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An Incomprehensible World

Book Essay on: Robert Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide
( New York: Basic Books, 2000), 561pages.
UCSB: R853.H8 L54 1986

by Melissa Wasserman
April 28, 2010

for Prof. Marcuse's lecture course
The Holocaust in European History
UC Santa Barbara, Winter 2010

About the Author
& Abstract
Book available at Amazon.com ($16)

About Melissa Wasserman

I am a senior religious studies major whose grandmother and grandfather are both Holocaust survivors. My grandmother, Esther Wasserman, was taken from the streets of her hometown in Zwolen, Poland and placed in the ghetto. She was transported to five concentration camps throughout the war: Tschenstochau, Skarzysko-Kamienna, Ravensbruck, Burgau and Turkeim, where she was liberated on April 25, 1945. My grandma Esther had four siblings of whom she was the oldest. Her youngest sister was Miriam, her youngest brother David, then Yisrael and Chil, who was the eldest boy. Her mother, Chuma Ajlman, her father, Shmuel Moshe Ajlman, Miriam (age 6), David (age 9), and Yisrael (age 14) were all killed in Treblinka death camp. Her brother Chil was a partisan and is still alive today, living in Netanya, Israel. My grandfather, Max Wasserman hid throughout most of the war, he survived by stealing from farms in Poland and living off of rotten pears and old crops. He was forced to dig his own grave, but miraculously escaped into the woods. He ended up in Turkheim, Germany where he met my grandmother in the displaced persons camp within the city after the war. My father was born a year later in 1946 and when he was six months old, they immigrated to America. I chose to write about Lifton’s book because psychology, in particular how the Holocaust mentally and psychologically affected both Jewish survivors and Nazi perpetrators, interests me greatly. I am also very interested in the trans-generational effects of trauma on Holocaust survivors’ children and grandchildren, as I believe that my grandparents experience during the Holocaust is a major part of my Jewish identity, and my life.

Abstract (back to top)

Lifton’s Nazi Doctors presents a comprehensive survey of how doctors facilitated genocide and assisted in the implementation of the “Final Solution.” He portrays the nazification of medicine that guided the transformation of physicians from trusted healers to killers of the state. Lifton presents how medical killing affected the Nazi doctors and in order for them to cope with the atrocities they were committing; they created “double” personalities to mask the feelings of guilt and to create a veil over their moral wrongdoings. I argue in “An incomprehensible World”, that through the actions of the Nazi physicians, it was possible for Nazi ideology to be implemented in a scientifically methodological way. By designating physicians as ideologically corrupted leaders, a medical justification was created for the execution of the “Final Solution.”

Essay (back to top)

Robert Lifton’s The Nazi Doctors explains the development of physicians from mere healing servants of the German state to killers protecting the biomedical integrity of the Third Reich. Lifton describes his goal to “uncover psychological conditions conducive to evil” by interviewing doctors who were absorbed in Hitler’s “Final Solution” and survivors who endured the atrocities of Auschwitz (Lifton 12). At the heart of the Nazi regime’s ideology was the successful destruction of medical doctors as healers, transformed into murderers. As Lifton interviews the SS physicians, their transformations become apparent to readers, and to themselves. Their involvement in the medical killings was crucial for Hitler’s ideology to become reality, but through their participation they acquired psychological consequences, such as personality doubling, alcohol dependency, emotional numbing and feelings of guilt.

The Nazi regime was built on a biomedical vision of racial purity. That ideology greatly contributed to the “nazification of Medicine” in which the medical profession became tangled in the web of politics(Lifton 30). The crucial moment of the advancement of Nazi policy was the transformation of the physician. Rudolf Ramm, a Nazi doctor who Lifton interviewed, explained an absolutely necessary “change in the attitude of each and every doctor, and a spiritual and mental regeneration of the entire medical profession.” He continued to explain that every veritable physician “must not only be a party member on the outside, but rather must be convinced in his heart of hearts of the biological laws that form the center of his life” (Lifton 33). The reorganization of the medical profession was called Gleichschaltung, a German word meaning “synchronization” or “coordination” (Lifton 33). Hitler expressed this term as an engulfing vision of unity and absolute identity: a consolidation of the Volk.

