The Gallery of Miracles and Madness

by Charlie English

  These men were well aware of Hitler’s views on the matter of the disabled, which had changed little since Mein Kampf. In 1933, when the Führer was being advised on the Law for the Prevention of Genetically Diseased Offspring, he had aired his idea for a program of “involuntary euthanasia” to rid Germany of its burdensome patients. The idea was rejected then on the grounds that the public would find it unpalatable, but Hitler knew that war would weaken resistance, particularly from the churches, and make it “easier and smoother to carry out.” After the war, Brack would tell the U.S. military court at Nuremberg what he understood of Hitler’s position when the Kretschmar letter arrived:

  Ultimately, Hitler intended to eradicate those people who were kept in insane asylums and similar institutions and were no longer of any use to the Reich. These people were regarded as useless eaters, and Hitler was of the opinion that the extermination of these so-called useless eaters would give the opportunity to release more doctors, nurses, orderlies, and other facilities for the use of the Wehrmacht.

  Gerhard Kretschmar seemed perfectly to fit Hitler’s idea of a “useless eater,” and when the KdF men informed him of the case, he leapt into action, summoning his personal physician, Karl Brandt, and ordering him to travel immediately to Leipzig to investigate. Brandt was to interview the doctors involved and find out whether Richard Kretschmar was telling the truth. If so, Brandt was to instruct the doctors to carry out “euthanasia” in Hitler’s name. The parents were not to feel responsible or incriminated, Hitler told Brandt, and any legal proceedings were to be quashed on the Führer’s authority.

  Brandt hurried to Saxony, where he spoke with Catel and concluded that the baby “seemed to be an idiot.” Next, he traveled to Pomßen to interview the parents. Then he pronounced that Gerhard should die. The baby was probably injected with a lethal dose of phenobarbital, and on July 25 he became the first official victim of Nazi Germany’s policy of state killing. He was chosen no doubt because of his severe disability, and because the manner of the request meant Hitler’s decision could be given a humanitarian, ad hoc gloss, when in fact the program that emerged from Gerhard’s murder had been under consideration for many years.

  Hitler now ordered that the KdF handle all similar petitions, and Hefelmann was instructed to put together a secret working group on child euthanasia. It would include Brandt, and operate under the covert name of the Reich Committee for the Scientific Registering of Serious Hereditary and Congenital Illnesses. On August 18, 1939, at the behest of this committee, interior minister Frick circulated a confidential memo requiring German midwives to notify the authorities of newborns who suffered from certain conditions, including “idiocy and mongolism” (especially cases involving blindness and deafness); microencephaly; severe or progressive hydrocephalus; malformations of any kind, in particular absence of limbs, severe clefts of the head and spine; and paralysis, including spasticity. Berlin incentivized midwives with a payment of 2 reichsmarks for every name they supplied. Three doctors would make the decision of whether to kill a particular child: Catel; Hans Heinze, the director of Brandenburg-Görden asylum; and the pediatrician Ernst Wentzler. It was important for propaganda purposes that the decision-makers were medical professionals, though none of them ever examined the children whose deaths they ordered. Naturally, they all subscribed to the party ideology. Wentzler, who earned 240 reichsmarks a month for the extra work, recalled: “I had the feeling that my activity was something positive, and that I had made a small contribution to human progress.”

  The children who were sentenced to death were taken to one of thirty pediatric clinics around the Reich. The KdF instructed clinic personnel to carry out the killings using a variety of techniques, including overdoses and starvation, which could take days or weeks. German medics would eventually kill around six thousand children in this way. This was a small fraction, however, of the far wider mass murder program launched around the same time.

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  Earlier that summer, Hitler had summoned a group of high-ranking officials, including Reich health secretary Leonardo Conti, his private secretary Martin Bormann, and Hans Heinrich Lammers, the head of the Reichskanzlei (the chancellor’s office, as opposed to the KdF). He told them he was instructing Conti to start a program to end the “worthless lives of seriously ill mental patients.” As Lammers recalled the meeting:

  [Hitler] took as examples the severe mental illnesses in which the patients could only be kept lying on sand or sawdust, because they perpetually dirtied themselves, cases in which these patients put their own excrement in their mouths as if it were food, and things similar….He said that he thought it right that the worthless lives of such creatures should be ended, and that this would result in certain savings in terms of hospitals, doctors, and nursing staff.

