an alternative to the operation actually performed, i.e., due to a lack of disclosure. This accusation then also formed the basis for his dismissal from service as Full Professor of Neurosurgery and thus the decision to end his professional career through this conviction.<\/p>\n\n\n\n Epilogue<\/strong><\/p>\n\n\n\n It was, as described before, a trap, one from which there was no escape, which could only have been avoided from the outset: had the appointment committee been open and fair with Prof. Auer and informed him that both the staff and Loew were against him, he probably would never have seriously considered this professorship, or, put differently, the committee would not have placed Auer first on the appointment list. Had he later behaved more dominantly and defensively in the situation, for example, by banning Loew from the premises due to his intrusive behavior, including employing the head secretary for his private purposes and continuing surgical activities in Auer’s absence, then Loew, who now had the faculty as an adversary due to his defeat in the appointment process, as well as his former colleagues, would have acted even more aggressively with them against Auer than he already did in the Ministry and state parliament. Money for the staff was a failed attempt by Auer to save the situation, as he had distributed the first private fees received from insurance companies to them in December\/January. Aggressive defense had failed because the minister was not interested in using the contents of the memorandum written by Auer in October for disciplining the doctors; direct dismissals were not possible because these were consistently tenured positions. The direct legal path was already blocked as soon as the doctors had launched their surprise attack via the press in October, because public opinion immediately turned against him; the public prosecutor’s office, from its political position, could not have been interested anyway. A retreat on all levels of the doctors’ demands was probably not an option in anyone’s imagination who knew Auer’s curriculum; at most, a feigned retreat followed by an attack from the background might have been a possibility \u2013 also not a realistic plan, considering Auer’s character.<\/p>\n\n\n\n Finally, when one includes Auer’s particularly exposed position due to his profession as a surgeon and his worldwide renown in assessments and considerations, it becomes clear that the trap was at least professionally fatal. The aggressiveness of the public prosecutors and judges, aiming for a prison sentence as special gratification, indicates that they had no objections to physical death by suicide, but would have felt nothing but further gratification.<\/p>\n\n\n\n [1] According to Attorney M\u00fcller, the recommendation came from Minister of Justice Walter, who possibly wanted to drag out processes “ad infinitum” and also sought to extend the existing “1st suspension.” Folder 5, 1, Diary 13.4.1991, Te. with attorney M\u00fcller.<\/p>\n\n\n\n [2] The cessation, however, occurred with the indication that, in essence, only the accused was considered the perpetrator based on prima facie evidence \u2013 further clarification or proof was omitted.<\/p>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":" Provincial farce – but life’s destiny A version of this text, complete with references to the sources used and the corresponding source texts, can be sent upon request. Contents Introduction I had fallen into a trap that was not discernible from the outside; by the time I began to suspect it, it was already too […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1774","page","type-page","status-publish","hentry"],"yoast_head":"\n\n
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When Prof. Auer, in view of the partly dismissive and poorly cooperative attitude of assistant doctors, engaged an occupational psychological consultant, the doctors rejected constructive cooperation; the consultant was even insulted and told not to show up again, although the Minister of Science welcomed Auer’s initiative (see remarks below).At the faculty level, Ostertag had tried to establish an independent, second neurosurgery section for himself, effectively dividing the department, and had found a large number of supporters in the faculty for this; his argument was that stereotactic surgery was about to take the dominant share of neurosurgery anyway and would take over all of neurosurgery in the near future. All this, however, occurred within the Homburg faculty behind closed doors. Prof. Auer knew nothing of all this; he had visited Prof. Ostertag a number of years earlier to study a method of stereotactic radiation with him, and later to discuss what cooperation might look like if he were appointed to Homburg. On these occasions, there had been no indication of competition or even conflict between the departments. When Prof. Auer was appointed, he discovered that Ostertag was no longer in Homburg, as he had simultaneously taken over a department in Freiburg – and had left his supporters in the Homburg-Faculty bewildered. Later, Prof. Auer discovered that Ostertag, in the course of his relocation, had removed and taken hundreds of his patients’ medical records from the department\u2019s archive, an act that legally amounts to embezzlement and theft. Many patients wanted to continue treatment in Homburg; this was greatly hindered by the loss of the records. When Auer reported the incident, the matter was dismissed by the hospital, police, and public prosecutor’s