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Michelle Landahl

Holocaust Journey

Engineering the Death of Lives Not Worth

Living: The Role of Medical Professionals in

Executing “The Final Solution”

13 February 2016

“Only a good person can be a good

physician.”

~Rudolf Ramm, leading Nazi medical ethicist

“Among all criminals and murderers, the most

dangerous type is the physician.”

~Miklos Nyiszli, pathologist to Dr. Josef Mengele

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Introduction

The Holocaust is arguably one of the most well-known and most evil events of human

history. After the horrors of Nazi Germany were brought to light, names like Hitler, Himmler,

and Mengele gained a permanent place of infamy in human history. After liberation, it became

clear that the murderous camps and ghettos established throughout Europe were engineered to

induce suffering from the moment of their inception. Prisoners lived in deplorable conditions

day-in and day-out until their eventual and systematic demise, and it is my belief that an

extensive knowledge of physiological and psychological mechanisms must have been required in

order for the nearly seamless extermination of millions to have occurred the way it did during the

Holocaust. Medical professionals must have played a significant role in the murder of those

millions, but exactly what role did they play in the planning and operation of the genocide, and

how did their insight influence the agony that occurred? My research has yielded results that

indicate the significant involvement of physicians throughout the killing process, even before the

establishment of the camps and up until the end of war.

Mental Hospitals and Sick Minds

The involvement of physicians in the deaths of those opposed by the Nazi regime actually

began before the formal start of World War II. The earliest murders took place in mental hospitals

throughout Nazi occupied countries, where a dangerous mentality had taken hold. For years, Hitler

and his associates and as well as many of his predecessors had been spewing propaganda relating

Darwin’s theories on the “survival of the fittest” to inferior members of society; toward the end of

the 1930’s, this idea began to take hold, and the “inferior” members of society were assigned

identities ("Auschwitz: Inside the Nazi State"). In addition to the Jewish “race,” they included

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homosexuals, the criminally insane, Communists, and those with mental and physical handicaps

(Baumslag 23). During discussions that took place during the summer and fall of 1939, Hitler

made it clear that it would be desirable to put an end to the “life unworthy of life,” referring

predominantly to the mentally and physically ill, although this definition expanded as the war

progressed (Kogon 14). A memo from the Interior Ministry dated 18 August 1939 required

midwives and physicians to report children born with deformities; those children were then taken

to so-called “special child groups,” where they were killed by injections of morphine or

scopolamine, by administering luminal, or by simply leaving them to die of starvation (Kogon 15).

Soon after this decree, Hitler began to select physicians who he believed would be willing

to assist him in his euthanasia goals. With the collaboration of Dr. Herbert Linden, the specialist

in affairs concerning the mentally ill, Hitler’s personal physician put together a list of numerous

leading German doctors who he considered suitable, on the basis of their opinions and their

professional qualifications, to take part in the proposed operation, and in October of 1939, Hitler

issued an order declaring that his appointees “are charged with the responsibility of extending the

authority of certain physicians, to be designated by name. These latter will be able to grant a mercy

death to patients considered incurable according to the best of human judgment.” (Kogon 16). Few

who were recruited refused the position, and with their compliance, the first euthanasia programs

were underway.

In order to determine which patients were going to be euthanized, a one-page questionnaire

was completed by a physician in the clinic in which the patients were housed, and the paper was

processed by two authorities (Caplan 43). One positive decision would warrant the death of the

patient. These “authorities” were compensated between 5 and 10 pfennings for their time, so each

one of their murderous decisions “cost about as much as a cigarette” (Caplan 44).

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When it came to actually killing the patient, many hospitals had already installed gas

chambers. The first experiments testing gases to kill took place in Brandenburg Hospital in January

of 1940, which were spectated by all of the euthanasia doctors (Muller-Hill 65). Viktor Brack,

head of the euthanasia operations in Germany, emphasized that the gassings “should be carried out

only by physicians” (Annas 7). A Nazi report filed in 1942, which some believe implies the

transition from gassing patients to gassing camp inmates, contained the following information

about the planning involved to make the executions run as smoothly as possible:

One of the essential requirements for carrying out euthanasia is that it should be as

unobtrusive as possible…in the first place, the surroundings should be unobtrusive…orders

for euthanasia must be given and executed entirely within the framework of the normal

activity of the ward. Thus, with few exceptions, it should be difficult to distinguish

euthanasia from a natural death. This is the goal towards which to strive. The fact that a

few active psychiatrists with progressive attitudes have been practicing medical euthanasia

in their hospitals and that today a hospital can carry out medical euthanasia without

attracting attention shows that this goal can be achieved (Caplan 69).

The physicians both evaluated and chose those patients who would be killed and supervised their

gassing, in a foreshadowing of the death camps (Lifton 302). Staffed by physicians, hospitals and

asylums used gas chambers disguised as showers, again “in a rehearsal for Auschwitz” (Lifton

301). The patients were even given towels and soap before being ushered off to their demise

(Kogon 26).

