Copyright (c) 2000 First Things 101 (March 2000): 80-84.
The Death of Medicine in Nazi Germany: Dermatology and Dermatopathology Under the Swastika. By Wolfgang Weyers, M.D. Madison Books. 472 pp. $18.95.
The Nazi War on Cancer. By Robert N. Proctor. Princeton University Press. 365 pp. $29.95.
Reviewed by Wesley J. Smith
For lovers of history and those interested in preserving cultural morality and virtue, the Nazi era is a mine that never runs out. Evil has rarely been so open, notorious, corrupting, and successful: tens of millions slaughtered in war, millions more killed in organized genocide; the ethical practice of medicine subverted to the point where German doctors willingly exploited and murdered their weakest and most vulnerable patients; a once proud and civilized nation reduced to the habits of a rabid dog.
Even now, more than fifty years after the horror, we find ourselves compelled to sift repeatedly through the ashes, to seek, to question, to inquire, to learn and relearn the lessons necessary to ensure that "Never again!" remains our enduring commitment.
In this regard, vigilance is acutely necessary in the medical sphere. As in Germany in the 1930s and 1940s, in America today Hippocratic values and the sanctity of life ethic are under attack. A cadre of elite academics, moral philosophers, lawyers, and other members of the intelligentsia, known generically as bioethicists, seek to replace these traditional values with what they call a "quality of life ethic," in which the moral value of human life is viewed subjectively instead of objectively. In bioethics thinking today, most often it is not the "human community" that matters but the "moral community."
Only "persons" inhabit this moral community, which wouldn’t be a problem except that in modern bioethics, all humans are not necessarily persons. Some among us—the so–called nonpersons—count for less than others and may be excluded from the community itself, thereby being deprived of the rights and pro tections that persons enjoy. Among those at risk in America today are infants (particularly those born with disabilities), people with dementia and other profound cognitive disabilities, the dying, and the frail elderly—the same groups who fell victim to German doctors under the Nazi regime.
As in Germany then, so today in the United States euthanasia and assisted suicide are being energetically promoted and practiced. Indeed, people diagnosed with terminal illness in Oregon may ask their doctors to prescribe a lethal overdose for use in assisted suicide. On the other side of the country, Peter Singer, the world’s foremost proponent of infanticide, whose philosophy and values clearly echo those of prewar Germany, is now a tenured bioethics professor at Princeton University.
It is in this context that two new books on the German medical Holocaust are worth considering. Although completely different in their approaches and areas of concentration, both books provide valuable knowledge and insights into the history of that awful era and reveal disturbing parallels to our own times.
German author Wolfgang Weyers’ The Death of Medicine in Nazi Germany takes a unique approach to the tale of the medical Holocaust. Weyers’ style takes a while to grow on the reader, but in the end, it works quite well. The author methodically takes us through the fall of German medicine in a linear, A–to–Z fashion, beginning with the history of anti–Semitism in Germany, through the pre–Nazi attack on Hippocratic ethics, the Nazification of German medicine, and the resulting medical horrors. He ends with a chapter on the postwar years in which we learn that most doctors who participated in the medical evils of the time paid no significant penalty.
This story has been recited in several worthy books, perhaps most expertly by Robert Jay Lifton in The Nazi Doctors, and if Weyers’ general historical recitation were the sum and substance of The Death of Medicine in Nazi Germany, the book would be of only passing interest. Fortunately, the "big picture" is not all that interests Weyers. After first providing a relatively brief macro history in each chapter, he turns quickly to individual stories, a method that makes his book different from others of its kind and, in the end, an important contribution.
Weyers is a dermatologist and the official historian of the International Society of Dermatopathology, and he puts his dual interests to good use. He describes, in sometimes excruciating detail, how the times and events of that era influenced the medical specialty of dermatology as a whole and the physicians who practiced in the field as individuals. Making the story even more personal—and chilling—are the approximately 250 photographs of individual dermatologists from the era that make palpably real the human beings over and through whom the Nazi tyranny marched.
It is not a pretty story. We learn, for example, how prior to the coming of the Nazis, the field of dermatology was top–heavy with Jewish practitioners due to the general anti–Semitism of the medical profession of the time; dermatology was more open to Jews than other fields because it was considered less prestigious. Partially as a result, German dermatology was for a time the most advanced and professional in the world.
