Der Pathologe: Roman (German Edition)

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The Perils of Peace: The Public Health Crisis in Occupied Germany.

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They noted that [p]hysicians treating patients under a national health insurance are obliged to communicate their diagnosis to the government officials there employed.


Thus the original relationship of trust between the doctor and patient is being more and more overshadowed by non-medical considerations. And even today, with the brutal, government-inspired system of extirpation and eugenics ended, the physician must keep on fighting for that freedom of his profession to which the fulfilment of his fundamental duties is forever joined. For it seems to be of small moment for the future whether the imposed code of contempt for the dignity of man issues from bureaucratic indifference or ideological aggression.

Most of these commentaries focused on general medical practice and the independence of private physicians and medical researchers. But repeated references to bureaucratic influence, and Mitscherlich's concerns about insurance doctors, show that autonomy was also seen as crucial to medical officers and state-employed doctors. Given their proximity to the state, they were, in fact, identified as needing special protection from political interference.

In some features, Mitscherlich's argument differed from that of other commentators. He pointed to the dangers of a mechanistic view of disease and medical care, and argued that one of the central problems underlying Nazi medical abuses was that doctors had adopted overtly utilitarian aims. An ethically rather than scientifically driven method had to rescue medical practice and restore the doctor—patient relationship. The diagnosis that an overpowering and manipulative state bureaucracy was at the heart of Nazi medical abuses was often shared by American and British observers, keen to highlight the similarities between what they saw as the totalitarian states of Nazi Germany and the Soviet Union.

The people presented here regularly reminded both their German and Allied colleagues of the importance of their training, their past work experience, and their way of doing things. Many complained about foreign interference, particularly that by Soviet officers. As though we are academic novices! To them, the expertise and resourcefulness of German doctors and officials were beyond reproach.

And incidentally, the local Russian commanders were only rarely sticking to the orders they had received from the Soviet administration. Others were more optimistic about being able to reassert the German heritage. Franz Redeker observed that the Soviet authorities had more or less given them a free hand in the reorganization of the health service. At a meeting of the Berlin district medical officers in July , he reminded those present that in matters of public health organization and health insurance the German experience was unique and should be replicated and redeveloped.

The Magistrat of Berlin and the Berlin City Health Department

The care for the sick and their provision with medicine and treatment in hospitals are the responsibility of the state. On the other side we have the way the Americans handle it: Germany has previously stood in between. The Red Army has now let us decide how to solve the problem. Hence we can once more revive the idea of a health insurance. These arguments on the importance of an autonomous medical profession were different in tone from those on the freedom of science and medicine from state control advanced elsewhere.

In Britain and the United States, internationalism was asserted as a key ingredient of scientific freedom. At the same time as Dale was lecturing on the virtues of scientific internationalism, in Germany this internationalist rhetoric still lay in its infancy. Here, nationalism coloured much of the discussion. The resulting contradiction between a resentment of state control and a celebration of German state institutions remained unresolved, even unidentified. In the discussions in the German medical journals, the statement that some form of international cooperation was necessary, was invariably followed by an insistence that past German findings and traditions were of special value and deserved special protection.

Just as the German people have to build new homes and houses out of the rubble and ruins of their old buildings by making use of the old stones that have survived the fires, we as free German doctors also want to gather the old, tried and tested stones of our science, so that they can be cleansed, and together with new materials combined in a harmonious international construction of the most noble, honourable and compassionate humanity which knows no national bounds.

Although neither science nor its humane orientation knew national boundaries, specifically German building blocks were to be provided for its reconstruction. In similar language, the biochemist Emil Abderhalden argued a few months later that Germany had to be recognized as an important member of the new international community and deserved equal rights, particularly because of its many past contributions in medicine and science. The German people should and must be inspired by them and recover through them.

They can be assured that these cultural and scientific contributions will have a favourable effect and will in the near future be generally accepted again. The mental gymnastics they performed were in some ways very successful, as we will see in later chapters. By blaming troubles on the intrusion of politics into medicine they removed themselves from the scene of the crime. By maintaining that Nazi medicine had subordinated medical and scientific demands to political ends, that it had made medicine a tool for politicians, they found supporting evidence for their argument on the profession's need for independence.

