Medicine in articulo mortis in Nazi German concentration camps and jails. Part Two

Part Two

Perfidiously and viciously, all the appearances were kept up. The camp had its doctors, and its hospital wards had curtained windows and were bound to look tidy: after all, a patient would lose a tooth or two if the chores were not done properly. On the day when the camp was inspected by some committee or important figure, that is during a hoher Besuch, your soup might contain some groats or even a piece of potato instead of smelly rotten turnip. The next day you were back to “normal,” with nauseating hogwash for hospital food. Thus the sick, thanks to the “humanitarian” SS administration, asserted their right to receive any necessary medical care and treatment. The problem was that all the prisoners were unwell, except for the criminal functionaries, Kapos and block supervisors, and their bootlickers. Castrum doloris et mortis.^a Whole blocks full of prisoners, roused at daybreak and forced to work like slaves, were infected and diseased.

I cannot say what was worse and riskier for a prisoner: trying to gain admission to hospital or at least to get an appointment with a doctor by obtaining permission from a number of raving sadists, as stipulated by the camp regulations; or just waiting for the disease to develop and rotting away at work and in the block. The same deadly lottery went on every day, every hour, with every breath you took in the camp. Those who were lucky managed to reach Polish doctors in the hospital wards, where they were given as much help as possible.

The doctors themselves did everything to take hundreds and thousands of prisoners to hospital in order to provide some treatment or, in extremis, just a place to die a peaceful death, which was craved for by all those shadow people, those human rags who could hardly drag their feet, who were constantly rushed about and beaten whenever possible. But how could one help and deal with this enormous mass of sick people in the camp, especially that by civilised standards each of them required prompt medical care? No one received the desperate Mayday call, no matter if the senders were praying or cursing. They could only continue their race against time and death.

For some prisoners liberation came at the last moment, when they could still get help. I was all swollen after a long period of starvation, and weak after a spell of typhus so, as a “free man,” I had to be virtually dragged by Dr Jan Nowak to Prague; our departure point was Leitmeritz, where we had been deported from Gross-Rosen, travelling for three days in an open-topped coal wagon. It was January. Several moribund prisoners were shot, others died after the liberation of exhaustion and diseases they had got in the camp. Death sentences were carried out for as long as the camps were in operation, some of them just a few days before the camps disintegrated. Yet many people survived all of that, and are still alive. By what means or miracle, I do not know. I cannot explain it. They must have had some special resilience, the ability to survive the unsurvivable – against reasonability and the human idea of probability. Only one thing is certain: no one returned home in the pink of health. Each of us came back “flawed,” either with an inner, mental scar or damage to his physical condition, which presented itself sooner or later; frequently both kinds of problems coincided.

As I have said, there were very few doctors. Therefore prisoners tried self-treatment. You could call it “folk medicine,” or perhaps it was just a manifestation of the human survival instinct. They resorted to their own invented “therapies,” or recalled scraps of medical information, which sometimes brought positive results. Everyone sought help in every possible place and in every imaginable manner. Actually, camp medical “knowledge” deserves its own study. That “folk medicine” was applied by people in dire need, so the attempts were sometimes pathetic or based on superstition, not very different from the abracadabra of old witch-doctors in far-off, godforsaken villages. The camp was a conglomerate of all kinds of people, some of them almost illiterate, such as Russian POWs or Polish peasants from economically backward regions, where the “doctors” practising “medicine” were unlicensed bonesetters or charmers who “cured” the sick with their magic spells. But even when some quack treatments, primitive and illicit, were known, they were applied in utmost secrecy, undercover. The most frequent outcome was the saddest one, and it came sooner than it would have done without the intervention.

The treatments were the oddest possible and the consequences probably not to be explained by science or academic medicine. For instance, I observed that Russian officers, that is fairly educated people, who were imprisoned in the concentration camp after an unsuccessful escape from an Oflag, tore cement bags, which had just been emptied a moment earlier, to make dressings for festering wounds or pus-filled abscesses. When I sternly warned them that such thoughtless behaviour would end in infection, they jeeringly asserted they had healed innumerable purulent wounds in precisely that way. They admitted they knew all the old wives’ tales about asepsis, but the method had been successfully tried in German POW camps, and good results were guaranteed. To prove it, they showed me their scars left by old deep abscesses.

At the time I had not been imprisoned in the camp for long, so I had no connections to be admitted to the surgery in the hospital block, where some lucky prisoners, having returned from work, had their wounds dressed by Dr Stanisław Konopka (now a professor of medicine working in Warsaw). He and his orderlies cleaned and treated wounds incurred during the day’s labour. Although they had only some paper bandages and liquid disinfectant, their help was really professional and the dressings were hygienic. But in the early days of my imprisonment I did not know how I could get my wounds dressed. Janusz Pratkowski and I were just recent arrivals and we were working in a Kommando that was digging canals.