From the beginning, the Third Reich emphasized the integrity of the Volk. The state had the right to kill to defend the integrity of those with German blood. Doctors who participated in killing for the state (euthanasia) underscored that what they engaged in was destroying life that was unworthy to live. Alfred Hoche, professor of psychiatry at the University of Freiberg, vowed that the state’s policy of killing was compassionate and most certainly consistent with medical ethics. He argued that people with any kind of mental illness were already dead; they were “empty shells of human beings” (Lifton 47). The implementation of the state’s euthanasia programs began with the killing of children. Upon birth, midwives were required to make reports of malformations of all kinds, and doctors were obligated to make similar reports of all children up to the age of three. Euthanasia was directly implemented into the lives of physicians so the program would pass as something medical and therefore something trusted. Everyone was to act as if the “biologically invaluable” children were going to be therapeutically healed. There were various types of falsifications and deceits in order to persuade the family members and the public that what these doctors were performing was some sort of therapy. However, in some instances the general public was not the only one being deceived. The Reich misled many doctors into believing that what they were doing was the work of the nation, and therefore it was biologically relevant to do so. There was a strict medical structure that was upheld in the program, and that sort of theme influenced into the forming of concentration camps in the Holocaust.

The specific medical structure functioned as a way to diffuse responsibility. The doctors themselves were euthanizing by the order of the state and the state was merely creating the programs to be acted upon by the doctors. The state diffused responsibility by claiming that its hands were not the ones directly killing patients. Under the policy of the T4 program, a licensed doctor had to directly kill the patient and it was not permitted for anyone without a medical license to do so (Lifton 71). Hans F., a doctor who was involved in the killing process, described, “According to the thinking of that time, in the case of children killing seemed somehow justifiable” (Lifton 57). He continued, “when [the children] arrived, they had been insufficiently fed and were in terrible condition. The events were arranged so that the killing was not quite killing” (Lifton 57). Doctors similar to Hans F,, must have known the situation that they were immersed into as well as aware of their own personal healing-killing reversal.

In October 1939, a policy that extended the right of medical killing to both adults and children was implemented, also known as the T4 Program (Lifton 62). However, the decree was backdated to September so the policy could be directly linked to the war (Lifton 63). The T4 program was executed through questionnaires in which there was a great amount of stress put on the patient’s ability to work. When a physician or psychiatrist selected a patient, they were loaded onto a bus and taken to “transit institutions.” The destination of where the bus headed was generally kept a secret to maintain the discretion of the project. The first gas chamber used for medical killing was constructed by Christian Wirth and lent to the T4 program. There was constant need for the murder to be “medically legitimized” even thought the Nazis were aware that the program was psychologically detrimental to the doctors’ health. Since shooting and injections seemed to have a greater psychological effect on physicians, gas was preferred (Lifton 78).

Many doctors found some way to associate their euthanasia work with a sort of scientific research to ease the sense of guilt. When Nazi doctors experienced conflict in the work they were doing, they found ways to “subdue those conflicts in adaptation to a murderous environment,” however many fell short of an actual moral confrontation (Lifton 107). Johann S. was very excited about the idea of “biological truth” and participated closely in the nazification of German medicine (Lifton 129). He was sympathetic to “euthanasia” because he felt that the program was a blessing for medical patients who would never have the chance to live a truly normal life and to be released from their “burden”. However, in contradiction he was also very critical the actual project. He objected to the Nazi state being able to take human life but thought that solely doctors should be able to conduct medical killing. S. described his attitude toward Hitler as worshipful (Lifton 131), however, at the same time he said that it was very unfortunate that Hitler became a “godlike being” (Lifton 132). Johann seemed to have many contradicting ideas and statements about the matters of the Nazi party, and because of this, he was another product of what Lifton calls “doubling.”

The transition from euthanasia to genocide was achieved through Special Treatment 14f13. Physicians no longer needed in the T4 program were sent off to the camps to supervise murder operations there. Instead of being limited to mentally ill patients, this program opened its doors to political prisoners, Jews, Poles and criminals (Lifton 137). However, with the inclusion of able-bodied workers, a problem arose that continued to surface throughout the war. One faction of the SS wanted to exploit these prisoners for their own economic benefit, while others wanted immediate mass extermination. This internal conflict within the Nazi regime was never fully resolved because both mass murder and slave labor took place at the camps, satisfying both Nazi ideology and economic benefit.

Doctors participated in selection killing to prevent overcrowding, spread of disease and to weed out those who were no longer “valuable” to the state. It was not necessary for the doctors to conduct the selections, but because they did so they sank right into the healing-killing paradox (Lifton 149). “The Nazi Impulse was to bring the greatest degree of medical legitimation to the widest range of killing” (Lifton 138). However, some of the doctors saw the healing-killing paradox as something that was not morally or ethically wrong. A Nazi doctor explained that out of respect for human life, he would remove a gangrenous appendage from a diseased body just as he removed the gangrenous appendage [Jew] from the Volk (Lifton 16).