Their allusions to the golden fruits of old German traditions, intellectual strength, and cultural achievements signalled to the occupiers not to meddle, and not to impose new orders or new ways of doing things. Another expression of this self-awareness of past German achievements can be found in the many newly published, or reprinted and amended, biographies and biographical essays on famous doctors and scientists. They identified older and positive German traditions and called for their application in the present. In writing about their famous teachers or colleagues, doctors and medical scientists celebrated German idols as the founding fathers or forebears of current good medical practice, and presented themselves as evidence of this heritage's survival.

These heroes now reminded them that, after all, not everything about German history was to be regretted. Although these figures often had significant international reputations, and in many cases had worked abroad for a long time and with foreign collaborators, in these accounts their German ancestry was seen as most crucial. The famous pathologist Rudolf Virchow became a favourite icon of the post-war years. A wealth of articles and biographies celebrated his revolutionary scientific findings, his healthy patriotism, his apolitical dedication to pure medicine, his humane medical practice, his civic-mindedness, his battle against outmoded German structures and institutions, his application of scientific principles to public health—in short, his status as a German role model.

But more recently, Froboese went on, Virchow's name had been tarred by negative propaganda. The young generation of doctors, particularly, had to learn to appreciate his scientific importance, his personal integrity, and true patriotism. May we all resolve to leave this extraordinary man out of the play of wild passions and instead bestow on him the honour and justice he deserves as a seeker of truth! In these accounts Virchow's participation in the revolution in in Berlin was presented, if at all, as a very marginal episode.

Of the pages of Helmut Unger's biography, roughly two deal with Virchow in Before this latest work on Virchow, in the s Unger had published a novel which promoted euthanasia, as well as popular accounts of Robert Koch's and Emil von Behring's achievements. Along with Virchow, figures such as Robert Koch, Emil von Behring, and Paul Ehrlich were turned into public favourites and portrayed in a similar celebratory light.

But now, as positive German national traditions were to be rescued, the Jewish doctor Ehrlich was fitted onto this canvas. Ehrlich's former secretary Martha Marquardt republished her memoirs of Ehrlich with a new preface and postscript, and proclaimed: A series of advertising flyers by the chemical concern Hoechst made use of these icons see Fig.

Much of this output was not just popular, but also had important pedagogic functions: Farbwerke Hoechst advertising flyer [] This material is not covered by the Creative Commons licence terms that govern the reuse of this publication. For permission to reuse please contact the rights holder directly. This organization had its roots in the Soviet Order No. In the other zones administrations were established only at the local and provincial level, but from the beginning the Soviet authorities focused on centralized administrations, or quasi-ministries, charged with a range of functions for the whole of the Soviet zone.

For the first few years after its establishment the ZVG had around staff. It was divided into three administrative and approximately ten specialist departments see Tables 4.

Paleopathology and Nutritional Analysis of a South German Monastery Population

It was headed by a president, and by December three vice-presidents had also been appointed, each overseeing three or four departments. In contrast to the Magistrat Health Department, in this organization university professors, doctors, and medical experts whose careers had been interrupted by the Nazi rise to power in January through loss of positions, emigration, imprisonment, or involuntary periods spent in other work made up a significant portion of senior posts. Who were the people working at the ZVG?

Much of post-war life in Germany, and German contacts with Allied officials, revolved around political parties, so they form a useful way of identifying and demarcating different groups and networks. It was a primary aim of the occupation, repeatedly asserted at the wartime conferences, to cleanse Germany of all Nazi influences, and as a result German political organizations were officially dissolved by the end of the war. But just over a month into the occupation, the Soviets had encouraged the re-formation of German political parties—some time before their French, British, and American counterparts.

Many activists had worked within their party circles for decades, and it is possible to distinguish between three roughly drawn groups of people working at the ZVG. Social democrats were one group, and in the immediate post-war period were the majority among executive officials. Many had been involved in municipal public health in the s and s. Most of them had also worked in the German public health service before Some insisted on their aloofness from politics, and a number of them were also active in the Magistrat Health Department.

