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The German Patient
Crisis and Recovery in Postwar Culture
By Jennifer M. Kapczynski THE UNIVERSITY OF MICHIGAN PRESS
Copyright © 2008 University of Michigan
All right reserved. ISBN: 978-0-472-07052-7
Chapter One
Sick of Guilt
Is the destruction, the bloodshed at an end? Alas, we do not know. But for the moment there is peace. No, it is something else. It is the end of the illness, that inner illness, the end of the unnatural, of that forced way of life, a life that was no longer a life, of the pressure of an inner regime, that mysterious world of violence and false appearances that kept us in suspense, against which we fought futilely, but that ensnared us and whose simple disappearance we so desired, often without hope, although we knew nothing of what would follow. -Wilhelm Hoffmann, Nach der Katastrophe I think I share all your views on the subject of the "nation" and on the freedom to choose political responsibility and therefore a state. There is, however, something that one cannot choose but has to "accept." ... If someone says: You are a German Jew-I am a German-those are of course just words, and everything depends on their interpretation. I think constantly now, with my heart, about what my being a German means. Until 1933 that was never problematic for me. But now one at least has to contendwith a fact I perceive more strongly in Switzerland than I do at home in Heidelberg: The whole world shrieks at one, so to speak: You are a German. -Karl Jaspers, in a letter to Hannah Arendt
In the tumultuous years that followed the end of World War II, postwar discourses associated Germanness with two things: guilt and pathology. As the epigraphs suggest, these designations emerged virtually side by side. If the "inner illness" afflicting the nation had subsided, its aftereffects were still to be felt-not least, in the accusatory stance of other nations, which made the designation of "German" a damning diagnosis in and of itself. Consumed by a collective crisis, Germany appeared, in the view of many contemporary intellectuals, to be quite literally "sick of guilt"-ailing not just as a result of twelve years of Hitler's rule but also the steady confrontation with the mass scale of the regime's ghastly crimes, and the growing sense that German culture at large would have to account for its responsibility for those offenses.
Just how Germany should confront the question of culpability was hotly contested. If postwar German thinkers shared a belief that the nation must be restored, they were divided about how to understand the issue of German responsibility for the actions of the collapsed regime. In the realm of politics, as Norbert Frei has demonstrated, a fledgling West German government endorsed a politics of "discretion" regarding participation in the Nazi regime, leading to a "triumph of silence" that tolerated and even embraced perpetrators and contributed, among other things, to the West German government's poor record for prosecuting Nazi crimes. In the more immediate years that followed the end of war, however, before this selective silence emerged as official state policy, diverse intellectual schools sought to answer the "German question." As a result, competing discourses of guilt vied for prominence. While both factions shared important commonalities-most notably a certain biomedical language when discussing the German relationship to fascism-their differences were pronounced.
With his 1946 volume Die Schuldfrage (The Question of German Guilt), Karl Jaspers undoubtedly exerted the greatest influence on this intellectual debate. Jaspers argued for a juridical and theological conceptualization of guilt, stressing the importance of legal as well as psychological remedies for the nation's condition. Rejecting collective categories, he advocated a nuanced understanding of culpability and emphasized the role of the individual in the process of coming to terms with the crimes of Nazi Germany. Jaspers imagined a new model of German citizenship founded on personal responsibility and proposed that the nation would find regeneration through the redemption of its individual members.
Ultimately, the model espoused by Jaspers would prevail, setting the course for official West German attitudes toward national guilt for decades to come. But in the mid-1940s, as debates about German responsibility were still taking shape, a different, parallel discourse emerged. In contrast to the school that followed Jaspers's legal model, which envisioned the nation as a kind of German Defendant on trial for the crimes of the Nazi regime, this second group of writers approached guilt as a largely medical problem. They constructed the nation as a German Patient and treated guilt as one symptom of fascism. Through a course of therapy, they argued that Germany could be restored to physical, mental, and political health. These writers saw the nation as a collective entity and stressed the communal nature of both the disease and the cure.
