Nazi doctors: read with caution

A lot of what I write is relatively...light in nature. I've been told I'm funny, at least (which is better than just being funny-looking--what I'd be left with otherwise). Recently, though, the question of just what the ethical standards of physicianship are has come up at WUSM. There was a presentation on the atrocities perpetrated by the Nazi 'doctors' (I put doctors in quotes because those who so demonstrate so clear and complete an absence of conscience, so utter a disregard for humanity and decency, no longer deserve the title), and--understandably--there has been some upset, mostly related to some not-so-sensitive questions that were asked afterwards. Namely, whether the Nazi doctors were subjected to peer pressure, and whether this in part explained their actions. I will add that I was not at this talk, and so am at best dealing with secondhand information about said upset...realistically more like third or fourth-hand, with the attendant reliability issues that entails. Nevertheless, this seemed like fertile ground for exploration, and something about which I must make my opinion known.

As most people (I hope?) know, the Nazis' crimes against humanity included 'medical experimentation' conducted chiefly by 'Drs.' Josef Mengele [Auschwitz, all manner of horrors], Carl Clauberg [Auschwitz, both forced sterilization and forced impregnation, ie rape], Sigmund Rascher [Dachau, especially high-altitude and hypothermia experiments], and--killing any naive belief one might have that women are always nurturing and incapable of such vile inhumanity--Herta Oberheuser [Ravensbrueck, creating 'battle wounds' and infecting them with gangrene and staph]. To call their undertakings 'research' is to defile both that word and the memories of those who were tortured. Mengele is perhaps the most infamous of these doctors; his experiments, particularly on twins, are the stuff of nightmares. He injected solvents into twins' eyes in attempts to alter their color, performed surgeries--like intestinal resections--without anesthesia, and allegedly attempted to 'create' conjoined twins by sewing a pair of Romani twins together. These are not the acts of a scientist, however depraved, and they are most certainly not the actions of a physician. They are what happens when an already sick individual is given such power that his perversion becomes florid, all-consuming, utter. They are what happens when a psychopath is not subject to the slightest judicial or societal restraint.

I've known about these things since middle school, when the Holocaust was first mentioned in our history classes and I found myself appalled that such things could have happened; not so much that Germans 'allowed' it to happen (there is something to be said for what someone does under duress, the ways in which a totalitarian state twists the mind and the soul--read Alice Miller for an in-depth exploration of this from a psychoanalytic perspective). Reading and hearing about them has an effect on everyone merely by virtue of their humanity: it is impossible not to be repulsed. As a medical student I find that my response, while essentially the same, is still more profound.

As a physician-in-training (not even yet a doctor) I took an oath on the day I got my white coat; more importantly, I made a promise to myself and to the world when I chose healing as a profession. I swore that above all, I would do no harm; that I would always put the needs of my patients foremost. I promised that I would act with humanity, compassion, and humility, and that I would work for the preservation of human life and dignity. There are circumstances in which this is not easy--when, indeed, it might even seem unfair. As a specialist in Jewish medical ethics said at a talk I once attended, if a terrorist and three of his victims come into your ER, and the terrorist is triaged at a higher level than the victims, he gets care first (ideally, of course, everyone's getting it at the same time). Or, to paraphrase a little-heard B-side of Alanis Morissette's, if a man's in the emergency room with a bleeding head because he was beating his kid and she hit him back...you still stitch up Dad's head. WITH adequate anesthetic (not, of course, that I would think of doing it any other way).
L'olam lo suv. Never again.