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Authors: Lynn H. Nicholas

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Not everyone was cut out for this work. One asylum doctor, named Hoelzel, when asked to take on euthanasia duties wrote to his superior, Dr. Hermann Pfannmuller, one of the most vicious of the killers, and declined the post. Hoelzel acknowledged that although the “new measures” were “convincing,” it was “another thing to carry them out
oneself
, in their final consequence. I am reminded of the difference which exists between judge and executioner,” adding that

as vivid as my desire is in many cases to improve upon the natural course of events, as repugnant it is to me to carry this out as a systematic job after cold blooded deliberation.… I yet feel myself somehow tied emotionally to the children as their medical guardian, and I think that this emotional contact is not necessarily a weakness from the point of view of a National Socialist physician. However it hinders me from combining this new duty with the ones I have hitherto carried out.
13

By October 1939, with the killings moving apace, those running the program had stopped worrying about emotions and had begun to worry about the possibility of being prosecuted for murder. They therefore prevailed upon Hitler to provide some sort of formal authorization. The Führer, aware that such a document would be political dynamite, wrote the following extremely convoluted statement (no two historians translate it the same way) on his personal stationery:

Reichsleiter Bouhler and Dr. Brandt are charged with responsibility to extend the powers of specific doctors in such a way that patients suffering from illnesses considered to be incurable, may, in the best human judgment and after careful assessment of their condition, be granted a mercy death.

The document was carefully backdated to September 1, 1939, apparently in an effort to associate the killings with the war effort.
14

On the basis of this vague note, which was also used by Hitler’s minions as justification for adult euthanasia, some 100,000 lives would be terminated. Planning was well under way for the adults in yet another secret office, known as T4 after the confiscated villa at 4 Tiergartenstrasse in
Charlottenburg in which it was located. Here, under the direction of SS Sturmbahnführer Victor Brack, also of the KdF, another massive registration system was set in motion and technical problems confronted. The preferred method for killing the relatively small number of handicapped children was with drugs. This was not practical for the tens of thousands of adult patients targeted for elimination. The planners, using nonsensical economic statistics, had set themselves a quota of one patient per thousand of the German population, or about 70,000 handicapped souls, for “disinfection.” After considerable discussion, carbon monoxide gas was chosen as the most efficient method. In the fall of 1939, as the German Army poured across Poland, construction and testing (with human beings) of gas chambers and crematoria were begun at the Brandenburg asylum, just down the road from the children’s center at Görden, and at the remote Frankenstein-like castle of Graefeneck in Württemberg. Four other centers would be used at various times during the war.

Victor Brack, worried about exposure of the agency, realized that a number of local functionaries would have to be prepared for a sudden jump in death rates and cremations in their jurisdictions. In April 1940, therefore, the German Conference of Mayors was briefed in a secret meeting. After the usual line emphasizing the uselessness, expense, and lack of humanity of those deemed “unworthy” of life, Brack explained that it was necessary to eliminate them for the sake of more curable patients and the war wounded. To do so, the incurables “must be packed into primitive special asylums,” where “everything must be done in order to have them die as quickly as possible.” It would be necessary to act very cautiously, “for the public must not learn of it. It is difficult above all because of the church, which is absolutely opposed to cremating the dead; a dispute now with the Pope is completely undesirable. It is also dangerous because of the Americans, who could enter the war against us for such a reason.” But, he quite mistakenly added, “one can keep the entire problem secret from the population; that is not such a big problem.”
15

