| Exhibition Reviews | Health and History, 10.2

Exhibition Reviews

Darkest Page in the History of Medicine

Nazi Medicine, a travelling exhibition from the Sydney Jewish Museum, Darlinghurst—touring university medical schools across Australia, 2008–09.

http://www.sydneyjewishmuseum.com.au/exhibitions/past.asp

(accessed 12 November 2008) Seen at Sydney Jewish Museum, Darlinghurst, 5 June 2008.

The Nazi Medicine exhibition aims to raise awareness of the role played by medical practitioners and scientists in human medical experiments conducted during World War II (WWII) in Nazi Germany. It was conceived, researched, and authored by Dr. George Weisz, a Sydney-based orthopaedic surgeon, in collaboration with Roslyn Sugarman, curator, and Prof. Konrad Kwiet, historian, at the Sydney Jewish Museum. The targeted audience includes the general public (although it may not be suitable for children), but with a special focus on increasing awareness amongst medical students about what Weisz calls 'the darkest page in the history of medicine.'

The Sydney Jewish Museum, where the exhibition was originally shown, was officially opened in 1992 in the old Maccabean Hall, Darlinghurst, not far from Kings Cross Station. To access the Nazi Medicine exhibition itself one had to walk through the large, more extravagant Holocaust displays that graphically illustrate the atrocities of the Nazi regime—setting the tone for the visit. The permanent exhibits include interactive displays and can be augmented by personal tours by Holocaust survivors if arranged. These features make them intellectually accessible and give some intensely personal insights into the events of the Holocaust, justifying the many awards the museum has received including the Award of Distinction in the NSW Tourism Awards for Excellence and a Commendation at the 1995 Human Rights Awards.

Image 1: Dr. George Weisz holds a talk about the exhibition. (Courtesy of the Sydney Jewish Museum.).

After traversing the path through the permanent exhibitions, one entered the temporary exhibition area where the Nazi Medicine display was situated. A first impression was the paradox created by juxtaposing the warmth of softened lighting, furnishings and colours of the immediate surrounds, with the abject cruelty the exhibition's subject matter depicts. On the day of my visit, Dr. Weisz spoke about the development of the exhibition and acknowledged that it was inspired by a $US200,000 exhibition in the USA. Without the funds for such an elaborate creation he wanted to produce the same message without the magnificence and believed that a modest design could still stimulate thought and active refl ection. Consequently Nazi Medicine consists of a set of textual panels complemented by two video documentaries and models of surgical equipment used in WWII. Although this spareness was in sharp contrast to the sculptures and interactive exhibits of the museum's permanent galleries, it nevertheless allowed the exhibition to provoke thought on the social justice and ethical considerations associated with the Holocaust and enabled visitors to place the historical in a contemporary context. It also meant that the exhibition has been suitable for touring to other locations after its initial season at the Sydney Jewish Museum.

The exhibition deals with what the author has framed as the 'Four E-steps: Eugenics, Euthanasia, Extermination and Experimentation' in a way that reveals the events, for the most part, without telling the audience what to think about them, thus facilitating the process of active reflection. Instead of encouraging visitors to automatically label the cruel experimentation as monstrous, this matter-of-fact presentation assists them to think about how the events were allowed to occur. Consequently the exhibition is shock-inducing in that it provokes reflection on the darkness of humanity, not as an abnormality, but rather as an aspect of humanity which may arise when ethical bounds are removed and people are allowed to explore their darkest intentions. In Germany, the context for this exploration was the Eugenics program of the Nazi Regime which sought to achieve the 'perfect race' and in the process conducted forced euthanasia, sterilisation and experimentation on children with disabilities, gypsies, homosexual persons and Jewish people. The experimentation and forced sterilisation of children deemed disabled or malformed was for the most part conducted by German doctors and scientists— often experimenting on their own compatriots.

It would be easy to label the perpetrators of the Nazi experiments as simply monstrous but what the exhibition succeeds in doing is to emphasise their flawed humanity. This is achieved by naming individuals, so that they are no longer anonymous 'Nazis.' Nazi Medicine unmasks their status as evil exceptions to humanity and projects them as individuals who chose to perform inhuman, disgraceful tasks. This unmasking is supported by a recurring motif of the eyes of children in both the audiovisual display and the graphic panels. It is as if the perpetrators are being watched and held accountable even though many, in fact, escaped punishment. At the same time the eyes succeed in making visible the otherwise invisible victims. The message embedded here is especially targeted at current and future medical professionals, who are encouraged to reflect on the intrinsic sanctity of human life which exists regardless of the enforcement—or otherwise—of ethical regulations. It is worth noting that ethical regulations predated and remained in place throughout Nazi rule.

