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The death of medicine in Nazi Germany: Dermatology anddermatopathology under the swastika

2001; Elsevier BV; Volume: 44; Issue: 2 Linguagem: Inglês

10.1016/s0190-9622(01)70281-2

1097-6787

Charles E. Moore,

Historical Psychiatry and Medical Practices

The death of medicine in Nazi Germany: Dermatology and dermatopathology under the swastikaWolfgang Weyers, MD (A. Bernard Ackerman, MD, editor), New York, 1998, Ardor Scribendi (distributed by Madison Books). 442 pages. $49.95 (hardcover); $18.95 (trade paper).As the ranks of those who lived through the era of the Nazi persecutions thin, the immediacy of their memory is, of course, lost. History marches on, and even the collective memory of the two generations subsequent to that tragic period becomes ever more diluted by time and the compelling needs of our own particular circumstance.The fading of memory—collective, familial, and personal—inevitably must occur. But the persecutions the Nazis perpetrated upon their generation will not be forgotten. Those persecutions have become the archetypal paradigm of violence and torture massively authorized by bureaucratic techniques brought to perfection, or rather imperfection as the case might be better made. Everywhere we have powerful reminders of what happened: One thinks immediately of the Holocaust Museum in Washington, DC, the Anne Frank House in Amsterdam, the Dachau Memorial Site, and innumerable lesser memorials that catch the mind and memory. They are always before us, and will remain so.The important point is not that we should merely remember what happened and thoughtlessly pass on, but rather to persist in our study of how and why such distortions of philosophy translated into propaganda and heartless action can occur. By maintaining before us the specific quality of these events as a personal and human tragedy, we can hope to remain alert to the potential, and thereby the prevention, of their recurrence.Wolfgang Weyers' The Death of Medicine in Nazi Germany not only remembers, but places before us in compelling and dispassionate language, as if echoing the cool impersonal words that sent millions to their deaths, an eloquent human testimonial to an obscene moment in history. The perspective of this book is one in which physicians in particular will take great interest, but even though it purports to describe “the death of medicine in Nazi Germany,” it equally describes, in gripping detail, the death of everyone in Nazi Germany.In its first pages, following a helpful foreword by A. Bernard Ackerman, MD, under whom Dr Weyers trained as a dermatopathologist, we are provided an interesting background to the circumstances leading up to the “ultimate solution.” There is fascinating commentary regarding the reasons such a large proportion of Jewish physicians became dermatologists, and therefore dermatology becoming a specialty particularly subject to Nazi attention. Dr Weyers leads us along, step by step and page by tragic page, each anecdote and personality an escalation built upon those that came before, to a crescendo which no one who has read this book is likely to forget. The fascination lies in the details, both of personality and of incident. Through these pages are demonstrated the methods, neither subtly nor slowly applied, by which the Nazi regime within a decade utterly dishonored and degraded a tradition of excellence that German medical practice over the entire preceding century had achieved to the world's admiration. Do not most of us, if only vaguely, remember thinking we should be able to read German to become a physician? All of this was destroyed with an efficiency one might almost admire were it not so utterly stupid.Dr Weyers discusses that destruction through the perspective of the dermatological specialties, illustrated by the experiences of numerous of the greater or lesser dermatologists of that era. The choices these individuals were forced to make, and the doom they (and their families) potentially faced, were of the harshest, hardest kind, but relevant in some degree to every physician in Germany. They are, indeed, yet relevant to ourselves.In this tale, after all, we are introduced to true and veritable villains. There are a preponderant number who attempted to see nothing and hoped for the best. There are those who managed to escape. There are the rather rare heroes, such as Hans Scholl, a non-Jewish medical student who with his sister, Sophie, was executed by the Nazis. And Georg Groscurth (1904-1944), lecturer in Internal Medicine at the Moabit Hospital in Berlin, personal physician to Rudolf Hess, but also a clandestine saboteur who made of his apartment a hideaway and way-station for Jews in flight. Discovered by the Nazis, he was arrested in 1943, and executed 8 months later. His last letter, written to his wife minutes before his death and smuggled from his cell, is poignantly quoted in full, and ends by saying “…the children. You will tell them that they do not have to be ashamed of their father. In a moment it is over. My love, with your noble, dear