This third cluster was not a coherent group but rather an assembly of a range of backgrounds and mindsets. The SPD and KPD members, by contrast, shared similar biographies, and many were personally acquainted with each other. Most came from bourgeois or petty-bourgeois backgrounds; those who were Jewish came from assimilated families.

The older generation among them, those born in the mids and s, made up the majority of health officers. Many were later active on various Second World War fronts, but unlike their Magistrat colleagues few of them fought in the Wehrmacht. The majority of the SPD and KPD groups had studied medicine at major German universities, and a significant portion ended up in Berlin for their final semesters or practical year of clinical training. Most then worked for the municipal health system, particularly in municipal hospitals or as district medical officers.

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Felix Boenheim, for example, had spent a short period at the Moabit Hospital in Berlin before being drafted into the army. After the end of the First World War he worked at the municipal hospitals in Rostock, Nuremberg, and Stuttgart, before continuing his career at the Hufeland Hospital in Berlin. Alfred Beyer, one of the oldest members of the ZVG, had since worked at the medical departments of the Ministry of the Interior and the Ministry of Welfare.

Anneliese Hamann was a welfare service doctor in Berlin from to From until , Max Klesse was both a school and district medical officer. By he had given up his medical career, but he exhibits some of the shared features of these biographies.

He had been a medical officer in Remscheid, and later worked as a doctor for an insurance fund in Stuttgart. Here he became active in the opening of maternity and antenatal clinics. In his pro-legalized abortion drama Cyankali , he painted a grim picture of working-class living conditions, exacerbated by the lack of education and contraception and the existing moralistic abortion legislation. He was arrested in for carrying out illegal abortions.

As we have seen, some of their non-political colleagues had also worked in the public health service. A shared feature of KPD and SPD health officials was that their medical careers had been intertwined with their political work. Many had become involved in party politics in the years after the First World War.

Felix Boenheim, just after he was expelled from the army for insulting the War Ministry and narrowly missed a court martial , began to receive the Political Letters of the Spartacus group. Later, while working as a medical officer, he moved on to the KPD. By April , disagreements triggered partly by the fact that the party majority had supported the government's request for funds at the outset of war, led a group of left-wingers directed by Hugo Haase to form the USPD.

Haase was a famous lawyer who had defended leading personalities of the Left in a series of high-profile cases. He was also Felix Boenheim's uncle.

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Zetkin was also involved in post-First World War developments. As a teenager and junior doctor he carried out secretarial work for his mother, Clara Zetkin who played a leading role in the Spartacus circle and the founding of the KPD , and had accompanied her on trips and congresses abroad. The younger health officers, particularly those without family links to political parties, had in many cases come into the orbit of political groupings in the early years of the Weimar Republic, while at university.

Their politicized view of not just disease but the doctor's tasks was at odds with the majority of the medical profession in Germany. Even after the First World War, when it became clear that social democracy was going to be an even stronger force in German life, it found little support among members of the profession. Most of these politically active health officers in the ZVG had been active in political-medical organizations. Some of the communist doctors had in submitted, via the Communist Party, motions on health policy to the Prussian State Parliament and the Reichstag.

Here, and in other programmes, they demanded the unification of the health and welfare services under a central ministry, and the financing of the system from public funds. Other priorities were the reform of tuberculosis hospitals, new treatment centres for venereal diseases, maternity clinics, and the revision of abortion legislation. Many travelled to the USSR in the s and wrote glowing reviews on the successes of the newly nationalized Soviet health system. Consequently, some work on health policy also took place in a series of German—Soviet friendship organizations.

The association subsequently contained both social democrats and communists and became the biggest grouping of socialist doctors, a number of whom were present in the ZVG in Some of the association's health policy demands had included campaigns for birth control, the abolition of paragraph which prohibited abortion , the creation of a central health ministry, the creation of chairs in social hygiene at the major universities, and its compulsory inclusion in the medical syllabus. The association also became one of the most vocal opponents of Nazi racial hygiene.

Their programme showed that differences existed between factions within the KPD and SPD, particularly on issues such as the desirability of bringing public health under municipal rather than state control, and the role of eugenically oriented measures in health reform. This tactic, begun in , only ended after the Nazis had taken power and Stalin changed to a popular front strategy, but their relationship barely improved after the abrupt Comintern emphasis on building united antifascist fronts. In , when both parties had to negotiate the pitfalls of Soviet occupation, and when members now joined the same institutions, this was important baggage.