  In fact, there was no evidence that savings could be made, because Hitler had not ordered any financial analysis, and anyway the cutbacks meant spending on the psychiatric system was very low, but this was the excuse he used. It was a sign of their ambition and moral bankruptcy that when Bouhler and Brandt were informed of this development they moved to defend the murderous terrain they had staked out with the program to kill disabled children, rapidly maneuvering to elbow Conti aside, arguing that all aspects of “euthanasia” should be kept within the KdF. Hitler agreed, and ordered them to take charge.

  Bouhler and Brandt conferred on how to implement their vast new commission. Because they needed to scale up their plans dramatically, they began to expand the pool of reliable Nazi doctors who could be trusted to sentence people to death. Carl Schneider of the Heidelberg clinic was one of those added to the original panel of child euthanasia “experts.” Others included Hermann Pfannmüller of the Eglfing-Haar asylum and Werner Heyde of Würzburg. Bouhler set out his plan to a dozen such medical professionals in Berlin at the end of July. Hitler had been engaged with the problem of the mentally ill for many years, he told the doctors. Killing them would create space and free up hospital staff for the coming war. The operation had to be kept secret because of the likely reaction of the foreign press, and everyone involved would be protected from prosecution. As Heyde remembered:

  [Bouhler] spoke of the fact that because of the necessary secrecy it was not feasible to carry out euthanasia in the individual institutions in which the patient in question lived. [He] also spoke of the fact that the execution had been conceived in such a way that an evaluation system should be set up, similar to the one in the work of Hoche-Binding.

  The men from the KdF had chosen their doctors well. When Bouhler finished talking, the attendees immediately began to suggest their own ideas for classes of patients who could be “euthanized,” and everyone invited to the Berlin meeting agreed voluntarily to participate in the program except the SS officer Max de Crinis, who had no moral objection but complained he was overcommitted elsewhere.

  With their medical experts in place, the KdF turned to the method of killing. What was the quietest and most efficient way to murder large numbers of people? Various outlandish solutions were floated, including the staging of mass coach or train accidents. Eventually, the problem was put to the Kriminaltechnisches Institut (KTI), a support department of the security service, and in particular to the chemical analyst Albert Widmann. The Reich police chief, SS-Gruppenführer Arthur Nebe, in the presence of an official from the KdF, asked Widmann if the institute could manufacture large quantities of poison:

  “For what? To kill people?”

  “No.”

  “To kill animals?”

  “No.”

  “Then what for?”

  “To kill animals in human form: that means the mentally ill, whom one can no longer describe as human and for whom no recovery is in sight.”

  Widmann went away to think about it. After conducting experiments at the KTI, probably with animals, he concluded that carbon monoxide was the bes
t poison, since it was both invisible and lethal. It could be pumped into psychiatric wards at night, he suggested, while the patients slept. Though this delivery method would not in the end be used, the men from the KdF were persuaded that carbon monoxide would be an excellent killing agent and provided Widmann with an order to source fifty steel cylinders, which were to be filled with gas by the Ludwigshafen chemical conglomerate IG Farben. The procurement was to be done in the KTI’s name in order not to arouse suspicion.

  At the same time, the search was on for an institution that could serve as killing station. Dr. Egon Stähle, the enthusiastic senior officer of the Württemberg health service, provided the solution here, recommending Grafeneck castle, a home for disabled children in a remote part of the Swabian Jura. That autumn, various officials visited the establishment incognito. It seemed perfect. Built in the sixteenth century as a hunting lodge for the dukes of Württemberg, the castle stood on a steep artificial mound at the end of a secluded, wooded valley. It was isolated, and its clear sightlines offered sentries plenty of opportunity to spot unwanted visitors, yet it was only thirty miles from Stuttgart. There was even a train stop nearby, which served the famous stud farm at Marbach an der Lauter. The KdF organized the confiscation of the home from its owners and operators, the Samaritan Foundation, and relocated its residents. Local people were told that the building was to be repurposed as a hospital for infectious diseases.

