Ernst Ferdinand Sauerbruch and His Ambiguous Role in the Period of National Socialism
Marc Dewey Udo Schagen Wolfgang U. Eckart Eva Schönenberger
The role of German physicians under National Socialism is highly controversial. We show that Ferdinand Sauerbruch, one of twentieth century's most outstanding surgeons and chair of surgery at Berlin's Charité from 1927 to 1949, openly supported ...
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PubMed Central (PMC)
Ernst Ferdinand Sauerbruch (July 3, 1875–July 2, 1951) was one of twentieth century's most outstanding surgeons ( ). A vast number of publications are available on his life and surgical achievements.1–10 Some of these publications present a subjectively biased, positive portrayal of his role during National Socialism in Germany.1,3 In other publications, this period of his life is simply left out, although they allegedly present the work of his entire life8 or they claim that Sauerbruch was in great danger because he was part of the anti-Nazi resistance.7 The most important study published so far on Sauerbruch's relations with National Socialism4 was ignored in later publications.7,8 Given this situation, we deliberately looked at Sauerbruch's activities and attitudes during the period of 1933 to 1945 in the present study.

Sauerbruch was born in Barmen, Germany. He started to study natural sciences in Marburg in 1895 and later went to Leipzig, where he completed his medical studies in 1901. In 1903, when he resumed his work under Johannes von Mikulicz-Radecki (1850–1905) in Breslau, he started to work on his most important surgical invention: the negative-pressure chamber.11 This chamber for the first time enabled operations on the open chest.12 However, positive-pressure ventilation, which was developed by the physician Ludolf Brauer (1865–1951) at the same time,13 became the established procedure in clinical practice.14 After 1905, Sauerbruch worked in Greifswald and Marburg and later he was appointed to the chair of surgery at the University of Zurich in 1910 and then at Munich in 1918. Other important and internationally renowned inventions were the “artificial hand” for amputated patients and a functional leg prosthesis for patients with tumors of the thigh. Also known are his experiments with surgically produced conjoined animals.3

Ambiguous Role of Sauerbruch

These speeches portray Sauerbruch as an outspoken supporter of National Socialism, but this is not the whole picture. In his private life, he supported victims of Nazi persecution.22–24 Many Germans advocated the antisemitism propagated by the National Socialists while at the same time having some Jewish friends and supporting them economically when they were persecuted.25–28 In 1933, Sauerbruch mentioned to his former Jewish colleague Hermann Zondek (1887–1979) that some hospitals were indeed ‘verjudet’ (pejorative expression for what was subjectively regarded as an excessively high proportion of Jews) before the Nazis came to power.29 This derogatory remark about Jews in general by Sauerbruch was the decisive reason for Zondek not to return to Germany from his Swiss exile.29 On the other hand, none of the most renowned German surgical journals of that time (Deutsche Zeitschrift für Chirurgie, Archiv für klinische Chirurgie, Zentralblatt für Chirurgie, Neue deutsche Chirurgie, Verhandlungen der deutschen Gesellschaft für Chirurgie) contains any negative comments on Jews by Sauerbruch. Nor do any issues of these journals contain any statements by him in favor of National Socialism.

Although Sauerbruch later supported victims of Nazi persecution, at least 13 professors were dismissed from the surgical department of the Charité for political reasons from 1933 to 1945.30 The number of residents and attending physicians dismissed during this time was probably even higher. The German National Prize for Arts and Sciences was not the only honor bestowed upon Sauerbruch by the National Socialists: He was appointed Staatsrat (state councilor) in 1934,31 promoted to the position of Generalarzt (surgeon general) in 1942,32 and was presented with the Ritterkreuz zum Kriegsverdienstkreuz (Knight's Cross of the War Merit Cross) by Karl Brandt (1904–1948, Hitler's personal physician and lieutenant general of the Waffen-SS [armed SS troops], who was convicted of war crimes in the Nuremberg trials of physicians, and hanged).33

Sauerbruch did not join the Nationalsozialistische Deutsche Arbeiterpartei (NSDAP). By contrast, he was a member of the so-called Mittwochsgesellschaft (Wednesday's Society), a club for public figures with a critical attitude toward National Socialism. Some of them were involved in the attempted assassination of Adolf Hitler on July 20, 1944, such as Ulrich von Hassel (1881–1944, ambassador), Ludwig Beck (1880–1944, general), Johannes Popitz (1884–1945, Secretary of Finance), and Carl Friedrich Goerdeler (1884–1945, mayor of Leipzig until 1937).34 However, the racial theorist and National Socialist Eugen Fischer, already mentioned above, also was a member of the Wednesday's Society, which shows that it cannot be regarded as an assembly of general resistance to National Socialism.4 Sauerbruch presented 7 medical scientific lectures at Wednesday's Society's sessions between 1934 and 1944. No political comments made by Sauerbruch during any of these sessions of the society have been preserved.

Together with the minister Paul Gerhard Braune (1887–1954) and Friedrich von Bodelschwingh der Jüngere (1877–1946), Sauerbruch attempted to use his influence to put a stop to the “Euthanasia Program T4” of the National Socialist government by personally calling on the Secretary of Justice.4 This personal protest was part of a larger movement in Germany.35 Daniel Jonah Goldhagen attributes the growing concern and indignation about the euthanasia program as well as the protest against it to the fact that the people affected were non-Jewish Germans.36 The resistance was mainly sustained by representatives of the church and had the effect of at least officially ending the ongoing killing of the mentally or physically handicapped, euphemistically referred to as euthanasia. Later this program was continued on a highly secret level, now designated as “14f13.” Goldhagen regards this kind of protest on a large scale as a model for what a suitable and successful protest movement of the Germans against holocaust might have been like.

