The article is an abbreviated version by Marianne Kastrup of a lecture given at DGPPN 2020
The fact that there was no new beginning in 1945 was partly due to the lack of a manageable alternative psychiatric approach. This favored personnel continuity. It was only with the social upheavals of the late 1960s, with the beginning of our actual culture of remembrance, that a compromise-filled reform process began.
As a psychiatrist I ask: how did our psychiatric colleagues react after the collapse confronted with their failure? I would like to explore the question given the extent of the specific criminal actions, there was no new beginning, no stopping, not to mention remorse, shame or confession of guilt.
I'm sitting at a desk that comes from the Munich University Hospital, perhaps Kraepelin sat at this table. On this desk are the tin bowls from which the Kaufbeuren patients ate their starvation food and which were still in use in some wards in 1980, when I came to Kaufbeuren.
On July 2, 1945, three officers from the US headquarters in Kaufbeuren visited the hospital for the first time. They found a large number of unburied, emaciated corpses, the deputy director Dr. Gärtner had recently hanged himself, and they learned about the starvation of patients and about the killing of adults and children with Luminal. They sent a report about their findings and the crimes became public knowledge for the first time.
Society, represented by the officers, makes patients aware of their dignity and autonomy. The matter-of-factness with which the soldiers anticipated Article 1 of UN human rights declaration that was formulated three years later is impressive. However, there was no new beginning!
There were several reasons for this.
Firstly, at the end of the war only a few doctors were clearly critical and distanced from the murder of the sick and claimed to be creating an innovation.
There were also doctors who condemned the procedure and went into “internal emigration”, as it was later called.
The majority were, if not perpetrators, then accomplices, followers, who were perhaps repulsed by the specific acts, or were ambivalent about them and to my knowledge none used the liberation in 1945, to openly admit guilt and show remorse. A considerable number took their own lives. The motivation was less an admission of guilt and more a result of the blame that was perceived as an insult in the post-war period.
How did the survivors deal with their guilt? Confrontation with the consequences of the war was difficult to bear but the guilt of the psychiatrists was deeper. They had with their own hands or through orders, treacherously murdered helpless people, or helped, or known about it. They had done something that, according to the laws of the time, met the criteria for murder. This special guilt is further reinforced by the fact that they knew that National Socialism had merely opened the door to something that had already existed in psychiatric discourse for years.
Leo Alexander, a Jewish psychiatrist who left Germany in 1933 wrote a report on neurobiological research during the Nazi era and the role of the responsible researchers in the planned medical trials. He interviewed Julius Hallervorden, who worked at the Kaiser Wilhelm Institute in Berlin who examined brains from murdered patients. When asked: why did you request these brains? Hallervorden answered:
I heard people were killed with CO in various institutes and requested if you're going to kill these people, at least save the brains so they can be used and gave them the instructions needed.
Due to shortage of doctors the selection of patients to be killed were left to the guards. Whoever was a 'case' from the guards' point of view, or not liked by staff was put on the list and taken to the death center. There was wonderful material among these brains, wonderful imbeciles, deformities and early infantile diseases. I took these brains for granted. Where they came from and how was not my business.
When working at the Munich Psychiatric University Hospital in the 1970s, I was responsible for organizing the lectures by invited guests. I met them over a coffee before the lecture and I interviewed many prominent in psychiatry at the time. When talking about their colleagues, they often spontaneously mentioned: “he remained decent,” although I didn't discuss the crimes of that time. He probably mentioned that the colleague had resisted. Did those who turned a blind eye “remain decent”?
After the war, Americans appointed Anton von Barunmühl as acting director in the sanatorium and nursing home responsible for Munich. He worked there since 1927, including throughout the war. During the denazification process, he denied any involvement in the murders of the sick taking place in front of his eyes. To exonerate himself, he said, for example, that he took vacation on the days on which patients in his department were transported to the killing centers in the first euthanasia phase. He expected to be appointed director by the Americans, but they appointed Gerhard Schmidt as director with the task of solving the crimes. Annoyed, Braunmühl left and became director of the Kaufbeuren sanatorium and nursing home. Gerhard Schmidt was a senior physician in a clinical department with a distant attitude to National Socialism.
When working on the memorial book of “euthanasia”, we examined over 2,000 medical histories to determine whether they were victims of the murders. All Munich patients – also in wartime – were admitted to one of the two Munich city clinics, where it was decided whether they would be treated further in the clinic or transferred to the Eglfing-Haarerhospital. We found striking differences in the quality of medical records from these institutions. The Haarer entries were extremely short, hardly any life dates, and, in the foreground, derogatory assessments such as: useless, unworthy of life, no longer productive, probably devaluing the patients so much to be able to kill them. The medical histories from the university clinic were factual, detailed, containing detailed psychopathological description and a comprehensible diagnosis.
These differences in the histories proved that not everything was the same. The apologetic objection often expressed later, that the perpetrators should also be seen as victims of the zeitgeist, is refuted here; one could do otherwise.
Gerhard Schmidt came from this tradition; he took over management and documented the crimes. Braunmühl, started a revenge campaign with accusations of incompetence e.g. his exaggerated preoccupation with the fate of the relocated Jews and constant questioning of the staff about the hunger situation during the war.
Reading these documents touched me because when I took over managing the Kaufbeuren Institution in 1980, I was confronted with similar accusations from older colleagues. But times were different, I initially emerged victorious.
Not so Gerhard Schmidt. A commission examined the allegations, confirmed them without exception and dismissed him from one day to the next in 1946 appointing Braunmühl his successor!
In 1947, Braunmühl had an intrigue with Werner Leibbrand - a victim of persecution by the Nazi regime - appointed by the Americans as head of the Erlangen sanatorium. Leibbrand was one of the first to address the public in 1946 with the book “On the Human Rights of the Mentally Ill” describing the deportations of Erlangen patients and the starvation in the Erlangen institution. Leibbrand was appointed by the Allies as an expert for the planned Nuremberg medical trials and the Interior Ministry in Munich had assigned Leibbrand the position of psychiatric consultant, which Braunmühl, actually claimed for himself. In a similar way, using the same arguments, he began a smear campaign against Leibbrand, threatened the Interior Ministry with lawsuits and won. Unfortunately, Leibbrand left psychiatry; Braunmühl also got this position. A victory on all fronts!
When the American military government in 1948 asked the Bavarian Prison Directors to make a public statement on the “euthanasia” crimes they refused, stating:
“Anton von Braunmühl warns that we should only talk about these things if we really know what happened and how much could have been prevented through the intervention of the good old mental doctors.”
Why was there no new beginning after 1945? The authors of the first publications on this topic were slandered and all left psychiatry. □