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Table of Contents parts 1, 2, 3, 4, 5 |
part 1
University of Vienna Pediatric Clinic — March 1943
My glasses have long since become a part of my anatomy. I bathe, sleep, even copulate in them. I wonder if they will stay on my nose after my head rolls. And it shall roll! It’s only a matter of time. You’ve heard what happened in Munich? A handful of medical students who opposed the new racial hygiene laws were arrested, convicted and publicly guillotined. The choice of the execution piece is a little surprising. Of all the efficient methods available to them, they chose the French masterpiece.
Munich is only four hundred kilometres away from here. Remember, we’re one country now. One Reich that’s supposed to last a thousand years. One Volk. And it is my job as a physician to keep the Volk pure and unburdened. I had my new duties read to me shortly after the Anschluss. Every week I make a list of children deemed “unworthy of life” and refer them to the nearby clinic, Am Spiegelgrund, from which they aren’t expected to come out.
What makes someone “unworthy of life,” you may ask? Excellent question. It can be something as obvious as facial asymmetry, clubbed foot, spinal curvature or cranial deformity. Those are just a few things that would make one a candidate for euthanasia. External deformities are easy to spot. Mental deficiencies, on the other hand, require a more nuanced evaluation, a second opinion. Killing indiscriminately is obviously not the goal. This is where I step in. My lectures on autistic psychopathy had made me a star and an expert on the desirables, apparently. I sign each diagnosis with “Heil Hitler.” Not exactly the kind of work I envisioned when I became the head of curative pedagogy at the Children’s Clinic.
The hideous whale of the Reich has swallowed our medical system. Our hospitals, sanatoriums and laboratories no longer belong to us. Franz Hamburger, my former professor and now clinic director, seems rather at home inside the belly of the whale. He has no trouble reconciling the Hippocratic Oath with the racial hygiene initiative. Looking back, Hamburger was rather welcoming to the Nazis back in ’38. Most of my colleagues were.
Except for the Jewish clinicians, of course, who had to flee for their lives. A couple of them committed suicide. One of the lucky ones, Georg Frankl, found refuge in America. That was the last I heard of him. Needless to say, I know better than to ask about Frankl’s whereabouts. Perhaps I am a little jealous of him. I wouldn’t mind being in America myself.
The thought of picking up and fleeing occurs to me throughout the day. I loathe what my life has become, but not enough to walk away from it. Frankl had no choice. I still have my status, however precarious it has been for the past five years. I am the only one who has not joined the Nazi Party. A part of me clings to my Catholic upbringing, to the sentimental idea that each life is sacred. Those outdated ideas make me a laughingstock at best and a target at worst.
The Gestapo came for me not once but twice. They arrived at the clinic, allegedly to ask me a few questions. Both times Hamburger managed to send them away. Despite our differences, he still cares about me in a fatherly way. Our bond was forged during my student years. It predates the new regime.
“Asperger,” he whispered to me once, “I’m running out of excuses. I cannot protect you indefinitely. Show some enthusiasm. Put some heart into your work. Do it for your family. Who knows how much longer these rules will stay in place. You have three children to think about.”
Ah, yes, my three children! Thank you for reminding me. I try not to think of them too often, not during the work hours. The prospect of noticing some of my patients’ traits in my offspring horrifies me. What if a colleague of mine notices something odd about my children and reports them to health authorities? Doctors can be spiteful and vindictive towards each other.
I ask my wife Hanna to keep the whole family in the countryside, as far away from medical institutions as possible. On the other hand, I must be careful not to create an impression of secrecy, lest my colleagues suspect that I have something to hide. Imagine Erns Illing, the new head of Am Spiegelgrund approaching and asking me casually: “Say, Asperger, we haven’t seen your children lately. I hope they are all in good health. Is Gertrud still learning her violin? And Hans, is he cured of his stutter? I know a specialist who can check the roof of his mouth. Little Hedwig ought to be talking by now. What’s her vocabulary these days?”
Illing already knows too much about my family. In the past I was foolish enough to share my children’s medical histories with him. Now he keeps prying and following up on their progress. He must notice how unsettled those playful interrogations make me. I try not to curb my anxiety, as he tries to curb his pleasure for inducing that anxiety. To satisfy everyone’s curiosity, I sometimes ask Hanna to bring the children by the clinic, so my colleagues can see for themselves that the three little Aspergers are worthy members of the Volk.
But so are many the children in my therapy group! Not all of them are feebleminded. Far from it! I wish the health authorities could see that. Even abnormal personalities can be capable of development and adjustment. This knowledge gives us the right and the duty to speak out for these children with whole force.
Alas, I cannot save them all. If I advocate too ardently, if I seek pardon for too many, I will draw suspicion to myself. Every few weeks I must sign two or three of my young patients to Am Spiegelgrund to prove my commitment to weeding out the defective. My latest death warrant is sitting on my desktop, the ink still wet. It is for a three-year old girl named Herta Schreiber.
Severe personality disorder (post-encephalic?): very severe motor retardation; erethic idiocy; epileptic seizures. The child is an unbearable burden at home for her mother, who has five healthy children to care for. A permanent placement seems absolutely necessary.
