Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
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The Auschwitz Self: Psychological Themes 
“its possessor may have to meet the hard condition that once he can use his special talent he must do so, or the power he. does not choose to wield may turn against his own life.”15 In psychological terms, we may say that the backed-up power so threatening to its possessor is the potential sense of guilt, which can be fended off only by continuous application of that lethal power outward to an enemy. That same principle was active in the Nazi claim that every single Jew had to be killed, lest those remaining alive or their children kill Germans. The Auschwitz self, then, entered into a vicious circle of killing, threatened guilt and death anxiety, and more killing to fend off those perceived psychological threats.

From the standpoint of maintaining the healing-killing paradox, the doctor’s conduct of selections “made it perfect” (in Dr. B.’s phrase) bureaucratically (and therefore psychologically) because it conveyed the idea that “an exact medical judgment had been made.” But that very medicalization required the Auschwitz self to take on the physician’s self-requirement of  “how to carry out the matter [killing] humanely.” That principle of “humane killing” could take on considerable power for the Auschwitz self: sending typhus patients or potential carriers to the gas chamber did control that disease, and doing the same to large numbers of weak and sick prisoners did indeed improve the hygienic situation in Auschwitz. If one entered into the healing-killing paradox with a comprehensive Auschwitz self, it could seem to make sense, to “work”; and that in turn buttressed the overall doubling process.

Strong healing tendencies could readily lead to conflict in an SS doctor, to a situation in which his Auschwitz self was less than fully dominant. But, in the great majority of cases, that conflict was sufficiently overcome after the transition period for the doctor to do the work of the camp and for the Auschwitz self to become adequately functional. That was very much Wirths’s situation, as we know, and it was true also of men like Rohde, who was said to drink heavily and was described as experiencing “a problem of conscience” to the point of discharging a gun on one occasion out of frustration and anger — but who nonetheless “did exactly the same things as the others,” that is, went on doing selections. The healing ethos fights a losing battle if it fights at all, as the Auschwitz self takes over. When telling us how an SS doctor “after a few weeks in this environment … thinks, ‘Yes,’” B. was describing not a sudden epiphany but rather the end point of a process, brief and intense enough, in which the Auschwitz self progressively took hold.

That is why the Hippocratic oath, though a pledge to remain a healer and to disavow killing or harming those one treats, was all but abandoned in Auschwitz. The oath was perceived as little more than a distant and muted ritual one had performed at medical school graduation, and was readily reversed by the searingly immediate selections ritual, as well as by the array of direct pressures and rewards in the direction of a Hippocrates-free Auschwitz self. Indeed, with the oath to Hitler one essentially excluded the Jews from one’s Hippocratic responsibilities.  
Medical Killing and the
Psychology of Genocide

Robert J. Lifton
ISBN 0-465-09094
© 1986
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