Due to misfortune, or rather infection, I had enormous, painful and putrefying abscesses on my thighs and ankles. The latter was absolutely horrible. I wrapped my ankles in whatever I managed to get hold of, but it was not safe at all to be caught by an SS man with a dangling, unwinding rag when we were working or forced to parade march through the camp gates to the music played by the camp orchestra. I did not know what to do about my bigger and bigger wounds, so I took the advice of Yasha Rynkevich, a Russian officer who lived in my block, having concealed his Jewish origin. I wrapped the worst wound with strips made from a cement bag, past caring what might come of it. After a few days there was no more discharge, the wound seemed to be closing up and granulation tissue started to form. What more can I say? Nothing.

We had different explanations of such phenomena. Yet the festering wounds did heal. We hypothesised the process was like those described in Sienkiewicz’s novels when our ancestors used their dirty hands to make a mixture of bread and definitely unhygienic cobweb to apply it to open wounds. Who can say how it worked? Perhaps some penicillin was to be found in the cobweb, or in the cement dust in the bag? I cannot know. It was 1943, and Fleming’s antibiotic was not in general use until 1944, starting on the Italian front, after the landing of the Allied forces.

I wanted to find out how it was possible, so now, in Warsaw, I talked to Professor Tadeusz Korzybski, one of the best Polish experts on penicillin. His authoritative opinion was that cement bags could not hold any traces of antibiotic. So that enigma of camp medicine remains unsolved. Of course, I have no data to show that, contrariwise, in very many cases the wound got infected, the prisoner’s health deteriorated, and he was offered the only way out of the camp, through the crematorium chimney. I am describing only those treatments that I observed, and some of them I even tried. Later, when I knew how to reach Dr Konopka, I never revealed that, but probably he was very much aware of the variety of prisoners’ self-treatments. The best of friends and carers, Dr Konopka was. Our saviour and helper on the spot.

There were so many freakish remedies in the camp. Some sense could be seen, though, in wearing a supportive strap when the kidneys were damaged, because then they were secured in position while the prisoner walked or worked, or was forced to run and exercise for long periods. The damage was obviously caused by beating and kicking. Common conditions affecting the kidneys, except in the final stage – just as peptic ulcer disease which the prisoners may have had previously – became less severe or self-cured thanks to the poor camp diet and starvation. But as the camp “specialists” intentionally caused kidney damage, it was a typical problem: every evening prisoners’ gear was inspected in bright electric light and for any single louse discovered, the “owners” were hit five times in their lower back with a wooden chair leg. The most likely outcome of such “fun,” accompanied by hearty laughter from the block functionaries, was at best long-term haematuria.

The situation of the beaten prisoner was much worse if he lost bowel control due to the pain and defecated, which his oppressors were sure to notice. The procedure was always the same: the blows multiplied, and the unconscious victim was dropped in a water trough in the Waschraum, with all the taps turned on. If it happened in winter, he perished in the icy water, and the next morning he had to be laid among all the other dead bodies, neatly arranged in fives in the right wing of the block, as the functionaries always needed to know the count of those dead or alive. Ordnung muss sein! The report included the prisoner’s number and the cause of death: allgemeine Körperschwäche [general exhaustion].

Each wing of the block slept several hundred people and bunks were shared by two or even three. Both day and night shift workers used the same blankets and mattresses. And they fed the same lice. When the day shift were leaving for work in the morning, the night shift were just returning, to sleep in the self-same bunks, under those very blankets. So they also shared the pus, oozing from everybody and drenching everything. The prisoners’ pates were clean-shaven, but that just meant no head lice – their clothes were infested, and their skin badly bitten. Yet, as any survivor can confirm, the lice were not the worst nightmare. When they are full of blood, they stop biting, so after a while they left you alone and you could get some sleep. The fleas and bed bugs were the true pestilence.

They were an awful nuisance when a prisoner, exhausted by hard work, wanted to get a few hours’ rest. His fight against these pests was hopeless. Millions of them were everywhere, always active. Until the morning roll call came at dawn, everyone had been scratching his skin with dirty hands, which were actually never washed clean. The pus-producing germs and bacteria causing trachoma could spread easily. Before going to sleep, the prisoners washed their feet, otherwise, they were not allowed into the Schlafraum [dorm]. If the functionaries found that a prisoner’s feet were dirty, they administered the same punishment they used after discovering a louse. The rest of the body remained unwashed, as prisoners were too tired and they were not given enough time: the functionaries wanted to be done with their duties as soon as possible to start quiet time in the block.