As Hitler had foreseen, the fact that the state would take over care of a severely handicapped child was a godsend for some parents. Such was the case for the pregnant mother of Klara E., who, in the absence of her soldier husband, felt unable to cope with the blind, paralyzed Klara plus her four other, healthy children and the family farm. Some parents even asked for euthanasia. But the majority had to be persuaded to relinquish their children, and some actively resisted, often with the collusion of their doctors. This became very irritating to the authorities in Berlin, who, in September
1941, issued a chilling directive in order to stiffen the resolve of the local health professionals.
16
In no uncertain terms they were told that it was in the best interest of the
Volksgemeinschaft
, or community of the people, that children with severe mental problems be given “promising treatment or be institutionalized.” The necessity of treatment could not be questioned, and had been spelled out in previous directives. Institutional-ization, it continued, would free the parents from economic worries and stress and allow them to take better care of their healthy children. It would also “clarify” the hereditary characteristics of the child’s problem and “where appropriate” dissuade parents from further procreation. Caretakers, the directive warned, are sometimes not prepared to send a child away, as they often think they see improvement when, in fact, they are really only “adapting” to its condition. This, they note, is especially true of “mongoloid” children, “whose affection, friendliness and love of music often inspire unrealistic hope in their relatives.” Such parents should be told that “timely” institutionalization was the best for them and the child.

At least one local bureaucrat was not impressed by this loveless broadside. The unnamed director of the state health office in Tuttlingen was ordered to send ten-year-old Gunther F. to the killing ward at Kaufbeuren, where “the best treatment” and “modern therapies” could be given to him with “the equipment installed by the Reich Committee.” He was told that “if the parents or guardians make unexpected difficulties, they should be informed about the respective circulars of the Reich Ministry of the Interior [used as a front organization for communications from the Reich Committee] in a proper manner.” The Tuttlingen director would have none of this and replied: “As a matter of principle I will not admit children into the Reich Committee institutions against the will of the parents or the guardians. For the time being you will consider the case closed.”
17

It is clear that most parents were not suspicious at first. The files of the institutions are full of letters from mothers wanting to visit, send laundry, and asking for news. The institutions themselves soon developed public relations techniques aimed at calming anxiety. In many cases they simply lied. Letters full of sweet euphemisms such as “your little son” or “your dear Annemarie” and phrases subtly preparing parents for the coming decline in the child’s condition were sent in reply to inquiries:

Children who suffer from disturbed development of the kind affecting your child always remain mentally retarded.… Experience shows that 90% of these children fail to grow older because of their susceptibility
to infectious diseases.… Should your child become ill we will notify you immediately. You do not need to worry. We have recently commenced a course of medication.
18

The “course of medication” was, in fact, a big worry. A series of doses of Luminal was the preferred method of killing children. Luminal depresses the respiratory system, and the victims, after a couple of days, usually developed pneumonia, especially if they had been weakened by starvation rations in the preceding weeks. To speed things up a dose or so of morphine mixed with scopolamine was given at the end. There is considerable evidence that the children’s deaths were not always painless. The Luminal process and its accompanying suffocating pneumonia often took days. Some of the more sadistic doctors preferred other methods, such as starvation or electric shock. There is also evidence that the children realized in their innocent way what was going on: in one institution nurses were surprised to find them playing something called “the coffin game.”

Efforts to remove a child from the custody of the Nazi health authorities once it had been declared “incurable” were seldom successful, but did occasionally occur. One doctor sniffily noted that “against medical advice” he had had to give a child back to the “unreasonable father.”
19

The case of Elly O. is more typical. Elly was a cheerful four-and-a-half-year-old spastic child, described as “euphoric” and “a chatterbox,” who talked to everyone and only cried when faced with “extraordinary situational changes.” She was able to repeat long sentences and name most ordinary articles. She had been taken into a Bonn clinic after her family’s house in Aachen had been bombed and her mother and two siblings had been evacuated. Two weeks after the bombing Elly’s mother wrote to say that she would like to pick up the child in a week’s time, since she was now able to take care of her again. The clinic doctor, trying to arrange Elly’s release, informed the local authorities that although the child’s condition could not be cured, there was no reason she should not be allowed to return home. But the authorities refused to release Elly on the grounds that insufficient care could be provided by her “bombed out and homeless mother.” They recommended, therefore, that the child be sent to another institution. No effort seems to have been made to check the parents’ accommodations. Elly was kept at the Bonn clinic for two more months and on March 24, 1944, was sent with nineteen other small patients to the euthanasia ward at Kalmenhof Hospital in Idstein, near Wiesbaden, where she died thirteen days later of “pneumonia.” The report does not
tell us if cheerful Elly cried much in the course of this “extraordinary situational change.”