Set against this antagonism was the shared disruption of their careers after and the persecution of those involved in socialist health politics, many of whom were also Jewish. Almost all of the politically active members of the ZVG lost their positions after Some moved on to private medical practice: Alfred Beyer was sacked from the Ministry of the Interior in February because of his SPD membership, and set up his own practice after Anneliese Hamann was dismissed in for communist activities, and from worked in her own practice.

Max Klesse, too, opened a practice after being sacked in Some were involved in underground work, and some were imprisoned: Fritz Leo was arrested by the Gestapo in , and then spent two years in prison in Zwickau and eight years in four different concentration camps. Helmut Lehmann was sacked and arrested in March , and once again in as head of a resistance group of SPD members and trade union officials in Berlin. Following the July plot he was arrested again and sent to Tegel prison, from where he was liberated in April Some emigrated and only returned to Germany after Zetkin had already moved to Moscow in Baer left in , and went first to Spain, then to China and Burma.

Coutelle emigrated to Moscow in , and later also went on to Spain and Burma. Friedeberger emigrated to France in after he was dismissed and briefly arrested in Following two years of internment in Morocco, he then emigrated to the United States in In , Marcusson emigrated to Switzerland after he had been arrested in April , and then moved on to Moscow in February Neumann also emigrated to Switzerland, then to France in , later to Mexico. Friedrich Wolf, who was arrested over the abortion scandal in , travelled to Moscow following his release, working for an Agitprop theatre group of the KPD.

Kurt Winter emigrated to Switzerland in , later to Spain and Sweden. A significant portion of the communist set also joined the International Brigades during the Spanish Civil War. Rolf Becker arrived in Spain in , and worked as chief medical officer of the Eleventh Brigade until Maxim Zetkin also arrived in , when he became an advisory surgeon to the Republican Army. Baer, Coutelle, and Winter all arrived in Spain in and fought until the end in Friedrich Wolf left Moscow for Spain in , and after the disbandment of the International Brigades was interned in France.

They all had worked on a succession of political projects that needed doctors: For them post-war Germany was, at least in part, another item on the political agenda. Eva Kolmer was one who made this link explicitly in retrospect.

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In sum, the SPD and KPD sets in the ZVG overlapped biographically in a series of subsets and intersecting circles, which bound them together and set them apart from their other colleagues. Some had met as Berlin medical officers or at the municipal hospitals; others had worked together in the Association of Socialist Doctors, the exile groups, or the International Brigades. And even those who had not actually met in person before could easily place and assess each other on the basis of shared patterns. These biographical patterns are important for a number of reasons.

Elsewhere, individual communists were appointed to public health administrative posts, but they were isolated and often had difficult relationships with the occupiers. The way in which they presented themselves at meetings and during discussions with other health officers in the immediate post-war years demonstrates the survival of their party identities. Tensions and open disagreements between SPD and KPD people ranged from contrary assessments of the political situation to frustrations about personnel politics.

The social democrat Max Klesse, a vociferous letter writer, was often critical of communist and Soviet strategies. In a letter to Zetkin, he criticized the KPD's proclamations on the extensive German support of the Hitler regime and the lack of any real resistance. Apart from general disagreements, personnel policy was an issue that frustrated the social democrats, not least because they suspected favourable treatment of their KPD colleagues by the Soviet forces.

The reality was more complicated. They aided the SPD, in particular, more scrupulously than the KPD would have liked, creating the impression among some social-democratic leaders that the Soviets actually preferred working with SPD politicians. The case of Paul Konitzer was also not typical for the treatment of social democrats. As first president of the ZVG, the Soviets had approved Konitzer's appointment, and had listened to and respected him, until he was arrested in February and apparently hanged himself in prison in April , while awaiting his trial. Following his career as public health activist and social hygienist and his dismissal in , Konitzer had been drafted into the Wehrmacht in Zeithain was liberated by the Red Army on 23 April In the Soviet authorities discovered the bodies of tens of thousands of Russian POWs, who had perished as a result of typhus and other epidemics which were rampant in the camp.