heart, you will take it well, never despair…Georg.”Somewhat fewer than half of the 566 Jewish dermatologists practicing in Germany in 1933 managed to escape, but only 15 of the remainder survived within the confines of Nazi Germany itself. No survivors could have been left unscathed, and most must have been severely scarred.Having completed this book one feels a tremendous sense of relief. The tendency is to say, to hope, that “it couldn't happen here.” It is very difficult to imagine, in any case, what one might have done under the circumstances imposed upon these physicians who, with their families, seem quite identical to oneself. It is easy to hope that one might have been a “hero” when these challenges are thought about abstractly, read about, and in no way actually forced upon oneself. Beneath that hope, however, lurks the very distinct possibility that one might have been nothing of the sort, and have fallen into that middle group, who did nothing, and simply hoped for the best for so many good reasons. We make do, after all, day by day; accepting by insidious degree what comes; praying for that turn for the better, which surely must occur. As for the villains, they are always there.You and I, each of us reading, assure ourselves that we would not be among this group, egregiously ready to take advantage of an opportunity no matter how craven, ready to advance ourselves literally over the bodies of others for the sake of our own privilege and prestige. The point is that these physicians, regarding whom Dr Weyers has done detailed research, presenting them to us in so human and individual a fashion, are indeed ourselves. They reflect our own possibility in a mirror turned to the past, and yet also in their presentation here they are a warning for the future.Are there not, even about us now, erosions and subtle challenges to our meaning and ideals? Do we not see the practice of medicine becoming a question of politics as much as of care? This book is a morality tale for Everyman, suggesting that complacency is easily led, and duped, by hope until, quite suddenly, the evil is upon oneself, and there is no turning back.Dr Weyers has included numerous photographs, which dramatically complement the text. Most arresting, however, are the portraits, the names of many of whom still grace the textbooks of our own time as a result of their work. In these images we see the actual face of a moment in time when decisions and choices of an almost intolerable sort had to be made by real people. The faces are the faces of ourselves, and they ask us who we are, and what we would stand for.This is a book that not only every physician should read, but a book for everyone who reads. The death of medicine in Nazi Germany: Dermatology and dermatopathology under the swastika Wolfgang Weyers, MD (A. Bernard Ackerman, MD, editor), New York, 1998, Ardor Scribendi (distributed by Madison Books). 442 pages. $49.95 (hardcover); $18.95 (trade paper). As the ranks of those who lived through the era of the Nazi persecutions thin, the immediacy of their memory is, of course, lost. History marches on, and even the collective memory of the two generations subsequent to that tragic period becomes ever more diluted by time and the compelling needs of our own particular circumstance. The fading of memory—collective, familial, and personal—inevitably must occur. But the persecutions the Nazis perpetrated upon their generation will not be forgotten. Those persecutions have become the archetypal paradigm of violence and torture massively authorized by bureaucratic techniques brought to perfection, or rather imperfection as the case might be better made. Everywhere we have powerful reminders of what happened: One thinks immediately of the Holocaust Museum in Washington, DC, the Anne Frank House in Amsterdam, the Dachau Memorial Site, and innumerable lesser memorials that catch the mind and memory. They are always before us, and will remain so. The important point is not that we should merely remember what happened and thoughtlessly pass on, but rather to persist in our study of how and why such distortions of philosophy translated into propaganda and heartless action can occur. By maintaining before us the specific quality of these events as a personal and human tragedy, we can hope to remain alert to the potential, and thereby the prevention, of their recurrence. Wolfgang Weyers' The Death of Medicine in Nazi Germany not only remembers, but places before us in compelling and dispassionate language, as if echoing the cool impersonal words that sent millions to their deaths, an eloquent human testimonial to an obscene moment in history. The perspective of this book is one in which physicians in particular will take great interest, but even though it purports to describe “the death of medicine in Nazi Germany,” it equally describes, in gripping detail, the death of everyone in Nazi Germany. In its first pages, following a helpful foreword by A. Bernard Ackerman, MD, under whom Dr Weyers trained as a dermatopathologist, we are provided an interesting background to the circumstances