The exhibition reveals the not widely known euthanasia program performed on German children with the help of German physicians in the name of achieving a 'perfect race.' The section on the so-called 'Aktion T4' plan highlights the suffering of many German people under Nazi rule. The posters and audiovisual material explore in graphic detail the unsavoury means and mechanisms used in experiments on inducing death. Perhaps the most awful image is of a collection of bones above a letter by a scholar in anthropology, Dr. Joseph Wastl. This letter informs us, in a business-like tone, that although the skulls of Polish adults from concentration camps are for sale, the 'skulls of Polish children' are not yet available. It is this kind of revelation that relentlessly drives home the exhibition's key message: that unless we seek to understand the past, we cannot be sure that that such events will never re-occur.

However, despite stimulating active reflection and unmasking individual perpetrators, the exhibition does not fully explore the circumstances that allowed German doctors to take part in horrific acts. Significant insights are lacking into why trained medical professionals, fully aware of the ethical obligations and traditions of the medical profession, chose to contradict such training and awareness by performing unethical experimentation. There is no exploration of what may have made these professionals abandon their roles as seemingly acceptable members of a highly regarded professional community and instead perform actions contradictory to the very core objective of the profession—to do no harm. These insights might be valuable in preventing the re-occurrence of such events.

Image 2: The objects are representative of medical instruments available during WWII (although these particular instruments were not used in any Nazi medical procedures or experimentation). (Courtesy of the Sydney Jewish Museum.).

Nevertheless the exhibition is successful in allowing visitors to suspend their natural inclination to label the perpetrators as monsters and to view them as examples of a flawed humanity. For members of the public—and for medical students, practitioners, and historians in particular—this is a valuable tool that assists when thinking about other situations in which medical professionals have performed unacceptable acts despite the existence of ethical regulations. One such example is the series of Tuskegee Experiments conducted by American medical professionals on African American men to observe the long term effects of untreated syphilis, despite the availability of treatment to prevent its progression. Pre-dating World War II, the experiment commenced in 1932 and continued through the war, the ensuing war trials and the development of the Nurenburg code of ethics, finally concluding in 1972. Thus, shockingly, even the experience of the Holocaust did not impact on its progression—in fact there was continued publication of the findings of the undisguised experiment in well-known medical journals.

There are also current medical issues where parallels can be drawn with the Nazi experiments. These include the apparent racially-based disparities in health care for citizens of the United States and the debate over the legalisation of abortion, where some argue that medical professionals have been instrumental in the murdering of hundreds of thousands of unborn children. All of these examples serve to illustrate that perspectives on ethics vary widely even when there are regulations in place. They demonstrate the importance of applying analytical thought to assumptions made in medical research.

I felt that the Nazi Medicine exhibition was most effective when it was least didactic; where it 'showed' an atrocity and left it up to the viewer to critically analyse the evidence. This was when the artefacts spoke loudest. For me, the photograph of an 'Illness Notification Form' was particularly startling. This was the form that doctors used to rate traits such as 'Feeblemindedness' according to a scale of 'Subnormal, Imbecile, or Idiot.' Their judgements would determine whether the patients had a 'life not worth living' according to the involuntary euthanasia program. As a future health practitioner I was surprised at how something as simple as a form can be manipulated. To me, simple images like these reveal more about past events than any number of words.

Ultimately, the exhibition provides a unique perspective on what Dr. Weisz calls the 'darkest page in the history of medicine' in which the process of understanding becomes as significant as the content. The exhibition has commenced a tour of several medical schools in 2008 and 2009, so that future medical professionals will understand the need to acknowledge the sanctity of human life even in the darkest of times.

KERENZE CHIPPENDALE
MEDICAL STUDENT
UNIVERSITY OF WESTERN SYDNEY, AUSTRALIA

From Surgery: A Long Road to History

George Weisz
(author of the Nazi Medicine exhibition)

I have often been asked to explain my journey from surgeon to medical historian. Although the road was long, I saw both my interests as forms of creative art, complementing one another. Born into a cultural family in Eastern Europe, with classical and operatic music resounding within the walls of our small apartment, and with a respectable library, our happiness lasted until two totalitarian regimes destroyed our family's physical and spiritual health.

Medicine was my all-consuming ambition, a vocation displacing everything else. For 37 years, while orthopaedic and spinal surgery preoccupied me entirely, music provided a permanent stimulation and art history a pleasure. Only much later, stabilised in my professional and family environment, could I return to my artistic interests.

I enrolled at university to study History, obtaining an Arts degree, and continued with study of the Renaissance, leading to a higher degree.

It was then that I discovered the many doctors who had turned to artistic creativity – Europeans, Americans and Australians. I crystallised this apparently unique phenomenon amongst the professions in an essay, The medico-artistic phenomenon.