  The final major task was to recruit a unit of hardworking psychopaths to operate the new facility. Naturally, Bouhler and Brandt turned to the SS. The first man tapped to lead the team was Werner Kirchert, an adviser to the senior SS medical officer, Ernst Grawitz, who was also head of the German Red Cross. Grawitz explained the task to Kirchert. The killing had to be completely hidden from the outside world, he said, adding, without apparent irony, that the SS men employed at the castle would have to work undercover, to protect the organization’s reputation: They could not wear uniforms and would be suspended for the duration of the activity. It was “not a pleasant task,” Grawitz had to admit, but it had to be done, and life would be made very comfortable for the employees. They would have access to the radio, a library, and great quantities of alcohol. The money was extremely good, too—twice what Kirchert normally earned. It was even possible that their families could be housed with them.

  After considering it for several days, Kirchert refused the job, as he thought the whole thing was impractical. Instead, he recommended his friend Horst Schumann, a thirty-three-year-old former storm trooper now working as a junior doctor in the Luftwaffe. Schumann accepted.

  German troops crossed the border into Poland at 4:45 a.m. on September 1, 1939, triggering the Second World War. Two Führer orders were dated to that day, which officially marked the moment when involuntary “euthanasia” supplanted the time-consuming process of sterilization as the main method of combating degeneracy. The first order, the so-called “sterilization stop,” declared that surgical procedures should now be pursued only where there was a particularly high risk of reproduction. (For various reasons, this order was ineffective, and sterilization would continue unofficially until 1945.) The second order, signed by Hitler the following month and backdated to September 1, was written on the Führer’s private stationery, complete with the sovereign eagle emblazoned in gold in the upper left-hand corner. It stated:

  Reich Leader Bouhler and Dr. Brandt are charged with the responsibility to extend the powers of specific doctors in such a way that, after the most careful assessment of their condition, those suffering from illnesses deemed to be incurable may be granted a merciful death.

  Hitler’s regime was about to start something no state in history had attempted before: the industrialized mass murder of its own citizens.

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  Rumors that a killing action was about to begin spread far and wide, despite the KdF’s attempts to keep it secret. Hans Bürger-Prinz, the professor of psychiatry at Hamburg, recalled sitting with medical colleagues in the autumn of 1939 when a regional health official told them the city’s sick would be picked up for “euthanasia.” Such a program would be impossible to implement, Bürger-Prinz thought, telling the official: “Imagine doing that in practice!” Josef Schneider, a church finance officer in Rottenburg, remembered being told in October that “euthanasia was soon to begin.” The anticipation was so great, and the conditions in mental hospitals so dire, that staff had already started to jump the gun, administering overdoses to particularly difficult patients and logging their deaths as “general state of exhaustion” or “acute heart failure.” At Emmendingen, an assistant named Dr. Theato entered the asylum at night, took a large quantity of morphine and hyoscine from the medicine chest, and injected three patients with lethal doses. By the time they were found the following morning, it was too late to save them. Theato, who had already received his call-up papers for the military, was nowhere to be found.

  At the Eglfing-Haar asylum outside Munich, the institution’s director, Hermann Pfannmüller, was entirely open about his killing program. That autumn, he explained his methods to a tour group who were being shown around the Heil- und Pflegeanstalt. Entering a “clean, well-kept” children’s ward containing twenty or so children between the ages of one and five, Pfannmüller announced that, as a National Socialist, these “creatures” naturally represented only a burden upon the Volkskörper, the body of ethnic Germans. They did not kill such children with poison, injections and the like, he said, since that would only give the foreign press new propaganda material. “No: as you see, our method is much simpler and more natural.” Assisted by a nurse who worked in the ward, he pulled one of the children out of bed, displaying the young patient around “like a dead hare,” as one of the visitors, a schoolteacher named Ludwig Lehner, remembered. Then Pfannmüller announced with a cynical grin that “this one will last another two or three days.” They did not suddenly withdraw food, he said, but reduced rations gradually. He made no secret of the fact that among the children to be murdered were several who were not mentally ill at all but were the children of Jewish parents. The image of the fat, grinning doctor holding the whimpering infant in his fleshy hand stayed with Lehner for years afterward.

