This is a great article written by Robert Evans of ‘Behind the Bastards’ fame that goes into Luigi’s background, social media presence, and apparent ideologies.

We all have had patients with chronic pain, we all know someone with chronic pain, and some of us unfortunately have chronic pain. We know how horrible it can make someone’s life, and how much worse life can be if your insurance just keeps denying anything that could help.

Edit: Here’s a link to what is most likely the real manifesto: https://www.kenklippenstein.com/p/luigis-manifesto

Ken Klippenstein is a very reliable journalist and this version of the manifesto contains the snippets that have been released by law enforcement. Also, considering the thing was hand-written, that very long version involving his mom is dubious. (And there’s not any good evidence that his mom is in anything besides decent/good health)