leading up to the “ultimate solution.” There is fascinating commentary regarding the reasons such a large proportion of Jewish physicians became dermatologists, and therefore dermatology becoming a specialty particularly subject to Nazi attention. Dr Weyers leads us along, step by step and page by tragic page, each anecdote and personality an escalation built upon those that came before, to a crescendo which no one who has read this book is likely to forget. The fascination lies in the details, both of personality and of incident. Through these pages are demonstrated the methods, neither subtly nor slowly applied, by which the Nazi regime within a decade utterly dishonored and degraded a tradition of excellence that German medical practice over the entire preceding century had achieved to the world's admiration. Do not most of us, if only vaguely, remember thinking we should be able to read German to become a physician? All of this was destroyed with an efficiency one might almost admire were it not so utterly stupid. Dr Weyers discusses that destruction through the perspective of the dermatological specialties, illustrated by the experiences of numerous of the greater or lesser dermatologists of that era. The choices these individuals were forced to make, and the doom they (and their families) potentially faced, were of the harshest, hardest kind, but relevant in some degree to every physician in Germany. They are, indeed, yet relevant to ourselves. In this tale, after all, we are introduced to true and veritable villains. There are a preponderant number who attempted to see nothing and hoped for the best. There are those who managed to escape. There are the rather rare heroes, such as Hans Scholl, a non-Jewish medical student who with his sister, Sophie, was executed by the Nazis. And Georg Groscurth (1904-1944), lecturer in Internal Medicine at the Moabit Hospital in Berlin, personal physician to Rudolf Hess, but also a clandestine saboteur who made of his apartment a hideaway and way-station for Jews in flight. Discovered by the Nazis, he was arrested in 1943, and executed 8 months later. His last letter, written to his wife minutes before his death and smuggled from his cell, is poignantly quoted in full, and ends by saying “…the children. You will tell them that they do not have to be ashamed of their father. In a moment it is over. My love, with your noble, dear heart, you will take it well, never despair…Georg.” Somewhat fewer than half of the 566 Jewish dermatologists practicing in Germany in 1933 managed to escape, but only 15 of the remainder survived within the confines of Nazi Germany itself. No survivors could have been left unscathed, and most must have been severely scarred. Having completed this book one feels a tremendous sense of relief. The tendency is to say, to hope, that “it couldn't happen here.” It is very difficult to imagine, in any case, what one might have done under the circumstances imposed upon these physicians who, with their families, seem quite identical to oneself. It is easy to hope that one might have been a “hero” when these challenges are thought about abstractly, read about, and in no way actually forced upon oneself. Beneath that hope, however, lurks the very distinct possibility that one might have been nothing of the sort, and have fallen into that middle group, who did nothing, and simply hoped for the best for so many good reasons. We make do, after all, day by day; accepting by insidious degree what comes; praying for that turn for the better, which surely must occur. As for the villains, they are always there. You and I, each of us reading, assure ourselves that we would not be among this group, egregiously ready to take advantage of an opportunity no matter how craven, ready to advance ourselves literally over the bodies of others for the sake of our own privilege and prestige. The point is that these physicians, regarding whom Dr Weyers has done detailed research, presenting them to us in so human and individual a fashion, are indeed ourselves. They reflect our own possibility in a mirror turned to the past, and yet also in their presentation here they are a warning for the future. Are there not, even about us now, erosions and subtle challenges to our meaning and ideals? Do we not see the practice of medicine becoming a question of politics as much as of care? This book is a morality tale for Everyman, suggesting that complacency is easily led, and duped, by hope until, quite suddenly, the evil is upon oneself, and there is no turning back. Dr Weyers has included numerous photographs, which dramatically complement the text. Most arresting, however, are the portraits, the names of many of whom still grace the textbooks of our own time as a result of their work. In these images we see the actual face of a moment in time when decisions and choices of an almost intolerable sort had to be made by real people. The faces are the faces of ourselves, and they ask us who we are, and what we would stand for. This is a book that not only every physician should read, but a book for everyone who reads.