office as not worthy of prosecution. However, when, conversely, Auer was accused by the assistants of his own department of having taken a single medical record away from the department, the Homburg District Court immediately ordered a house search at his residence, which was also carried out. The trigger for this house search on February 14, 1991, was an initiative by Hospital Director Prof. Feifel, who, without verifying the actual events, immediately spread the insinuation in a memo that Prof. Auer had wanted to manipulate a medical record. The investigation initiated by him was immediately taken up by the State Prosecution Department (STA); the latter started by inviting the assistant doctors to give their opinion.At the same time the assistants filed a criminal lawsuit against Auer, accusing him of having committed around 50 serious medical malpractice cases within a few months. The STA ordered an expert opinion to be given by a committee of members of the German Neurosurgical Society professional society: Auer was cleared of the accusation of medical malpractice, instead, the committee stated that they suspected a vendetta against Auer for other than reasons of his patient care or surgical expertise. <\/p>\n\n\n\n
When Prof. Auer arrived and took over Loew’s position, he had become his enemy from being a friend. Loew then exploited Auer’s being ignorant about the change for months: he sold him his old office furniture at an indecently high price, employed his former, now Auer’s, secretary while Auer was in the operation theatre, and Loew also demanded permission to continue operating on his private patients in what was now Auer’s department and responsibility, without liability insurance. Loew also demanded bills for the operation fees to be written for him by Auer, and to then hand him the money out. When Auer replied to this request that he first had to check the legal requirements for such actions, Loew operated behind his back without permission while Auer was absent at a conference overseas, or instructed his former employees to admit one of his private patients. On the occasion of another case, the enmity became openly apparent: The moment the scandal was fuelled by newspaper reports, Loew immediately joined the revolting doctors and offered himself to return to his old position, while Auer would be suspended immediately.Loew’s hostility was answered by Auer with an investigation that revealed the following: Loew had procured a high insurance sum for the widow of a patient who had died in his department by unjustly accusing his senior assistant and forcing him to voluntarily resign. When the responsible insurance director was confronted with this fraud, he was shocked and felt betrayed.Loew had become a victim of his fear of losing power and becoming lonely in retirement (as well as financial difficulties in operating his private plane and vacation home in Corsica). For many years, he had not only dominated the Medical Faculty, but also ruled in his own department in a gently acting, silent reign of terror. He now began to strategically position Auer’s employees, who were his former ones, against him, just as he had done for years before against his senior physician Ostertag, as described above. However, this positioning had already begun a year before on the following further level of events:Namely, when the neurosurgery assistant doctors learned that their desired candidate Herrmann was not to be placed at the top of the appointment list, but Auer, a delegation of the neurosurgery doctors informed the committee members in a conversation whom they wanted as the new head and full professor, namely Prof. Herrmann, and that they would by no means accept a head like Prof. Auer and would find ways to destroy and eliminate him should the commission not follow the doctors’ wishes. <\/strong>Prof. Schnabel, the chairman of the Faculty\u2019s search-committee for a successor of Loew\u2019s chair, was called to court to testify that the faculty knew about this threatening behaviour of the neurosurgery assistant doctors to destroy Prof. Auer if he were to be appointed. Indications of such intentions of the doctors also emerge from memories that Prof. Gaab mentioned and later confirmed in writing.The commission followed this demand of the neurosurgery doctors just as little as that of Prof. Loew. In later testimonies in court, some of the doctors openly stated that they had collected material e.g. during rounds, that could be useful to them for day X from the day Auer took office. So their primary concern was to take revenge on the Faculty for not having received the candidate they demanded as the new head, but Prof. Auer. Thus, on this level as well, the affair became a power struggle between parties with Auer as a means to an end.Auer himself was involved from the beginning in matters of employees whose purpose he could only recognize later from advertisements and accusations: it concerned, for example, the authorship of an operation report from June 1990, which later became the subject of a fraud trial against Auer. The intention to destroy was also evident in an anonymous complaint to the statutory health insurance association (KV) and the medical association: the idea for this probably came from the history that affected all the doctors in the hospital and had already resulted in a \u201cSaarland doctors’ scandal\u201d a few years earlier: directors of hospital departments were prohibited from billing the health insurance companies for outpatient examinations that