As a result of this transformation from healer to killer, many doctors had an extremely hard time mentally adapting to the new role. Conforming to the newly developed “Auschwitz self” (Lifton 212) became quite difficult for those who had consciously taken and wanted to maintain their Hippocratic oath. Most consumed alcohol to make the transition easier. One SS doctor described it: “In the beginning it was almost impossible. Afterward it became almost routine. That’s the only way to put it” (Lifton 195). Everyone was expected to resign to their “Auschwitz self,” and those personas became socialized easier with the isolation of the camp from the outside world. Not only were the doubled personas physically isolated from the outside world, they were also morally disconnected from the outside world and their original personas. That emotional and moral numbing became an important part of the “medical killing self” that more or less separated from the rest of the original self in the process of doubling (Lifton141).

Dr. Ernst B. recalls the two different psychological sets of Nazi doctors’ moral selves: “one based on ‘values generally accepted’ and the education and background of a ‘normal person’; the other based on ‘this [Nazi-Auschwitz] ideology with values quite different from those generally accepted’” (Lifton 211). Dr. B., explains the fact that Nazi doctors had the capacity to understand exactly what they were doing, but sort of turned their backs on their ‘normal person’ values and embraced the ‘Nazi Auschwitz’ ideology by the formation of the double self. Once the double self was formed, “atrocity begot atrocity”, and the continuity of killing persisted in order to continue justifying the actions of the “Auschwitz self” (Lifton 213).

Lifton defines doubling as: “the division of the self into two functioning wholes, so that a part-self acts as an entire self” (Lifton 418). There was a certain transfer to the doubled self in order for the doctors to avoid feelings of a guilty conscience. Lifton explains that doubling occurs as an adaptive defense mechanism rather than a character schizophrenic disorder. He goes even so far as to say that even though Nazi doctors experienced doubling in different ways, all of them doubled (Lifton 424). By doubling, the doctors possessed some sort of hope of a world after Auschwitz. Even the institution doubled by using euphemisms such as “The Final Solution,” a term used for mass murder; which also served a psychological purpose to create a lighter environment and a pragmatic (scientific) situation for doctors to participate in more. The key function of the doubling and numbing is to attempt to avoid feelings of guilt and responsibility when one was involved in mass murder. Even though the doctors created this separate persona, distanced from the world and involved in a great phenomenon of bettering their nation, not a single doctor (of those with whom Lifton spoke) arrived at a clear ethical evaluation of what they had been involved in (Lifton 8).

While attempting to put his Auschwitz experience in words a Holocaust survivor describes: “this world is not this world” (Lifton 3). The Jewish survivor indirectly questions “our capacity to approach Auschwitz,” and is not the only one to examine the dilemma. An eastern European physician survivor explains: “We ourselves who were there, we will never understand it, because it cannot be understood” (Lifton 13). The theme of the incomprehensibility of the world of Auschwitz not only applies to the atrocities that occurred, it applies to the transformation of doctors from healers to murderers, the psychological destruction of survivors, Nazi doctors, and the events themselves, which will never be entirely grasped. In fact, the events that took place during the Holocaust were so horrific that the world became a place that was morally inconceivable.


Annotated Bibliography and Links (back to top)(links last checked 4/28/10)

Book Reviews

  • Benny Kraut, "The Nazi Doctors (Book)", Library Journal 111.15 (1986): 29-29. Academic Search Complete. Web. 27 Jan. 2010.

    Benny Kraut explains Lifton’s psychoanalysis as a phenomenon and explains that the Nazi’s that participated in the medical killing had an extreme alteration of values that were morphed into an idea of their actions as societal therapy. He states that Lifton’s book addresses the question of how the Nazi doctors devalued their Hippocratic Oath and became “killer-healers”. Kraut calls the book an essential read that is profound, thought- provoking and a remarkable achievement.

  • Robert Gellately, "Medicine and Collaboration Under Hitler", Canadian Journal of History 26.3 (1991): 479-85. Academic Search Complete. Web. 27 Jan. 2010

    Gellately addresses Lifton’s link between the doctors being both healers and killers. He notes that Lifton does not address the history of medicine within Germany and how “nazification” affected the medical process. He makes the broad statement that German physicians offered themselves freely to the Third Reich and had a certain clout because of their intellectual authority. However, he then goes on to say that there was some sort of medical resistance that took place within Nazi Germany.

  • Geoffrey Cocks, "The Nazi Doctors (Book Review)", American Historical Review 94.2 (1989): 477-77. Academic Search Complete. Web. 27 Jan. 2010.

    Geoffrey Cocks explains that Lifton’s book accurately conducted studies based on interviews: however, does not take into consideration any documentary findings. Cocks criticizes the book’s idea of “doubling,” which conveys the idea that the doctors killed human beings in order to assert their power in the world. He refers to Lifton’s “doubling” as an “outdated generalization about the German psyche (p 477). Cocks also criticizes Lifton for not accurately portraying the book from an historian’s perspective.