This notion of the country as a sick body had several important consequences. While it suggested that National Socialism represented a treatable condition and thus carved out the possibility for an eventual recovery, it also raised a number of questions about collective and personal responsibility. Could guilt and illness coincide, or were they mutually exclusive? And if the nation had been overcome by the "disease" of fascism, to what extent was it accountable for what resulted from the ensuing illness? As this chapter lays out, while some writers clearly resorted to illness as an exculpatory model, others held that the concepts of guilt and illness were equally relevant to the postwar situation and advocated a medicalized view of the nation that included acknowledgment of complicity. In these analyses, illness provided not a substitute but rather a supplementary frame through which to examine the German condition: the nation was not sick or guilty, it was sick and guilty. This conflation of guilt and illness thus did not serve simply as a means to avoid the discussion of responsibility, but rather to complicate it. Blurring the line between guilt and innocence, the discourse of Germany as collectively ill offered a useful rubric for exploring the vast gray area between perpetrators and victims. Meanwhile, the etiological focus of these writings-that is, their attempts to identify the source of the German "disease"-served a diversity of political ends, sometimes indicting the culture that preceded National Socialism, sometimes attacking Nazism itself, and sometimes taking aim at the postwar Allied occupation as the root cause of Germany's condition.
The Doctors Trial
The metaphysical contemplations that comprised the dual discourses of the German Defendant and the German Patient were unthinkable without the very real crisis of German medicine that unfolded in the years following the war. In light of the profession's strong ties to the National Socialist regime, Allied occupiers paid special attention to its denazification. The Nazi-era Reich Physicians Chamber was disbanded and the Consortium of West German Physicans Chambers established in its place, and U.S. occupation regulations, for example, initially prohibited former party members from practicing medicine. This was a genuine cause of concern for German citizens, since it contributed to a shortage of medical personnel at a time of great need. Moreover, at least some postwar Germans remained skeptical regarding the need for political change in the field of medicine. Consider the caustic words of one reader of Die Zeit who favored reinstating the banned doctors, who argued that patients do not visit physicians "in order to be injected with the officially sanctioned worldview, or to have an unpalatable one surgically removed." In fact, the ban was short-lived, as the dire medical situation of the postwar period led the Allies to grant temporary licenses to a wider number of physicians in order to meet demand.
By all accounts, health conditions in the years following the war were abysmal. Rationing had begun well before the war's end, and by the conclusion of combat, food was in dangerously short supply and would remain so until the currency reform of 1948. The occupation administrations had difficulty meeting even their own established minimum rations levels; some estimated that German civilians received fewer than 1,000 calories per day. After traveling through the British sector in fall 1946, Victor Gollancz wrote movingly of the deplorable conditions he witnessed, in the hope of spurring fellow Britons to take action-whether out of humanitarian concern or fear of political repercussions. After describing a "ghastly morning photographing cases of hunger oedema and emaciation," he warned readers, "our prestige here is pretty near the nadir. The youth is being poisoned and renazified. We have all but lost the peace-and I fear that this is an understatement." In his 1950 account of the American occupation, General Lucius L. Clay recalled the central importance of food for the maintenance of both the physical health and political stability of postwar Germany: "The provision of an adequate supply was more than a humane consideration." "We could not hope to develop democracy on a starvation diet. We could not even prevent sickness and discontent." To illustrate this point, Clay's book included two striking juxtaposed photographs, the first depicting a sumptuous "black market meal in the Femina night club in Berlin" alongside a second showing an emaciated young boy "suffering from starvation and not expected to live."