Then the horror arrives. We witness individual Jewish dermatolo gists—professors, medical association leaders, and some of the best practitioners in the specialty—victimized by the early Nazi directives that drove Jewish doctors out of medicine. Different people reacted in different ways. Some saw the future before it arrived and fled to other countries, particularly the United States. Others self–identified as loyal Germans and refused to leave. Many of these were not only forced out of medicine, but were eventually beaten, driven from their homes, forced into ghettos, gassed.
Weyers names the names and tells the stories of the "opportunists" who filled the vacuum left by the Jews, and he details the consequences for dermatology, which under Nazi auspices quickly became inhabited by quacks and charlatans. Like other areas of German life, dermatology became highly politicized, so Nazi friend and foe alike walked on proverbial eggshells. When Professor Eric Hoffman, a world–renowned dermatologist and an initial supporter of the Nazi takeover, finally realized the evil that had been unleashed, he tried in vain to keep his university from becoming Nazified, resisting the attempts to promote incompetents who were politically converted. For his troubles, Hoffman was denounced to the Gestapo by his own colleagues and was soon removed from his university chair. Overt Nazi supporters were also sometimes victimized. When Josef Hamel, chair of the Department of Dermatology at the University of Jena, observed three of his students smashing a bust of Hitler, he reported falsely that the sculpture was broken accidentally. He too was reported to the Gestapo and sent to Buchenwald for six weeks for covering up the "political crime."
After the war, as dermatologists tried to rebuild their broken specialty, some universities invited their exiled Jewish colleagues back into the fold. Few returned. Weyers climaxes his book with the letter of Pro fessor Emil Meirowsky, who refused reappointment to the University of Cologne with eloquent and righteous rage: "You have forfeited your call as professors," Meirowsky wrote to the dean of the medical faculty, "your call as doctors, as protagonists of humanity irrespective of race, creed, and color: I am called upon by my conscience to ask you to delete my name from the archives of your faculty."
This is history with a small "h," and it takes a little getting used to. But in the end Weyers’ approach works in a manner akin to a newspaper photo graph made up of dots in which each dot forms a tiny part of a total image. By focusing so intensely on the personal stories and tragedies of individual dermatologists, Weyers slowly brings into focus the larger historical picture and compellingly depicts the true evil that German doctors helped unleash on their patients, each other, their nation, and the world.
I am not quite sure what to make of The Nazi War on Cancer by Robert N. Proctor, a book that describes the German medical approach to treating and preventing cancer and the concerted effort made by public health authorities to combat smoking during the Nazi years. There is no question that Proctor has performed an admirable research job uncovering fascinating, unexpected, and, in a few cases, extraordinarily arcane historical nuggets. German medicine’s approach to cancer during the Nazi years, Proctor reports, was literally decades ahead of its time. The Germans understood the connections of smoking, pollution, and diet to cancer, and saw that early detection was the key to prolonging and saving life. Accordingly, the pub lic health authorities threw themselves energetically into cancer awareness and detection campaigns and even provided mass cancer screenings.
It is striking to realize that the Nazi government’s methods were virtually identical to those currently employed in the United States and Canada. Then as now, public service announcements sought to dissuade people from smoking using celebrities (especially the nonsmoking Hitler) as examples. Then as now, tobacco companies were accused of addicting children. Then as now, restrictions were placed on tobacco advertising and smoking was banned in some public buildings. There were also serious calls for the government to ban all smoking in the workplace, and counseling centers were estab lished to help people overcome their nicotine addiction.
This is all well and good, as far as it goes. The problem with The Nazi War on Cancer is that after unearthing some very provocative and intriguing facts, Proctor doesn’t do anything with them. He asserts, in an odd comment, that the Nazi campaign against smoking was "as fascist as the yellow stars and death camps." Does that mean our own anti–tobacco efforts are a quasi–fascist enterprise? Further, should we be alarmed by the striking similarities Proctor has uncovered between the Nazi methods of medical and public health advocacy and those of our own time? Having opened these and other interesting and important doors of inquiry, he doesn’t take us through them. Instead, he writes rather tepidly:
The history of science under Nazism is a history of both forcible sterilization and herbal medicine, of both genocidal "selection" and bans on public smoking. We do not need to forget Mengele’s crimes, but we should also not forget that Dachau prisoners were forced to reproduce organic honey and that the SS cornered the European market in mineral water. Both elements—the monstrous and the prosaic—are key.
The key to what, exactly? The author doesn’t say. And that’s a shame, because Proctor presents the reader with parallels that we ought to worry about and ponder.
Wesley J. Smith is the author of Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder. His next book will be Culture of Death: The Destruction of Medical Ethics in America.