  • Fritz Stern, Foreign Affairs 65.2 (1986): 404-405. Academic Search Complete. Web. 27 Jan. 2010.

    Fritz explains Lifton’s “doubling” concept. However he acknowledges that Lifton expresses that there were “decent Nazis” who seldom acted with some “normality” and thought of themselves as untainted by the Nazi regime’s ideology. Lifton considers that what the Nazi doctors did—most people and most doctors were/are capable of doing.

  • Baruch Connie Cohen, "The Ethics of Using Medical Data from Nazi Experiments" Jewish Law Articles. Ira Kasdan, 1997. Web. 5 Mar. 2010.

    In this article, Cohen creates a very comprehensive outline of the Nazi Medical Experiments, its ethical criticism, validity, and benefits to society. He refers to the data that was collected during the Nazi Medical Experiments as invalid because the experiments were ethically tainted. He briefly explains some of the experiments that the Nazi’s performed and then describes how some proposed the usage of the Nazi data. He then goes on to analyze the scientific validity of the experiments conducted by the Nazi’s and then goes even further describing other incidents of morally tainted data and the dilemma with those cases as well.

Books and Articles

  • George Annas, The Nazi Doctors and the Nuremberg Code: Human Rights and Human Experimentation New York: Oxford University Press, 1992. ISBN 0195101065

    This book presents a series of articles written as a detailed account of the generation of the Nuremberg Code. It surveys the document’s relevance to the field of human experiments. The beginning of the book overviews experiments conducted by Nazi doctors during the Holocaust, then proceeds to focus on its relevance to America, including ethical issues that are raised by modern research and human experimentation.

  • Vivien Spitz , Doctors from Hell: the Horrific Account of Nazi Experiments on Humans Boulder, Colo.: Sentient Publications, 2005. UCSB Call Number: Sciences Engineering Library R853.H8 S68 2005

    Vivien Spitz describes the Nuremberg Trials in Germany in reference to the official records that she reviews of the trials. She records the trials of 20 Nazi doctors who were charged during the trials. She cites experiments of the concentration camps and explains that the experiments portrayed an immoral world devoid of any sense of medical ethics.

Relevant Websites

  • Baruch Connie Cohen, "The Ethics of Using Medical Data from Nazi Experiments" Jewish Law Articles. Ira Kasdan, 1997. Web. 5 Mar. 2010.

    In this article, Cohen creates a very comprehensive outline of the Nazi Medical Experiments, its ethical criticism, validity, and benefits to society. He refers to the data that was collected during the Nazi Medical Experiments as invalid because the experiments were ethically tainted. He briefly explains some of the experiments that the Nazi’s performed and then describes how some proposed the usage of the Nazi data. He then goes on to analyze the scientific validity of the experiments conducted by the Nazi’s and then goes even further describing other incidents of morally tainted data and the dilemma with those cases as well.

  • Louis Bulow, Angels of Death 15 Nov. 2002. Web. 5 Mar. 2010.

    This website provides a brief explanation of the head doctors who conducted experiments in Auschwitz, such as Josef Mengele, Carl Clauberg, Karl Brandt and Johan Kremer. The site also gives accounts of survivors of the Auschwitz experiments including the account of a twin survivor who was experimented upon with her sister. There is also a page that explains several of the experiments that were conducted as well as extremely graphic photos of some of the experiments.

  • United States Holocaust Memorial Museum, "Online Exhibitions | The Doctors Trial." 1996. Web. 06 Mar. 2010.

    In commemoration of the 50th anniversary of the trial of Nazi doctors, the USHMM published an official record of the trial, including opening statements, indictments, testimonies and sentences. Information is presented about all of those accused guilty and on what counts including photographs of the prisoners. Excerpts from Father Leo Miechalowski and Vladislava Karolewska are presented. Father Miechalowsky was a priest in Poland who was arrested and deported to Dachau. He was selected as a participant in experiments concerning malaria and was injected with various compounds. Karolewska was a member of the Polish resistance and when captured was deported to Ravensbruck were she was selected to be tested in bone regeneration experiments.

(back to top)

Any student tempted to use this paper for an assignment in another course or school should be aware of the serious consequences for plagiarism. Here is what I write in my syllabi:

Plagiarism—presenting someone else's work as your own, or deliberately failing to credit or attribute the work of others on whom you draw (including materials found on the web)—is a serious academic offense, punishable by dismissal from the university. It hurts the one who commits it most of all, by cheating them out of an education. I report offenses to the Office of the Dean of Students for disciplinary action.

prepared for web by Melissa Wasserman on 4/28/10; last updated: 11/21/10
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