Sauerbruch was head of the medical section of the Reichsforschungsrat (Reich Research Council). In this position, he approved “an increasing number of research projects from 1941/42 onwards [...] which aimed at performing experiments on humans in concentration camps or asylums.”37 Still, there is no definitive evidence to be found that with what was referred to as his “unbureaucratic” style, Sauerbruch should have realized that in many of these experiments the death of the subjects was deliberately accepted.37

Furthermore, Sauerbruch was a regular member of the scientific senate of the Academy of Military Physicians. This senate was responsible for approving all experiments performed by the German Wehrmacht. Several witnesses documented his participation in the 3rd working conference of the counseling physicians of the Academy of Military Physicians in 1943, at which Professor Karl Gebhardt (1897–1948, director of the so-called sanatorium Hohenlychen, Himmler's personal physician, convicted of war crimes in the Nuremberg trials of physicians, and hanged) and Dr. Fritz Fischer (1912–1948, resident in Hohenlychen, convicted of war crimes in the Nuremberg trials of physicians, and sentenced to lifelong prison) reported on experiments investigating the effects of sulfonamide on prisoners of the concentration camp Ravensbrück.38,39 Sauerbruch contributed to the subsequent discussion, but, much to the astonishment of his former Jewish attending, Rudolf Nissen (1896–1981), he did not criticize the experiments. However, Nissen believes that it was not possible to publicly voice criticism in this context.38 This is supported by another report stating that the majority of physicians present at this session considered the experiments superfluous without expressing their criticism (declaration of June 18, 1947 by Ludwig Lendle given to the Verlag Lambert Schneider, from the manuscript department of the Deutsches Literaturarchiv [German Literature Archives], access No. 2000.7). During the Nuremberg trials of physicians, Karl Gebhardt and Fritz Fischer declared that “it was absolutely clear that the experiments had been performed on the prisoners of a concentration camp” and that none of those present at the session expressed their criticism.39 Chief Prosecutor James McHaney commented: “This affidavit proves beyond doubt that knowledge of these criminal experiments was available to leading physicians in Germany [...] They were individuals who were in a position to take measures to prevent such things and had the duty to do so.”39 In the Journal of the University of Göttingen, Wolfgang Heubner, together with Sauerbruch, protested against this representation of the situation in the 1947 published book Das Diktat der Menschenverachtung (The Dictate of the Contempt of Humanity)39 by Alexander Mitscherlich and Fred Mielke, making it clear that “there are no grounds whatsoever for blaming us for encouraging violations of humanity through inadmissible silence.”40 In an affidavit, Sauerbruch declared, moreover, that during the 3rd working session of the counseling physicians of the Academy of Military Physicians “none of the participants was likely to have heard that experiments were performed on prisoners” (declaration of July 14, 1947 by Sauerbruch given to the Verlag Lambert Schneider, from the manuscript department of the Deutsches Literaturarchiv [German Literature Archives], access No. 2000.7). Alexander Mitscherlich responded to this criticism and clarified the intention of his book, The Dictate of the Contempt of Humanity, which was not to accuse or to ostracize anybody but rather “to point out the dangers to which scientists were exposed by no longer being able to control the forces they unleashed. It is a problem that concerns not only us Germans. This is why the book has everywhere been correctly interpreted as intended, that is as a forewarning of an all-pervasive danger rather than as a means of encouraging a cheap hatred of Germans.”41 This all-pervasive danger is also present nowadays, and parallels to the situation in Nazi Germany were recently drawn impressively by Elie Wiesel, former prisoner of the concentration camp Buchenwald andrecipient of the Nobel Peace Prize in 1986, in a perspective article.42

In his much acclaimed article on the role of German physicians under National Socialism, Hartmut Hanauske-Abel regards the behavior sported at the meeting of military physicians as typical of the time since “no-one had the courage to sacrifice himself and to oppose the government publicly.”43 In another study, Hanauske-Abel demonstrates that German medicine did not gradually slide down a slippery slope into “Nazi medicine” but that the relationship between the medical community and the government was dramatically changed by the convergence of political, scientific and economic forces in 1933.44 However, it remains open whether public criticism or even opposition would have been effective or whether Sauerbruch would then have risked losing any possibility of exerting his influence. On the other hand, Sauerbruch would not have endangered his position as a university teacher by not publicly supporting the Nazi regime as is illustrated by others who did not show this kind of public support. From today's perspective, the prominence and importance of Sauerbruch as a public person raise expectations of more progressive and critical behavior. Nevertheless, it is very hard to tell how difficult it actually is to express public criticism in a totalitarian state. On the other hand, there was also active resistance to the Nazi regime at the Charité, for instance by the physician Georg Groscurth ( ).

After 1945

Sauerbruch was one of only a few chairmen of the Charité who experienced the collapse and the occupation of Berlin in the Charité in 1945. During the final stages of World War II, Sauerbruch had moved to the Charité and lived there to continually operate on wounded soldiers in a surgical bunker.5 Sauerbruch became Medical Officer of Berlin's first postwar municipal council, effective from May 17, 1945.45 In this position, he organized epidemic control, but he also hesitated to agree to the removal of all fascist elements from the health services. On October 12, 1945, the 4 Allies on the basis of Sauerbruch's political actions and attitudes between 1933 and 1945 decided to remove him from office at the municipal council.45 A detailed analysis of Sauerbruch's political stance after 1945 was conducted by the former chairman of Medical History at Berlin's Charité, Professor Dietrich Tutzke, and published in 1985.45 Sauerbruch was clearly a figurehead of East German science,46 and his ambiguous relationship with the Nazis was neglected both in the German Democratic Republic (East Germany)3 and the Federal Republic of Germany (West Germany)47 until the 1980s.4,45