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Chapter IX: The Psychological Interpretation of Culture and History

The medical ideology of Nazi Germany: Removing a “gangrenous appendix” from within the body politic
Richard A. Koenigsberg
The Nazi Doctors: Medical Killing and the Psychology of Genocide

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From 1976-1998—a twelve-year period—I neither published nor presented papers. In 1987, the Israeli clinical psychologist Avner Falk—apparently having read my two books—invited me to present a paper at a meeting of the International Society of Political Psychology. On July 3, 1988—on a panel that included Dr. Vamik Volkan—I spoke on “The Dream of the Nation.”

In 1989, Robert Pois, author of National Socialism and the Dream of Nature, invited me to speak at a conference in San Francisco on “The Rise of Adolf Hitler and Other Genocidal Leaders.” My paper has gone through many iterations and now appears as a Library of Social Science online publication, “Nationalism, Nazism, Genocide.”

But the primary impetus for my return to scholarship was the publication in 1986 of Robert Lifton’s, The Nazi Doctors: Medical Killing and the Psychology of Genocide.

In Hitler’s Ideology: A Study in Psychoanalytic Sociology (1975) I described Hitler’s view of the German nation as a “living organism” (see Chapter VI) that was suffering from a potentially fatal disease (see Chapter VIII). Hitler’s project was to wage a battle against the nation’s disease—to prevent the death of Germany.

My book is an empirical study of the relationship between Hitler’s fantasies, his ideology and his perception of reality. To my astonishment, Lifton discovered— among Nazi doctors—an ideological fantasy that was identical to Hitler’s ideological fantasy.

Lifton spent several years interviewing 29 men who had been significantly involved at high levels with Nazi medicine. Lifton’s reconstruction of the deep structure of Nazi ideology is based on the interviews, combined with an analysis of written accounts, documents, speeches, diaries and letters.

The central fantasy uncovered by Lifton was that of the German nation as an organism that could succumb to an illness. Lifton cites Dr. Johann S. who spoke about being “doctor to the Volkskorper (“national body” or “peoples’ body”). National Socialism, Dr. Johann S. said, is a movement rather than a party, constantly growing and changing according to the “health” requirements of the people’s body. “Just as a body may succumb to illness,” the doctor declared, “so the Volkskorper could do the same.”

When Lifton asked another doctor, Fritz Klein, how he could reconcile the concentration camps with his Hippocratic Oath to save lives, he replied “Of course I am a doctor and I want to preserve life. And out of respect for human life, I would remove a gangrenous appendix from a diseased body. The Jew is the gangrenous appendix in the body of mankind.”

Lifton mentioned this phrase “gangrenous appendix” to another Nazi, Dr. B., who quickly answered that his overall feeling and that of the other Nazi doctors was that “Whether you want to call it an appendix or not, it must be extirpated (ausgerottet, meaning also “exterminated,” “destroyed,” “eradicated”).

A number of the Nazi doctors interviewed by Lifton, then, conveyed a fantasy that closely resembles the fantasy that I uncovered at the core of Hitler’s ideology. In this Nazi fantasy, the nation is conceived as if a gigantic organism. Jews in this fantasy are imagined to be diseased entities within the organism whose presence might cause the body politic to die. According to this Nazi fantasy, preventing the death of the German organism—required the “removal” of these diseased entities.

Combining Lifton’s findings with my own, it’s possible to develop a broader theory on the relationship between phantasy, ideology and historical acts.

Nazi ideology—and the Nazi movement—grew out of an ideological fantasy. This fantasy revolved around the idea of the German nation as an actual organism—suffering from a disease that might prove fatal unless radical actions were undertaken.

Hitler conceived of himself as the “Doctor” of the German nation, who had a responsibility to attack and wipe out the cause of Germany’s illness. On February 22, 1942, Hitler stated that the discovery of the Jewish virus was “one of the greatest revolutions that have taken place in the world.” The battle that the Nazis were engaged in, he declared, was the same sort as the “battle waged during the last century, by Pasteur and Hoch.”

Nazi ideology, it would appear, grew out of a systematic, coherent fantasy—projected into realty. This fantasy revolved around the idea of Germany as an actual body (politic) containing a deadly disease. The Final Solution—the death camps—represented a response to this fantasy—an enactment. In order to save the life of Germany, the cause of her disease had to be destroyed.

This fantasy—of the nation with a disease that had to be attacked and destroyed—was shared by many Nazi leaders. Lifton concludes his study by stating that the medical ideology was not just one doctor’s perception, but was a “vision put forth by the Nazi movement.” The unifying principle of the biological ideology was that of a “deadly racial disease, the sickness of the Aryan race.” The cure for this disease was the “killing of all Jews.”

The data I presented in Hitler’s Ideology—along with Lifton’s findings on Nazi doctors—allow us to perceive the “deep structure” of Nazi ideology. Nazism revolved around the fantasy of Germany as an actual body (politic). Jews were conceived as bacteria or virus within the German body. The Final Solution was undertaken to remove pathological microorganism from within the body politic, thus enabling Germany to survive.