they had not personally undertaken in their outpatient clinic. However, the hospital as the owner and operator of the outpatient clinics of the individual departments demanded this billing from their heads of departments, as it drew income from it. Accordingly, many department directors billed for these services without actually having provided them in person, instead assigning employees to this outpatient activity. For this reason, they had been accused of “gang-like fraud” a few years before Auer took office, because they had violated the requirement of “personal service provision.” When Auer took office, therefore, he was invited by the KV to sign the new contract between Neurosurgery and Saarland and was made aware of this requirement on this occasion. However, for many departments, including Neurosurgery, this requirement was actually an unrealizable demand: the head of department was obviously unable to simultaneously make patient rounds, operate all day, and care for over 100 outpatients in one day. When Auer refused to participate in the KV-care system of outpatient in view of this unfulfillable demand, he was allowed to employ his assistants for this outpatient care (this special permit was to be valid for 6 months; when no new regulation was offered towards the end of this period, Prof. Auer informed the clinic that this outpatient operation might have to be discontinued). Unaware of this permission as an interim solution, one of his assistants had tried to report Prof. Auer to the KV. At the same time, the same person reported Prof. Auer to the medical association, claiming that he was withholding legitimate claims for private operations from him and instead taking them himself. The fact that the same person, Caspar, had set up a kind of private clinic in neurosurgery himself during the Loew-era, and was now demanding corresponding allowance from his new boss. Both reports went nowhere as false claims, but found their way into the newspaper: because again the same person, Dr. Caspar, had assigned a befriended journalist to the case (there were also rumors that Caspar was the brother-in-law of newspaper writer Jungmann, but had also operated on the journalist, which is why he was obligated to him):Now there were daily new reports in the regional newspaper, \u201cSaarbr\u00fccker Zeitung\u201d, about untenable conditions in neurosurgery. When the Minister of Science issued a reprimand, the doctors went on full attack: first they began a strike on October 26 with a medical emergency staffing of the department, which just allowed to provide emergency care. They had initiated their campaign on October 19, 1990 with a sensational message launched to the leading regional newspaper, ten days after Prof. Auer’s return from a congress trip to India and Australia. Thereafter, they sent a letter signed by the majority of the neurosurgery-assistants to Minister of Science, Breitenbach, inwhich they not only took the side of Caspar, but also complained in general. Classified details from inside the department appeared in the newspaper, that only assistants of the department itself could have known, did not lead to any measures from the side of administrations, they were part of the plan in a mix of politics and law. Both the University Hospital, the regional administration and the staff of Neurosurgery were in reality involved in a process of self-destruction of their system, obviously unaware of what they were doing \u2013 by contrast to activists in party political interests.<\/p>\n\n\n\n
<\/strong>These assistant doctors of the department were themselves victims in several respects: as system-damaged in a years-long struggle of two departments of a department with two section within the same building, they only had power struggle in mind, incapable of constructive debate. They carried out this irresponsible struggle on the backs of their patients, even at the expense of the life of one of these patients, as the further explanations will show. The zeitgeist allowed them a power struggle that had to lead to the self-destruction of their own order system; with their power struggle, they also destroyed the trust of the population into their University Hospital and the Dept. of Neurosurgery, their work place.<\/p>\n\n\n\n
Apart from Feifel, another middleman to the CDU was possibly acting in the background: the dean of the medical faculty, Prof.Wanke. In addition, Auer experienced direct hostilities from the head of neuroradiology, Piepgras, e.g. Auer in turn did nothing against Piepgras, although he had repeatedly found him completely drunk on duty in the morning, giggling and slurring in his office.<\/p>\n\n\n\n
The Ministry of Science found itself in a dilemma: the neurosurgical assistants formed a united front; an official from the Ministry of Science spoke to Auer about the “psychopathic behavior” of individual assistant doctors. However, there was no way to suspend the ringleaders. On the other hand, it was unclear whether the professional accusations against Auer would be sufficient to remove Auer through legal proceedings; in that case, they would have had the opportunity to let the senior neurosurgical assistants have their way and thus outwardly demonstrate the restoration of peace and order. Initially, the minister ostensibly attacked the regional press (SZ) in the state parliament, stating that he would not allow the University Hospital\u2019s reputation to be destroyed by this newspaper; on this occasion, he also mentioned that the ministry had been called by a journalist from the newspaper the day before the doctors’ accusation paper against Auer was submitted, including classified details from it. An article also appeared in the newspaper that day, communicating these classified details. The minister himself thus confirmed that he was aware that, contrary to the prohibition on disclosing internal information, the doctors had provided the newspaper with all the information they later forwarded to the minister. However, nobody took action against the \u201cgang\u201d of assistant doctors, the so-called whistle-blowers.<\/p>\n\n\n\n