  Having found their method, staff, and a venue, Brandt and Bouhler moved to establish the substantial bureaucracy required by their program, which would later be known as Aktion T4, after the address of the villa at Tiergartenstraße 4, near the Berlin zoo, which became its headquarters. The Aktion T4 apparatus would include a number of front organizations whose names hinted at a philanthropic or charitable purpose. Thus, the “Reich Working Party for Mental Asylums” was given the task of collating the names of potential victims, dealing with their personal effects, and overseeing the registry offices that would fake their causes of death. This group set an early target to “euthanize” patients in the ratio 1,000 : 10 : 5 : 1, meaning that for every thousand people in Germany, ten were classed as mentally ill, five were in institutions, and one of these would be killed. Given that psychiatric institutions held around 350,000 patients in 1939, Aktion T4 was setting out to murder 70,000 people. Additional front organizations created by the KdF included a “Community Foundation for the Care of Asylums,” which would employ the personnel, run the buildings, acquire the gas, and exploit the gold teeth and jewelry stolen from the dead. The Community Patients’ Transport Service Ltd., known by its German acronym, Gekrat, would bring patients to the killing centers in buses borrowed from the Reichspost, the national mail service. In April 1941, a “Central Accounting Office for Mental Asylums” would also be established to fraudulently collect maintenance payments for patients who were already dead.

  On October 9, 1939, the Ministry of the Interior sent out a circular letter to psychiatric institutions, signed by Leonardo Conti, the Reich’s top doctor, which announced that copies of two forms were being forwarded to them for the purpose of gathering economic data. One r
equired details of the asylum itself, including its size, condition, number of beds, and type of construction. The other, more significant questionnaire, titled “Meldebogen 1” (Reporting form 1), demanded details for every patient who fell into the following categories:

  Suffer from the following diseases and are not employed or are employed only for mechanical work:

  Schizophrenia

  Epilepsy

  Senile dementia

  Therapy-resistant paralysis and other lues diseases

  Feeblemindedness of any cause

  Encephalitis

  Huntington’s chorea and other incurable neurological states

  Have been in institutions for at least 5 years

  Are held as criminally insane persons

  Do not possess German nationality or do not have German or related blood, stating race and nationality

  The real purpose of this registration form was not made clear. At Emmendingen, the medical director, Dr. Mathes, had heard a rumor that the asylum was to be evacuated, since it was so close to the French border, and he spent the first weeks of the war trying to find new places for his fourteen hundred patients. As the forms arrived during this time, it seemed to him that the two things might be related. But it didn’t really matter. Whatever their purpose, he had no choice but to make sure the forms were completed. He included one for Franz Karl Bühler, who fulfilled two of the stipulated criteria: He was diagnosed as schizophrenic and had lived in institutions for more than five years.

  Mathes returned the forms to the program’s Berlin headquarters, where they were photocopied and sent out to one of the medical “experts” for a verdict. The expert marked each patient with either a blue “−” or a red “+”, or, in the few cases in which he couldn’t decide, a question mark, sometimes with an added comment, such as “Worker?” As with the child euthanasia program, these medical men never met or examined the people they were sentencing, and they were not allowed to review their own patients. They were paid on a sliding scale: Those who appraised up to 500 files a month received 100 reichsmarks (worth around $725 in 2019), while those who assessed more than 3,500 a month were given 400 reichsmarks. The sheer quantity of life-and-death decisions being made by the most prolific reviewers would lead to numerous mistakes in which healthy individuals and good workers were added to the death lists.