This killing within the confines of hospitals went on for nearly two years, and before the

dust settled, an estimated 300,000 patients were murdered (Muller-Hill 70). In the fall of 1941, the

gas chambers at many psychiatric hospitals were dismantled and shipped east, where they were

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reinstalled at Majdanek, Auschwitz, and Treblinka (Annas 224). The same doctors, technicians,

and nurses often followed the equipment, meaning that the same medical professionals working in

hospitals across the country were now running the gas chambers within the death camps

("Auschwitz: Inside the Nazi State"). In this sense, “there was a continuity in both theory and

practice between the destruction of lives not worth living in Germany’s mental hospitals and the

destruction of Germany’s ethnic and social minorities” (Annas 224).

Designing Death

When it came to the camps and ghettos themselves, it is clear that serious planning went

into every aspect of the Holocaust, from manipulating the social climate under the Nazi regime

to the living conditions within the camps themselves. The infamous “special treatment” of the

Jews “was organized by public health officials, physicians, nurses, administrators, and lawyers”

(Proctor 35). Physicians devised and promoted the claim that the very presence of Jews

endangered German families and troops, and this propaganda was distributed through scientific

journals (Muller-Hill 21). Public health became an instrument of Nazi ideology. After the Nazi

takeover of the German government, the National Department of Public Health was dissolved

and replaced by an “expert council” on public health, and by 1941, “Nazi doctors, nurses, and

public health officials were receptive to the final solution as a way out of the self-induced public

health dilemma” (Muller-Hill 22). Jews were blamed not only for the economic problems within

Germany but also for disease, branded “a breeding ground for typhus-filled lice,” and this fear

permeated German society (Müller-Hill 15).

The camps and ghettos themselves were also largely designed by physicians and other

medical professionals. In fact, many believe that it “was the Nazi doctors who initiated pressure

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on high-ranking Nazi officials to progress swiftly to ghettoization” (Gutman 24). By the 1940s,

Nazi scientists were extremely knowledgeable. Physicians recognized the importance of a diet

high in fruit and fiber, and in the early war years managed to enact a law requiring every bakery

to produce whole grain bread (Caplan 37). They were also well-versed in disease pathology. At

the time of the War, typhus was rampant in society, and physicians knew it would be even more

so when a large group of people were confined in a small space with poor sanitary conditions.

The way the small, squalid ghettos were created “made the outbreak of epidemics inevitable”

(Fertig 35). Quarantine coupled with the pernicious unsanitary conditions craftily devised by the

German authority resulted in the spread of disease. In the Warsaw ghetto, 500,000 Jews were

crammed into about 100 acres of land, meaning that if every inch of land was used and every

person was equally distributed, each person had less than 9 square feet to themselves (Fertig 54).

Over 25,000 died in the Warsaw ghetto due to conditions alone (Fertig 55). In the Dvinsk ghetto

in Latvia, 16,000 people were confined to the ghetto, but only 100 survived a four month

quarantine (Baumslag 57). Were these conditions created by neglect and apathy to human

suffering, or by sinister and murderous planning? Testimony at the Nuremberg trials claimed that

there “was no doubt that the German medical authorities and their collaborators knew that they

were deliberately exposing the Jews to a typhus-rich environment” (Baumslag 56). The

technologies of typhus eradication and repulsive conditions used first within the ghettos and later

in the camps “were murderous by design and thinly camouflaged genocidal intentions” (Lifton

67).

Physicians continued to use their knowledge about the human body to facilitate

concentration camp functioning as well. They could make determinations on who could

withstand a beating and be made an example of, and who could not (Gutman 54). They

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determined that a diet consisting of 600 calories could sustain a person and 1100 could sustain a

worker on the brink of death but provide him with enough strength to work, so diets meeting

those needs were given to those who were still valuable to the Nazi regime in some way

(Gutman 62). The others were plucked from the herd by physicians and escorted to their death at

the hands of other doctors, those who had turned their backs on the Hippocratic Oath that they

had sworn to uphold.

Executing the Executions

Prior to the establishment of Auschwitz and other death camps, the Nazis had developed

“a policy of killing within medical channels, decided by medical means and carried out by

doctors and their assistants” (Baumslag 28). This idea was continued when it came to genocide

in the camps. In 1941, Heinrich Himmler issued an order that medical boards should visit all

concentration camps to sort out all those prisoners who were unfit for work, ill, or psychopaths

(Communists) (Caplan 68). Himmler recognized the special role of physicians in this regard; he

understood the power of the faith that people put in doctors and their belief that physicians meant

only to heal and never to harm. This trust was knowingly manipulated and abused throughout the

course of the war. In the years that followed Humbler’s declaration, the Nazis continued to

capitalize on the general public’s faith in physicians. On March 9, 1943, the Reichsfuhrer of the

SS issued an order that only physicians trained in anthropology could perform selections at

concentration camps (McKale 72). These appointed physicians knowingly determined who

would live and who would die on a daily basis.

