July 2, 2018

The New York Review of Books” Dr. Death by Lisa Appignanesi

Long-deceased Viennese doctors, unless they’re called Freud, rarely make newspaper headlines. But one has recently done so on both sides of the Atlantic. On April 19, the academic open-access journal Molecular Autism published a detailed article by the Austrian medical historian Herwig Czech about Hans Asperger, the Viennese pediatrician whose name has since the 1980s designated a syndrome that forms part of the wider autism spectrum. Like many prominent Austrian medical figures of his generation, Asperger’s wartime record of involvement in some of the deadliest aspects of Nazi medical practice had long remained unquestioned or was glossed over. Now he stood exposed as having been far from an opponent of Nazi thinking; racial hygiene was, in fact, at the center of his beliefs.

The historian Edith Sheffer’s book Asperger’s Children was published a month after Czech’s exposé. Her research was contemporaneous with his and draws on the same archival sources, but books take longer. Hers is an impassioned indictment, one that glows with the heat of a prosecution motivated by an ethical imperative. She charges Asperger with a heinous medical crime: sending at least thirty-seven of his child patients to their deaths. Herta Schreiber, who had suffered meningitis and diphtheria, was just short of three when her de facto death certificate was signed, in part on the grounds that she was “an unbearable burden to the mother.”

Accused with Asperger is the whole of the Nazi ideological apparatus that converted a diagnosis—a highly personal form of human assessment—into the first rung of a routine killing machine. Finally, Sheffer wants to indict the entire capacious category of autism, which she argues includes too many different kinds of people alongside the high-functioning, often talented, but somewhat relationally challenged people who have been given the diagnosis of Asperger’s—a diagnosis that for the US has now been shifted, in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM), into the broader autism spectrum.

The term “autistic” originated with the talented Eugen Bleuler, director of the Burghölzli, the pioneering psychiatric hospital in Zurich. In the early part of the twentieth century some of Europe and America’s best physicians spent at least a season there. Bleuler valued Freud’s insights and took a cue from psychoanalysis in his efforts to attend to unconscious mental processes and listen to patients’ words. Among the staff was Carl Jung, whose patient Sabina Spielrein also became a well-known psychoanalytic practitioner and the teacher of the famous psychologist Jean Piaget. Patients were seen individually twice a day: doctors were instructed to write down everything they said, whether or not it sounded like nonsense.

Read the full review here