An investigative commission reported over 35, bodies in mass graves, and the Soviet authorities held Konitzer responsible. Konitzer's fate stands out. Social democrats also directed other central administrations, and none died in such ambiguous circumstances. Alfred Beyer, for example, had a dazzling career as one of East Germany's most celebrated social hygienists. That Konitzer, before his death, was right at the heart of it, is revealed in a letter by Zetkin to the SED's central committee on his worries about Konitzer's reliability.

A main factor was that they were badly advised, especially by people like comrade Ulbricht. This situation had to end, this much had been agreed in his close circle. He asked the central committee to find a party comrade who could, should it become necessary, take over, although he noted that Konitzer probably had to stay for now for reasons of political expediency. On 18 February Konitzer was sacked and arrested, and by 22 April he was dead. As real as these divisions were, those between the SPD and KPD members and their non-political colleagues were often deeper.

Minutes of meetings and private correspondence contain details of repeated disagreements and open hostilities. A good illustration is an exchange at a meeting in November on the issue of doctors becoming organized within the new trade unions. The debate centred on the question of whether the majority of German doctors were ready for this kind of organization, and whether ex-Nazi Party members should be allowed to join. Max Klesse countered objections by saying: Why urge the Nazis anyway? We urgently need our representation now.

Klesse's letters also reveal regular run-ins which were often not even about specific issues so much as a more general kind of loathing. If it was not for my duty as a socialist to help you and hold out for your sake in this outfit, at least until enough new socialists can be found, I would have long preferred to re-open my practice instead of being annoyed all the time by this damn bourgeois and harmful windbag.

At any rate, he probably arranges things deliberately or out of stupidity? While he had enjoyed working with the comrades, he wrote, the daily frustrations caused by the regular clashes were becoming too much. He wanted to inform Zetkin in advance so that a socialist could be found as his replacement. People like Harms, Bergmann, and Friedrich Bentzin a long-standing military doctor who now headed a sub-department and was a friend of Bergmann's must not, Klesse insisted, be allowed to gain the upper hand: Magistrat health officers characterized their ideal medicine as stripped of all party politics, and detected antecedents of this apolitical medical practice in their own careers and in German medical traditions.

In contrast, the SPD and KPD personnel identified a history of German political-medical activism which was also in part exemplified by their own careers. While working as medical officers, many had argued that the doctors, the natural advocates of the sick and needy, had to tackle not just the symptoms but also the social causes of illness and disease. In Friedrich Wolf argued that the living conditions in the proletarian inner-city districts of Berlin were directly responsible for their high rates of tuberculosis and infant mortality.

Because these living conditions were a reflection of their economic situation, Wolf insisted that the engaged doctor's job could not simply consist in vaccinating or handing out drugs. Doctors had to educate the working class, press for both smaller and more substantial social reforms, and ultimately help to bring about a proletarian revolution.

Their argument on the political role of doctors acquired a new dimension with the rise of Nazism, often articulated in articles of the International Medical Bulletin —a journal founded by a long-term member of the Association of Socialist Doctors, Ewald Fabian, and published in Prague from until the annexation of the Sudetenland in , then in Paris from until mid Its first issue contained a manifesto, which proclaimed: The feeling of solidarity drives the socialist doctors to the side of the struggling proletariat, which has in capitalism seen the deepest misery and wretchedness and which wants to liberate humanity from this monstrous system by fighting for socialism.

The same issue published an outraged reply to Sauerbruch's open letter of see section on the Magistrat , signed by a group of German social democratic doctors in Czechoslovakia and some other organizations from across the world. Their task was to ensure that the German government could continue to work in peace.

Compassion and helpfulness are not only the motor of our profession but also of our political drive, and we have always wanted peace. We have done more: This last passage also hints at another part of their self-characterization after Not only were they political agents, but like Sauerbruch and Redeker they also saw themselves as part of a specifically German heritage. This was expressed at meetings and in debates, where they regularly reminded each other of the importance of their past work in public health administration.