I began with Erasmus's Oration in Praise of Medicine, continuing with doctors turned artists: Ficino (on the philosophy of ageing), Servetus and Rabelais (on religion and medicine), Schiller (on psychosomatic reactions), Carlo Levi (on poverty-stricken Italy, south of Eboli), Schnitzler (on emotional conditions and hysterical aphonia), and Copernicus (on astronomy).

I suggested that artistic creativity complements the practice of Medicine, with novelists (such as AJ Cronin) and playwrights (such as Chekov) writing about medical conditions. Dr. Somerset Maugham said, 'I don't know a better treasure for a writer than to spend some years in the medical profession,' and Dr. Chekhov wrote, 'Medical study has exercised a serious infl uence on my artistic activity.'

I felt that not only could doctors influence writers by offering them a better understanding of the sick, but that artists reciprocated in kind. From the creativity of spinal surgery, medical history seemed just another form of creativity. Reflecting on past and future medical education, I felt that Arts in the curriculum would implant more compassion into doctors.

My interests were oriented toward medical history hidden in Renaissance painting. I found diseases in the Durer, Montefeltro, and Medici families, with their various deformities and neurological conditions. My conversion to medical history occurred on a 'cultural' visit to Weimar. This quiet German city gave its name to, and was the seat of, the republic between the two Reichs. Although economically depressed, the Republic reached the world's highest scientific standards, particularly at the Academy of Sciences in Berlin, with physics headed by Einstein, chemistry by Haber, and physiology by Warburg—all Nobel laureates.

I visited a baroque ducal palace, the opera house (running a Beethoven festival with ironic overtones: the prisoners' choir from Fidelio and the Ode to Joy from the Choral Symphony, the words written by a medical doctor, Friedrich von Schiller, promoting brotherhood).

I visited the houses of Goethe, Schiller, Liszt, Wagner, the Bauhaus of Walter Gropius, the father of Art Deco-Nouveau. On Sunday, whilst listening to a Bach cantata, I wondered how all these devoted people sitting around me could have known nothing about a camp just five kilometers from the centre of the city—Buchenwald—where forced labourers manufactured armaments, worked in coalmines and where experiments were forced on unconsenting victims.

Weimar represented not only the intellectual glory of a distant past, but also the evils of a more recent past.

This triggered my study of medical crimes committed during the Third Reich. None of these crimes could be denied, as they were published in medical journals. These crimes, perpetrated by doctors, sworn to do no harm, were unprecedented in their magnitude and in their unscientific, ideologically driven methodology. I was puzzled by the doctors' willing participation in the policy of eliminating German society's 'free eaters,' aiming for the purifi cation of the Aryan Volk by ridding it of those with physical deformities, emotional disturbances, or mental deficiencies. I read that the democratically elected Führer had pleaded, 'Doctors, I can not live without you for one day, not for one hour....' The response was massive voluntary support, with 40% of the medical community joining the Nazi party and 7% joining the vicious SS.

I coined their actions as the four 'E-steps' of the Elimination policy. I was offended by the Eugenic policy, with doctors notifying the authorities of their 'patients' diagnoses and performing mass sterilisations. I was appalled by the Euthanasia policy, in which the disabled in 'Children's hospitals' were exterminated. I was horrified by the role of doctors in the Extermination policy and their participation in Experimentations.

Some of these experiments, later reviewed in the New England Journal of Medicine, were shown to have been poorly planned, badly executed, and fraudulently analysed. This pre-eminent medical journal editorialised that any reference to the findings of these 'experiments' would be unethical, even criminal.

I termed the period of Nazi medicine as 'The Darkest Page in the History of Medicine,' a time when doctors changed from healers to killers. They forfeited their Hippocratic commitments; they put on black uniforms and boots, wore skull insignia on their headgear, picked up syringes loaded with phenol or chloroform to produce intravascular coagulation and cardiac arrest, and took another oath, the Hitler oath. Reflecting on past and future medical practice, I felt that I had seen evidence of the greatest betrayal of everything sacred in Medicine. This heart-wrenching history should never be forgotten; it should be publicised in medical schools, amongst ethical groups, in scientific institutions and in legal faculties.

There should be total condemnation and no posthumous rewards for criminal doctors; those diseases named after Nazi discoverers (such as Reiter's arthritis, Wegener's granulomatosis and Hallervorden's neurological syndrome) should be given new names. The Pernkopf atlas of anatomy, using images obtained from victims, should be discarded.

The principles of medical ethics must be respected. At the end of my journey from surgery to history, I found satisfaction in the codes of ethics of the Australian Medical Association and of the Royal Australian College of Surgeons, ensuring that the Hippocratic principles are respected, even though, in this modern era, not all medical faculties celebrate the Oath itself.

I wish to acknowledge the editorial assistance of Dr. Peter Arnold.

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