An indication of this assumption, that politicized justice was the driving force in this affair, had already been given by the fact that the public prosecutor’s office (STA) generally ignored evidence against Auer\u2019s assistant doctors, dismissed counter-accusations, but colluded with these doctors, even holding private “beer-table” meetings with them for information exchange (the chief public prosecutor demonstratively pushed a stroller with the newborn of one of the doctors in the courthouse hallway, whom he had with one of the department\u2019s physiotherapists, while still married to another woman. At least four other doctors at that time had relationships with staff, e.g., Barbier and Donauer with physiotherapists). In line with Feifel’s opinion on Auer given to the minister, the ministry either did not react to reports of Caspar’s misconduct or did so after a long time with defensive and appeasing statements only.Instead, as a harbinger of the planned final destruction campaign on January 3, 1991, Auer\u2019s assistants on strike confronted the Saarland Medical Association with a multi-page paper on Prof. Auer’s allegedly unprofessional conduct, signed by 11 doctors. In this regard, it should be mentioned that the young doctors were more or less forced to join and co-sign the campaign. To that end, let’s look back at the time period before Prof. Auer’s first suspension began:<\/p>\n\n\n\n
On February 19, the Minister of Science issued a ban prohibiting Prof. Auer from entering his department and from carrying out his official duties. Corresponding letters of protest by other directors of departments against Feifel were also followed by protests from external universities, e.g., Prof. Pernecky from the University Clinic Mainz, Prof. Schramm from the University Clinic Bonn, and Prof. Roosen from the University Clinic Giessen (on behalf of 42 experts).The faculty’s own professors Schnabel, Wenzel, and above all Sitte, as the former president of Saarland University, developed plans in hours-long, urgent discussions with Auer from March to May 1991, trying to help Auer with how it might be possible for him to penetrate the entanglement and thus prevail against politicized justice and power games of the political parties. Sitte \u2013 who had been involved since spring 1991 \u2013 held discussions and corresponded with the Prime Minister and his Ministers, with the CDU chairman, the faculty, and the University Hospital\u2019s management in an effort to ultimately give the media-driven affair a survivable turn for the scapegoat. In May 1991, the then chairman of the faculty-committee for Auer\u2019s appointment, Prof. Schnabel, informed Auer that no one understood, “why Feifel was against Auer from the beginning.” At the directors’ conference on May 1, 1991, everyone voted for Auer’s return, except Piepgras, the alcoholic neuroradiologist; the latter probably representing Loew, to whom he owed a lot, according to Prof. Schnabel. The latter also believed that for several reasons, “the war was predetermined anyway.”From April 1991, a split occurred among the department\u2019s medical staff, with chief laboratory technician Zimmer and others on one side, and the head nurse and doctors, except Kivelitz, on the other; Kivelitz himself had since been sidelined. Caspar submitted his habilitation thesis in early May, but it was rejected as deficient. Donauer, however, informed an arriving patient that Prof. Auer “was not in the house and would not be present in the house in the future. Whether she was not informed about the incidents by the press. No one would allow themselves to be treated by Prof. Auer anymore, and he himself could only advise her against it.”Defense attorney Prof. M\u00fcller informed Prof. Auer shortly before the end of the “1st suspension” that the public prosecutors were dependent officials and that Justice Minister Walter intended to contact him after April 12, 1991. Further discussions between Auer’s lawyer, Prof. M\u00fcller, and Justice Minister Walter, as well as his State Secretary Pernice, were scheduled, for example, for April 11, 1991. Justice Minister Walter\u2019s proposal three years later, to drop all proceedings, if Prof. Auer voluntarily vacated his position as professor and chairman, was already mentioned earlier. From the very beginning, decisions were made “at a higher level,” exclusively in politics, as an official from the Ministry of Science revealed to Prof. Auer. This knowledge also emerged from a discussion between Auer and Prof. Schnabel, who gained the impression that the SPD government was set against Auer because their major problems were exacerbated by the scandal. During the most critical period in April 1991, there was even political consideration of abolishing the medical faculty and running and degrading the University Hospital to the state of a peripheral hospital. In a conversation with Dean Wanke, the latter stated, “the minister reserved all rights.”<\/p>\n\n\n\n