At the beginning, the social democrats were most vocal in this, and Konitzer and others often emphasized their past professional experience on specific issues under discussion. These reports would be much more useful, he said, if they were to remind people of the rich administrative experience and many useful older studies dating from before , some of which he had helped to carry out. In a debate about the relationship between regional and central administration of public health Lehmann was concerned about the constitutional basis of giving the ZVG the power to interfere in Land health departments.

Holling responded that he could not see any constitutional problems, since these proposals were fully in accord with Soviet orders. But we are Germans and not Russians. We want to present here our views and opinions on local government. This is what I have done, I do not have to represent Russian viewpoints.

In post-war analyses of the state of the public health service in the Soviet zone, many SPD health officers maintained that it had become possible to pick up, improve, and expand many progressive ideas from the s. In an article celebrating the anniversary of the creation of the ZVG, Alfred Beyer argued that this organization was a direct continuation of initiatives and schemes put forward by German medical officers in the s, often not put into practice at the time.

He argued that the role of the Soviet authorities and their orders consisted, apart from the early provision of food and vehicles, primarily in having made possible the implementation of these German concepts. Chief among the new features that were explained as the realization of older German schemes were the polyclinics: The social democrat Hermann Redetzky, who as head of the health department in Land Mecklenburg presided over the founding of the first polyclinic in Schwerin in , argued that the idea, the structure, and even the term had all been developed before the Nazi era.

The Nazi period had interrupted this development, but fortunately it could be taken up again after In a much later article, but in similar terms, Hermann Redetzky and the communist Kurt Winter reflected on the early post-war years. In the first decades of the twentieth century, they argued, the standard of German medical science had been high and a number of progressive ideas had been advanced, but in most instances they could not be implemented. Leading German social hygienists such as Grotjahn, Gottstein, and Lennhof had for decades insisted that the scientific and technical development in medicine urgently demanded the creation of polyclinics.

In and the Berlin health insurance funds had created over 40 insured health centres which worked excellently. In a volume dedicated to the role of Soviet orders in the reconstruction of the public health system, the editor Redetzky and many of the contributors agreed on one point in particular: Soviet officials had not imported new ideas but helped to create conditions where older German health policy conceptions could flourish. Of greatest significance had been the Soviet initiatives to find and appoint those antifascist German doctors to the health service who knew the country and were familiar with the German heritage.

In those years, a series of progressive medical and welfare officers active in social hygiene had been achieving great things in the lowering of infant mortality and in the battle against TB and VD. Thus, these older approaches were given a new lease of life after , not least because the German medical officers had been able to work closely together with their Soviet colleagues, publishing together and exchanging ideas. This theme of German approaches and tools was also taken up by the communists.

In their past political careers they had embraced a party culture which included a commitment to Marxist-Leninist theory and the communist cause, and loyalty to the Soviet Union. Even before the extensive Stalinization of the KPD, German communists had looked to the Russian revolution as the model that Germany would have to follow, and support of the Soviet Union was a litmus test of loyalty.

In a number of contradictory facets shaped the discussions among communists. Soviet loyalties were strengthened by the fact that Soviet troops had helped to defeat the Hitler regime; many German communists also believed that under Soviet occupation their long-held visions could finally be fulfilled. Many of those in Soviet exile had first-hand experience of the Stalinist purges. And on a personal level, Soviet support of deserving comrades often seemed to be lacking.

Despite the KPD's often inherent Soviet worship, there was a nationalist component to its early post-war work. Throughout the previous decade, it had attempted both out of political conviction and for reasons of political expediency to present the party as the leaders of an antifascist and national front, and their preparations had emphasized their role as defenders of the German nation. Stalin himself had pointed to the strategic importance of this position.

They ought to have a Com[munist] programme; they should proceed on a Marxist analysis, but without looking over their shoulders at Moscow; they should resolve the concrete problems they face in the given countries independently. And the situation and problems in different countries are altogether different. In England there are certain ones, in Germany there are different ones, and so forth. A diary entry by Dimitrov stated: The Com[munist] Party proposed a bloc of antifascist parties with a common platform.

Given these contradictions, there was considerable fluidity in debates of the early post-war years. Some in the KPD insisted that the primary task was the immediate construction of a socialist Germany along the Soviet model. But, at least until and as we have seen with Stalin's support , leading party officials supported a strategy which emphasized the particularities of the German situation.