Weakened by hunger and more general exhaustion caused by the end phase of the war, German civilians fell prey to a host of ailments. In addition to such direct consequences of hunger as underweight, malnutrition, rickets, and hunger edema, the population experienced a high incidence of infectious diseases like tuberculosis, diphtheria, typhoid fever, poliomyelitis, scarlet fever, and dysentery, as well as high rates of mortality, infant mortality in particular. Postwar living conditions exacerbated the situation. Bombing campaigns had leveled Germany's cities and led to a compromised water supply, inadequate sanitation, and overcrowding-a problem only worsened by the influx of millions of expellees. Moreover, the high incidence of rape, particularly in the Soviet zone of occupation (where as many as two million rapes have been estimated to have occurred), contributed to catastrophic levels of sexually transmitted diseases such as gonorrhea and syphilis, as well as a sharp spike in the number of abortions, many of which were performed illegally under dangerous conditions. Treatment for disease was hampered not only by a shortage of physicians, medical supplies, and hospital facilities, but also by a lack of adequate medicines, particularly penicillin and insulin. Although conditions improved markedly following the currency reform, it is clear that the war and postwar years had lasting health consequences, as evidenced, for example, by the West German "mothers' convalescent home" movement of the 1950s, which aimed to treat women suffering from the extended physical and psychic toll of recent years.
At the same time, the institution of German medicine was experiencing its own acute emergency, prompted by revelations about its complicity in the murderous policies of the Nazi regime. Whether out of conviction or opportunism, German physicians had joined the National Socialist movement in droves. They actively supported the regime's biopolitical aims, playing key roles in state-sponsored programs for sterilization, "euthanasia," and, eventually, mass killing. In the words of Robert Proctor, "Doctors were not pawns but pioneers when it came to Nazi policies of racial extermination." This included the cooperation of regular physicians, who participated in the regime's various public health initiatives, research scientists in such fields as biology, eugenics, and tropical medicine, who provided evidence to undergird Nazi racism, and psychiatrists, who played a key role in the sterilization and murder of populations deemed mentally unfit. A series of postwar trials made public the extent of doctor participation in the regime's gruesome efforts to "heal" the Volk, and as a result, postwar Germans did not simply associate the nation's medical establishment with healing, but also with guilt and death. As Michael Kater remarks, "If the SS doctor was a societal role model after 1933, in 1945 he appeared as a villain, becoming a heavy burden for the entire profession" and casting a shadow over the future work of German physicians.
The first Nuremberg Trial, initiated on 25 October 1946 with the issuing of an indictment against leading physicians and administrators of the National Socialist medical system, brought the question of guilt and disease into particularly sharp focus. Officially titled The United States of America v. Karl Brandt, et al. (Case No. 1), the case was known alternately as the Doctors Trial or Medical Case. The trial highlighted the relationship of Nazi biopolitics to Nazi crimes, charging the accused with war crimes, crimes against humanity, and "participation in a criminal organization," the SS. In so doing, the proceedings reinforced for postwar observers the close link between the quest for a healthy Volkskörper and the destruction of life. At the same time, the trial called into question the efficacy and appropriateness of having German physicians contribute to the national recovery effort. If medicine itself was "sick," could it possibly help combat the "disease" of fascism? Were doctors too tainted by guilt to participate in reconstructing a new, healthier Germany? In any case, it was clear that German medicine would have to occupy a central position in the process of coming to terms with the past.
The Doctors Trial followed the model of the International Military Tribunal's Trial of Major War Criminals (USA, France, UK, and USSR v. Hermann Goering, et al.), completed just weeks earlier, on 1 October 1946. That trial resulted in the conviction of some of Nazi Germany's most notorious figures, among them Goering, Rudolf Hess, Joachim von Ribbentrop, Julius Streicher, Baldur von Schirach, and Albert Speer. The American prosecutors for the Doctors Trial-under the oversight of Brigadier General Telford Taylor, Chief of Counsel for War Crimes, but conducted chiefly by attorney James McHaney and his colleague Andrew Hardy-expected similar success. They chose to begin the series of twelve planned Nuremberg Trials with the Medical Case because the evidence was particularly compelling: the crimes were egregious, relatively easy to prove, and emblematic of the regime's brutality. As Telford Taylor noted when he delivered his opening statement on 9 December 1946 at the Nuremberg Palace of Justice, while "it is true that the defendants in the box were not among the highest leaders of the Third Reich ... this case, perhaps more than any other we will try, epitomizes Nazi thought and the Nazi way of life, because these defendants pursue the savage premises of Nazi thought so far."
(Continues...)
Excerpted from The German Patient by Jennifer M. Kapczynski Copyright © 2008 by University of Michigan . Excerpted by permission.
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