Sauerbruch, the Nazis, and the War Years

Astrid Viciano

February 25, 2020

An almost unbearable smell had invaded the bunker of the university hospital clinic Charité in Berlin. The wastewater could no longer flow from the operating theatres where the surgeons had been working, during endless days and nights.

Seriously injured people filled the corridors, awaiting their turn. To top it all, the doctors had run out of morphine, noted Adolphe Jung, an Alsatian surgeon, in his diary on April 29th, 1945. He had operated on 300 patients with serious traumas during the last 10 days, and many others with light injuries. "I haven't changed my clothes in 8 days," added the doctor in his notes.

Adolphe Jung, a spy for the Allies, meticulously documented the conditions under which he had to live and work at the Charité during the last weeks of the Second World War. Above all, he described the everyday life under the Nazi regime in the clinic of the German star surgeon Ferdinand Sauerbruch. A few months ago, the notes of the Alsatian doctor were published for the first time, in German. They provide a deeper understanding of the prominent German doctor who is seen as a supporter of the Nazi regime by some, whereas others idolize him as a blameless fighter in the anti-Nazi resistance.

Sauerbruch has been the central figure in a highly successful German television series called 'Charité at War' (Netflix), which gives insight into the ambiguous history of the clinic. Moreover, the renowned medical history museum of the same hospital dedicated a whole exhibition to the German physician, based on the diary of Adolphe Jung.

The fate of the two doctors at that time appears inextricably interwoven: Adolphe Jung, who was forced to leave his home town of Strasbourg by the Nazi regime, and Ferdinand Sauerbruch, who had made an astonishing career under the same regime at the Charité and had become one of the best-known doctors in Germany.

Shades of Grey

Rather than coarsely highlighting extreme positions, Jung's notes manage to grasp the nuances and ambiguities of the time. "Back then, people had to choose over and over again, whether they wanted to go with the Nazi regime or oppose it", says Susanne Michl, medical historian at the Charité, who published the diary notes as a book, together with two other colleagues.

These nuances convinced Frank Jung, Adolphe's son, his wife and family to publish the diary in German. "The records make it clear that not everything was black or white at that time," says Frank Jung.

His father described Sauerbruch as an unusually talented surgeon, one who often completed four to five procedures in only one morning. During surgery, however, he would often bully his colleagues. Often he would tell young doctors to leave the operating theatre, sometimes even firing them without notice. "He ruled over his assistants. By using his knowledge, slyness, and power, he would make them submissive," explained Adolphe Jung in his notes. Sometimes Sauerbruch would be charming and engaging, sometimes short-tempered and ruthless. "His personality was full of contradictions," says Thomas Schnalke, director of the medical history museum of the Charité.

Sauerbruch Chamber

Sauerbruch had probably accustomed himself to the harsh handling of young doctors in Breslau, where he trained with the famous surgeon Johann von Mikulicz-Radecki early in his career. Radecki reigned with military dictum, and made Sauerbruch face a big challenge right after his arrival: Until then, surgeons had avoided thorax surgery, because the patient's lungs would collapse immediately after the first incision. The air flowing in from outside removes the negative pressure that usually exists in the narrow space between the chest wall and lungs. Patients are then at risk of suffocation.

Radicki wanted Sauerbruch to solve this pending problem. And he did: He invented a chamber in which the surgeon could operate under reduced pressure, with the help of a dedicated pump.  The patient's head protruded through an opening in the chamber, which remained sealed by a rubber sleeve around the patient's neck.


As a young assistant, Sauerbruch had to defend his method against criticism from well-known surgeons. When a competing procedure using positive pressure finally prevailed, he quickly attributed this invention to himself as well.  "Even as a young surgeon, he did not lack self-confidence," says Schnalke.

Contradictions

This may explain why Sauerbruch was not afraid to treat Jews in his clinic when this was officially prohibited long ago. He once invited an SS doctor to visit his clinic, occupied him with a specialist discussion and a lot of cognac - his ruse prevented the arrest of a Nazi opponent persecuted by the Gestapo. Nevertheless, Sauerbruch received the German National Prize for Art and Science in the Reich Chancellery, and called for the support of Nazi politics in an open letter in 1933.

He was a clear opponent of the Nazi mass killings of sick or disabled patients or people undesired by the regime. Nevertheless, he met with Max de Crinis regularly. The neurologist was instrumental in the preparation and implementation of the Nazi 'euthanasia' programme, Adolphe Jung describes him in his diary as a friend of Hitler - and as a fanatic.

During a lecture in 1943, Sauerbruch heard about cruel experiments with gas fire pathogens in the Ravensbrück concentration camp, but did not protest against it. And in the Reich Research Council, Sauerbruch was responsible for the medical division, which among other things, approved experiments in Auschwitz.

What does that mean? Sauerbruch's aim was to survive in difficult times, says Frank Jung. And he helped many people. Sauerbruch, for example, had admitted Adolphe Jung to his clinic after he had been forced into the "old Reich" by the Nazis. Adolphe Jung had previously refused to work at the newly founded Reich University in Strasbourg.

However, it does not become clear from the notes whether Sauerbruch knew that Jung worked at the Charité as a spy for the Allies. In his room at the clinic, Jung photographed secret documents together with Fritz Kolbe, an official from the State Department. Kolbe or Jung brought the pictures to Bern or Strasbourg, and sent them to the English, the French Résistance and the Americans.

"My mother and my three siblings in Alsace would have been shot or deported immediately if my father would have been caught," reports Frank Jung. He was not born until after the war.

However, his father had to witness the Charité in ruins in 1945, forcing the doctors to operate in the narrow bunker. After the Russians take Berlin, Jung returned to his homeland. With a bike, and provisions for a month in his pocket, he made his way to Strasbourg. Sauerbruch, on the other hand, stayed in the capital and was confirmed as head of the clinic at the reopened Berlin University.

Sauerbruch's Fame

Sauerbruch developed a special operation in 1922, especially for war injuries from the First World War. It was to be used, when the femur was so badly injured that it could not be saved.

To do this, Sauerbruch first made a long cut across the outside of the thigh, from the hip to the knee. Then the muscles and blood vessels were removed as well as the bone ends from the hip and knee joints. He would continue the cut on the outside of the leg down to the foot which he then amputated. Finally, he turned the bones of the lower leg 180 degrees and fitted them into the acetabulum, the natural socket of the hip joint. The aim of this procedure was to create an artificial thigh stump that could hold a prosthetic leg. This enabled the wounded soldiers to get back on their feet, and lead an independent life.

As a senior medical officer in World War I, he also developed active arm prostheses for war injuries - a pointed gripping hand, for example. In a film, Sauerbruch recorded what the prosthesis made possible for the patient: Since the thumb and index or middle finger of the prosthesis met, those affected were able to perform demanding hand movements.
In the film in question, two young men open a bottle with the prosthesis, close a belt and light a cigarette. The two patients had lost both arms as minesweepers, and Sauerbruch aimed at giving them new independence with the prostheses.

Michl S, et al: Zwangsversetzt – Vom Elsass an die Berliner Charité: Die Aufzeichnungen des Chirurgen Adolphe Jung, 1940–1945. Schwabe Verlag Basel Berlin 2019.

Translated and adapted from Medscape's German Edition.

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