A KPD appeal of 11 June a few days after Dimitrov's diary entry above called for the establishment of an antifascist, democratic Germany, and stated that the Soviet model was, for the moment at least, inappropriate. A new way had to be found to take account of the national peculiarities of Germany. The failed German revolution of should become the new point of reference, and should be, almost a hundred years later, finally completed. Using references to Marx, Engels, and Lenin, he argued that socialism in Germany could be achieved without the military confrontations and accompanying civil war of the October revolution.

There could be a distinctively German path of development. Like their SPD colleagues, they emphasized the importance of their German heritage, and continued to do so after For public health and medicine, they argued, German traditions, rather than a sudden Soviet orientation, were most crucial.

But in terms often not shared in this form with the SPD doctors, they explained that their own interpretations of the political-medical mission had in fact continued a much older, but until now always marginalized, tradition of political medical engagement in Germany. While Redetzky and Konitzer primarily focused on the achievements of the s, to communists such as Winter and Boenheim the failed German revolution of now became the crucial orientation point. But even if the social democrats could sympathize, for the communists the uncompleted revolution of became a particularly crucial marker.

Early versions of an emphasis on can be found in the International Medical Bulletin. In a article, Ewald Fabian writing under the pseudonym of E. Silva analysed the role of doctors in past struggles for freedom. In the Austrian freedom movement of , in the Bolshevik revolution, and now in Spain, he claimed, doctors had always taken leading parts. These figures, Fabian went on, must become role models for German doctors of the present, and inspire them to fight against the Nazi dictatorship.

After , celebrations of the revolutionary Rudolf Virchow were particularly pervasive among communist members of the ZVG. In striking contrast to the portrayals discussed earlier, studies and biographical essays focused almost exclusively on Virchow's role in the revolution in Berlin. Two examples of publications from the early s sum up the communist assessment. First, Kurt Winter's biography of Rudolf Virchow celebrated Virchow as a great revolutionary role model and idol.

Early in , Winter wrote, Virchow had been appointed by the Prussian government to investigate an outbreak of typhoid fever in Upper Silesia. His subsequent report blamed the social and material conditions of the Silesian population and government neglect for the outbreak. Eight days after his return from Silesia, Virchow fought in the Berlin uprising. Winter thought both points worth celebrating.

Second, Felix Boenheim's biographical essay on Virchow contained a similar kind of analysis, in a more measured and critical tone. He had not studied or understood the implication of Marxist teachings, and as a result his arguments on social reform had ultimately been superficial.

Nevertheless, Boenheim agreed that Virchow in his early career had been a revolutionary. They had realized that the fulfilment of their medical tasks demanded participation in politics and a solution to social problems. As a result, he was one of the liberal bourgeois men who fought in and acted as advocate of the working classes, however briefly, and showed faith in the oppressed people of Silesia.

Virchow had recognized the link between social and medical conditions by understanding that medical reforms always had to involve social and political reform. All this had been particularly obvious in his investigation of the Polish health question, Boenheim thought, where he had not shied away from drawing explicitly political conclusions. The difference in emphasis between communist and social democratic interpretations of Virchow becomes clear if we look at Alfred Beyer's portrayal of Virchow as a representative of true social democracy.

His character had been so fundamentally democratic and threatening to authoritarians, Beyer claimed, that Virchow had not only been unpopular with the older generation of German medical researchers at the time, but the Nazis had denounced him in a popular film. During the revolution in Berlin, Beyer went on, Virchow had worked for a democratic reform of the out-of-date university constitution, and the creation of a central health ministry, the introduction of hygiene as part of the medical curriculum, the creation of insurance funds, and an eight-hour working day.

As a true patriot and a fighter for the freedom of the whole German people, Virchow later demanded from Bismarck that Junker power must be curbed. His democratic conception was also evident in his scientific theories, Beyer claimed. Virchow had shown that cells were the basic unit of life, but he had also demonstrated that cells could not exist on their own—groups of cells formed organs, and groups of organs formed organisms.