In the search to find a way to quickly and effectively kill mass numbers of people, an

experiment was conducted at Auschwitz on September 3, 1941, using the gas prussic (HCN)

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acid, known commercially as Zyklon B ("Auschwitz: Zyklon B”). Eight-hundred and fifty

people were gassed, and the Nazis had discovered a successful method of mass murder, although

there was some delay between its discovery and its application due to its expense and the Nazis

desire for their murderous intentions to remain low-profile (Kogon 89).

From the spring of 1942 until the fall of 1944, the operation designed to annihilate

European Jews functioned almost flawlessly as trains poured in from Nazi occupied countries

and European satellites of the Third Reich (Fertig 6). At this point, Nazi doctors, using

knowledge gained through intelligence and/or experimentation, were prepared to utilize

numerous methods of murder to complete their genocidal goals. Benzine, gasoline, hydrogen

peroxide, epivan, prussic acid, chloroform, and air were all substances injected into the veins of

victims to achieve death (Caplan 98). Of these methods, phenol injected directly into the heart

was discovered to be the most “inexpensive, easy to use, and effective method” (Caplan 9).

When enough Jews had been transported to the camps, however, Zyklon B and carbon monoxide

from diesel engines became the method of choice to kill the most people per day. It took victims

up to 20 minutes to succumb to the cell-stopping effects of Zyklon B and potentially 2 to 3 hours

to suffocate by diesel engine fumes (“Auschwitz: Zyklon B”).

By 1942, three major extermination centers were operating – one in Belzec (at its peak

murdering 15,000 per day), another in Sobibor (20,000 per day), and a third in Treblinka which

could gas 25,000 persons per day (Weindling 45). Kurt Gerstein, a German chemical engineer in

charge of the technical disinfection with highly toxic gasses, testified that the system was

organized to cause the minimum resistance and to utilize as few staff members as possible:

“You just have to breathe very deeply, that strengthens the lungs, inhaling is a means of

preventing contagious disease. It’s a good disinfection.” They were packed into the gas

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chambers, and the doors were shut. Exhaust fumes from a diesel engine filled the room.

SS doctors and others watched through specially constructed peepholes on the door of the

gas chamber. Metal grids covered the peepholes so that the people inside could not try to

break it to get air (Gutman 62).

Testimonies such as this one were later used against those proclaiming their innocence or lack of

knowledge or involvement in the murders; prosecutors could use their own incriminating words

against them.

In smaller camps and ghettos where gas chambers were not cost-effective, both portable

and stationary gas vans were employed (Kogon 53). Prisoners could be discreetly loaded in the

back, suffocated with carbon monoxide fumes delivered through a specially designed ventilation

system, and then transported to a secret dumping ground to risk anyone discovering the bodies

(Kogon 52). This allowed the Nazis to kill numerous people quickly and then simply drive away,

leaving no evidence behind.

Physicians played a role even after death; once the screaming from the chambers ceased,

dentists were sent in to hammer out the gold teeth, bridges, and crowns of the victims (Gutman

63). These gas chambers were designed to be innocuous; the Nazis exploited expectations of

routine delousing using prussic acid, and gardens were even planted outside of the chambers to

give the illusion of a bathhouse (Gutman 64). After the war, it became clear that “doctors were

actively involved in all aspects of the façade” ("The Doctors Trial: The Medical Case of the

Subsequent Nuremberg Proceedings").

Physicians were also responsible for supervising their medical technicians trained in the

use of Zyklon B for gassing. They “brought the Zyklon to the gas chambers in Red Cross luxury

cars, saw that disinfectors were protected with gas masks, and were responsible for declaring the

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disinfected dead” ("Auschwitz: Zyklon B”). They even provided technical expertise for the most

cost-effective method of destroying bodies (Baumslag 47). Although many medical professionals

professed their innocence after the end of the war, their involvement was clear from

documentation as well as eye-witness testimony; the blood of nearly 11 million people was

predominantly on their hands.

Conclusion

World War II ended in 1945 soon after the United States’s involvement. In an attempt to

evade capture and discovery from the impending Russian front, many of the concentration camps

were either razed or evacuated, with the Nazis forcing inmates on death marches through the

brutally cold countryside. They could not run forever. When all was said and done, the Jewish

death toll alone was conservatively estimated at 800,000 from ghettoization, 1.4 million from

shootings, and 2.9 million murdered in the camps ("The Nazi Doctors"). From there, the world

was left to pick up the pieces. The Nuremberg Trials brought some perpetrators to justice, but

many escaped to other countries, and others were merely protected through anonymity. To this

day, the identity of many of the physicians who engineered this historic genocide remains

unknown. If we cannot put a face to their crimes, let us not let their deeds be omitted from

history as well. We must face what they have done in order to better understand where medicine

went mad during this dark time in history. The only conclusion and closure we may gain from

this is if we use this awareness to make sure that something like this happens “Never again.”

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Bibliography

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This is an article published by the reputable Public Broadcasting Service detailing the

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website includes historical reports and references primary source documents.

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