Heil Hitler
Herta’s mother firmly believes that her daughter will spend her days playing in the green courtyard, splashing in a warm indoor swimming pool and assembling puzzles. Let her cling to that illusion a bit longer. I know that Herta has two, maybe three months left to live. I know what is in store for that child at Am Spiegelgrund. The state-of-the-art treatments include electroshock, long icy cold baths, spinal injections of apomorphine. The girl will die of exposure and abuse, and her mother will receive a forged death certificate stating “pneumonia” as the cause.
Who knows? Perhaps, a small part of her will be relieved. I have seen that ambivalence in the mothers of disabled children. They are thankful to have someone else kill their children, something they would never the heart to do themselves. Mrs. Schreiber will not question the competence of doctors at the clinic, I am certain of that. She cannot afford to be combative, not with five other children at home.
So, if I must sacrifice a patient today, let it be Herta. It will buy some time for the other ones, my most promising cases. There are several boys in my group afflicted with autistic psychopathy, who in some ways outshine their normal peers.
Take six-year old Gerhard, who doesn’t answer to his name or look you in the eye. He opens his mouth only to deliver a lecture on astronomy. He can remember entire passages from a textbook and recite them in his monotone voice. How I envy his memory. Such a gift could have made my years in medical school much less stressful. Gerhard would make a fine university lecturer one day. He must remain in my care.
And seven-year old Friederich... Last month, Hamburger was beginning to hint that it was time to send Friederich to Am Spiegelgrund, but I am not ready to give up on him yet. Like Gerhard, Friederich does not engage in conversation, but he is obsessed with numbers and symbols. He spends much of his day in front of the blackboard, writing what appears to be algorithms. Children with such enhanced pattern-recognition abilities can be trained as code-breakers for the Reich. I believe I have a strong case that these two patients are assets, not burdens. Now I must prepare my notes for the upcoming review.
It seems that for success in science and art, a dash of autism is essential. The necessary ingredient may be an ability to turn away from the everyday world, from the simply practical, an ability to rethink a subject with originality so as to create in new untrodden ways.
Heil Hitler
God help me! It’s almost eleven. The review starts at noon. At one o’clock we take lunch. Hamberger will invite me to join him, promising not to talk about work. There are so many other pleasant things to talk about, like films, concerts and festivals. There’s a new brewery everyone raves about. I will politely decline the invitation. Hanna is supposed to stop by with the children. She was going to bake her famous apple cake this morning. Tart apples are in season, a little too tough to eat raw but perfect for baking.
Knowing Hanna, she’ll make enough for the entire staff. The cake will be pulled apart in seconds, and crumbs will scatter all over the clinic. The nurses will compliment Hanna on her dress and ask her when she will bring another little Asperger into this world. She will respond with her elusive, mysterious smile, then pull out a handkerchief and polish the lenses of my glasses. We do not want to bring more children into this increasingly absurd world. For the past three years we have been successfully avoiding procreation.
Luckily, my children neither show me affection nor expect any from me. They know better than hang on my neck or cling to my leg. Hanna trained them early on to keep respectful distance. Father is a very busy man. He is not to be bothered or distracted. For that I am very thankful to her and for so many other things.
Marrying Hanna was by far the wisest, best calculated decision of my life, an undeniable boost to my career. We met while hiking in the mountains. I was in my late twenties, and my colleagues were starting to nudge me about taking the next step. Family men are taken more seriously at the clinic and more likely to be promoted.
I give Hanna partial credit for my rise to the head of the pediatric ward. She is a good sport, keeping a straight face through all this quiet madness. One can hardly imagine a more perfect Austrian wife, organized and even-tempered. She doesn’t begrudge me my aloofness or my lack of romantic intuition. It doesn’t occur to me to surprise her with flowers or sweets. Thanks to Hamburger, who is not above casual affairs with his nurses, I know what perfumes are in demand.
The entire clinic smells like Chantilly by Houbigant. Not very patriotic, if you ask me. France is supposed to be an enemy of the Reich, no? One could argue that the art of perfumery transcends politics. I am certainly no expert. It’s beyond me how the smell of wilted peonies can make everyone ecstatic. Hamburger gifted a bottle to his mistress du jour and, before long, the fragrance spread through the hallways. Wartime austerity makes these small luxuries all the more cherished. Hanna deserves innocent indulgences more than anyone. When I ask her what she would like for her birthday, she requests a new cooking pot or a rolling pin. My angel of pragmatism!
Despite being cognizant of my undeserved blessings, I cannot help an occasional sting of envy. Frankl married a fellow clinician. Anni Weiss was a mutual colleague of ours. The three of us worked closely. Then in 1937, when things started getting precarious for Jews, the two left for America. It was Anni’s idea.
Frankl kept insisting that the anti-Semitic flareup would subside, there was no need to flee just yet. But Anni stomped her little foot and said she was going with or without her suitor. Frankl had no choice but to follow. And I’m sure he’s glad he did, for things got ugly.
Leo Kanner, another Jew, who had emigrated back in the 20’s, took them under his wing and gave them jobs at Johns Hopkins University. Their existence is both plush and stimulating across the Atlantic. They can discuss research in bed for hours. The golden couple of juvenile psychiatry! And I’m stuck here, doing dirty work, getting harassed by the Gestapo.
Hanna is my refuge, the keeper of the hearth, but she is not my intellectual equal. I am not sure I would want to bring clinical jargon to the dinner table at the end of the day, but it would be nice to have a wife who spoke my language. Hanna and I operate in different universes.
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Copyright © 2025 by Marina J. Neary