All this was mirrored in society, where individuals as the most basic unit also could not exist on their own, and therefore came together in a democratically governed and ordered state. He worked, taught, lived and strove as a model for true democracy; unwavering and incorruptible, brave, tireless and selfless.

A few months later, the same journal contained an article by Robert von Radetzky which talked about Virchow in very similar terms. This emphasis on a German heritage, demonstrating a close connection between medical and political engagement, was crucial for several reasons. It was a means for recruiting apolitical German doctors and medical officers to work with the ZVG on the basis of these shared traditions, and of exonerating it from the accusation of Soviet influence.

Conversely, it also highlighted the frictions between the socialist health officers and other German doctors. I deny my German colleagues the right to use those arguments unless they had the courage and the conscience to use them during the Nazi regime! This political-medical emphasis also had an educational dimension. It was seen as a useful tool both for teaching the population at large about socialist programmes, and for training young doctors particularly those who had only recently completed their medical training and who still lacked professional experience in the aims and advantages of a particular conception of medicine and the German heritage.

The German medical profession was deeply divided when the Allies arrived in Germany, and these divisions became more acute through the Allied presence and the political context of the post-war years. Perhaps nowhere were these divisions as visible as in a contrast of the two very different health offices presented here: They had fundamentally dissimilar perspectives on their jobs, medical and public health practice, and German history and traditions.

The self-proclaimed non-political doctors argued that they had remained true to scientific values and medical ethics and were uncontaminated by political concerns. While the Nazi regime may have corrupted medicine by subordinating it to crude political aims, this, they insisted, was all the more evidence for the need to guarantee that the medical profession stayed free from future political interference.

The politically engaged doctors and medical officers, on the other hand, argued that they had never lost touch with social reform efforts, which had to form a central component of any medical work. The post-war programmes had to attempt to re-educate the German population, remove its militarist and fascist elements, tackle social inequalities, and build a new kind of German society—and doctors were crucial for the fulfilment of these tasks.

These competing portrayals partly reflected different biographies, careers, and interests, but particularly for the first set this was often also a convenient way of absolving individuals from any question of guilt or responsibility, and defending the existing status quo and medical establishment. In Berlin, these clashes were particularly potent.

Under sole Soviet control until July , the bulk of reappointments took place without any input from the other three occupiers. The appointments document a dual Soviet strategy of dealing with German doctors: The first approach could help to reduce the economic burden of the occupation and aid the Soviet exploitation of German science and medicine; the second had political and security benefits, as growing insecurity over the future of Allied relations began to change Soviet priorities.

As Part II will show, the other occupiers, too, shared contradictory approaches to German doctors and health officials. While Berlin was intended to stand for the quadripartite occupation by the Allied victors, it soon became a symbol of their disunity. German doctors and health officers had radically competing ideas and attempted to influence the occupiers accordingly. They fought over the governance of the medical profession, the function of public health, and the future of their work.

But they had things in common. Where the non-political doctors represented German medical dynasties especially by having trained with famous individuals or having taken on their university chairs , the socialist doctors stood for German political dynasties as in Boenheim's, Zadek's, and Zetkin's families, but also in their party allegiances. Despite significant differences, they all shared a focus on German developments before They identified national traditions and a particular German way of doing things, and pointed to German founding fathers.

Even among those Germans who were vocal supporters of the Soviet occupation there was a strong sense of German identity, and Soviet role models were often scarce. The biographies of figures such as Rudolf Virchow that were newly published or rereleased after were partly attempts by the medical profession to protect itself and its public image. The writers tried to find legitimate past traditions and presented themselves as the best representatives of those traditions. But although they shared idols such as Virchow, they were seeing something very different in this past: Despite such claims on the aberration of the Nazi years, there was considerable continuity across the divide.

In the realm of public health a number of institutions and their personnel survived the defeat utterly unchanged, often in spite of vocal protests to the contrary. Jeffrey Herf and others have written about the nature of post-war German memory and the construction of narratives.

To the medical profession, which had so much to lose following the publicity of Nazi medical crimes, the identification and celebration of good German traditions had the double purpose of presenting a new starting point which radically broke with the Nazi so-called interlude, and of absolving the carriers of this tradition from any tarnish.

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