Elly’s father did not believe that the reported cause of her death was correct. Despite the difficulties of wartime travel, he went to Idstein to find the truth:

I arrived at Kalmenhof and saw first of all a group of children, who I asked about my daughter. The children answered that they knew her, but that she had been fetched and had not come back.… I went to the home and looked for a doctor or anyone who could give me precise information on the whereabouts of my child. I found a doctor who told me that she had died on April 7 of pneumonia. Since this explanation did not satisfy me, I demanded exact details. I said that I did not believe my child had died a natural death. They told me that I had better be careful or I would be taken away. When I asked to see the grave of my child I was taken to a cemetery where I saw a number of mounded graves. I was told that one of them was that of my child. When I asked if I could buy some flowers to put on the grave they refused.… I was not allowed to speak to the head doctor. I am still convinced that my child did not die a natural death at Kalmenhof.
20

Parents were, of course, never allowed to be at such children’s bedsides when death came. Notification of the final illness usually arrived after the child was dead. Indeed, the mailing of the letters was carefully planned to do just that. Most were also deprived of the comfort of a funeral. Those parents who did manage to arrive before the children were buried were appalled by what they found. One mother found a note in the pocket of her son’s clothes that clearly indicated his misery: “Dear Mommy, I will not stay here with these people.… I will go my own way. I will not stay here. Come and get me.” The boy, not mentally ill at all, but an “asocial” juvenile who had been transferred to the euthanasia ward from a juvenile training camp, had tried three times to escape before he was beaten to death. The death certificate indicated that he had died of “poor blood circulation.”
21
Another suspicious father, who was allowed to view his son’s emaciated and bruised body, confronted the head doctor and asked to be told the real cause of death. The man pointed to the gold Nazi Party badge in his lapel and said, “What they all die of.”
22

Especially distressing to families was the lack of information. The euthanasia committees, for both adults and children, often did not notify families when patients were moved. Relations would arrive to visit and
find the person gone, with no information as to his whereabouts. The files are full of desperate letters from searching relatives. The stories all have tragic endings, none more so than that of a Jewish woman who had stayed behind in Berlin to be near her institutionalized daughter while the rest of her family managed to get out of the country. On the advice of the sympathetic director of a local center, she wrote four times to the “asylum”—in fact an extermination camp—at Chelmno, near Lublin in Poland, to which the girl had been moved, but her efforts were useless. “Where can I look further?” she wrote the director again in January 1941. “Perhaps you are a father, dear Director, and can well understand, that I have spent agonizing months of sleepless nights worrying about my dear child.”
23

By the fall of 1940 not only the children’s relations were upset. On October 16 a curious dispatch entitled “Mysterious Deaths of Mental Patients from Leipzig Consular District and the Connection Therewith of the Black Guard (SS)” went from the American consulate in Leipzig to the embassy in Berlin. Earlier in the month a vice consul had been asked by an acquaintance if he had noticed anything odd about a group of death notices that were appearing in the local papers. The informant told him that the mother of someone he knew had been institutionalized and had then been moved with no notice. After weeks of writing letters and searching, the daughter discovered that her mother was in an asylum at Hartheim, near Linz. Shortly thereafter, she was told that her mother had died and been cremated. The ashes would be sent to the cemetery in Leipzig. When she went to the cemetery to make arrangements, the gardener there exclaimed, “My God, what in heaven’s name is going on here: this is the fifth urn of this nature I have received from Linz today!” The consul also reported that in the first two weeks of October, twenty-two very similar death notices indicating sudden death and cremation “near Linz on the Danube” had appeared in the papers and that the inhabitants of Leipzig were “stricken with a fear of the far-reaching consequence of this horrible affair. A feeling of horror and complete insecurity of life has begun to set in.” But, the consul added, “the notices … have become so obvious in wording, containing almost direct accusations, and have aroused so much attention, that it is felt they will soon be suppressed.”
24
Other American consulates reported similar rumors.

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