All the prisoners rested after work, having been driven into the Schlafraum with sticks by the functionaries’ assistants. Then the Blockführer’s dinner was cooked. He got roast potatoes pilfered from prisoners’ rations (as the kitchen staff exchanged food for various favours and privileges) as well as a sizeable chunk of horsemeat sausage, likewise stolen. His afters were delicacies that he received as “gifts” from the prisoners: fruit, sardines, and sweets, as I saw. Those were the dinners enjoyed by the Blockführer and his Kapos. During the meal they would discuss and deal with all the internal affairs of the camp, and even remember their families. For they were good, kind-hearted fathers and affectionate husbands indeed. To top off their dinner with some entertainment, they could always beat and kick a prisoner with a bladder condition, who wanted to find his way to the toilet on the sly. Frequently the functionaries drank alcohol, which was smuggled into the camp and bought by Kapos. When there was none, they inhaled ether, pinched from the SS hospital, and the next day all the block was reeking. Senior functionaries winked at such cases of substance abuse: from time to time their well-trained watchdogs had to be rewarded for their efforts. The benefits were strictly disciplined labour and peace and quiet in the blocks.

Occasionally the camp was disinfected. All the prisoners, stripped naked and with blankets over their heads, were turned out of the blocks, summer or winter, and herded into the Waschraum. We had to wait several hours for our turn to wash, as thousands of people were crowded outside together all at the same time. Finally, we scuttled under the showers which were spitting either bitterly cold or boiling hot water. At best it was a change from the routine, but not really a wash. Then we were hustled back into the blocks, which had been stripped of all the mattresses and blankets for disinfection with steam, just like all the camp gear. When another few hours or even the whole night passed, all those items were handed back with all the lice, bed bugs, pus, blood, and excrement still in them. Such operations to implement Nazi German standards of hygiene were a source of great pride for the camp administration.

Each block wing had six toilet seats. The one next to the window was off-limits and could be used exclusively by the Blockführer and Kapo. Woe betide any presumptuous creature who dared to perch there! So there were five toilets left. Initially, there were hundreds of contenders, but later, when the sub-camps were being evacuated to Gross-Rosen, over a thousand. At the same time, keeping Sauberkeit, that is cleanliness, was a prisoner’s primary duty. So the toilets had to be spick and span, day and night. A large proportion of the prisoners suffered from persistent diarrhoea (Durchfall), but they could seek hospital admission only when blood was visible in the stools, because that might spell a contagious disease, and a prisoner could try to see a doctor only when facing utmost exhaustion and the prospect of becoming a Muselmann.

The only remedy, considering the living conditions in the camp blocks, was not taking any food or drink for a few days, sometimes a fortnight. Also, you could eat a charred piece of bread. Sometimes it helped. But how could you forgo rotten turnip in hogwash soup, or a crust of your rationed bread, which you had been pining for all day long, especially that food was your constant obsession? That required a really heroic effort, which only a few could make. And you always died a slimy death. Diarrhoea resulted in severe dehydration. And that terrible thirst!

In my block there was one most desired job, or actually two jobs. The position was dubbed the Scheisskapo and the duties, quite responsible ones, involved permanent attendance in the toilet so as to keep the seats sparkling clean. The perks were staying indoors (what privilege in winter!), and practically no physical effort. An ideal job for a person who should not exert himself, for instance in old age, or who should be helped to survive. So we managed to convince our Blockführer – who had his virtues alongside his vices, as it turned out when we had delved into his mind and his ambitions – that his ideal applicants were the most senior prisoners in the block, the Generals Ignacy Ledóchowski and Radosław Stokalski, recipients of the Virtuti Militari decoration for military valour. I am perfectly aware that the situation I am describing was utterly degrading, but we were in the camp and wanted to seize the only opportunity we had to save the two men and to help them survive.

The Blockführer used to be a full-time second lieutenant in the Polish Army. Already in 1939 the Germans arrested him for hiding Polish officers who had not revealed their identity to the occupying authorities. Then his biography had many twists and turns. First, he was imprisoned in Auschwitz and because he spoke fluent German (as he had lived in the Silesian city of Tarnowskie Góry), he was soon promoted to the rank of Arbeitskapo in the Raisko sub-camp to supervise a few thousand young and strong women and girls tilling the fields. He was twenty-one. No Turkish sultan, no other Orient pooh-bah described in Arabian tales could have had so many youthful females at his beck and call, ready to obey. Especially as they were starving. One did not have to wait long to see the consequences, but that’s a different story. Suffice it to say that my protagonist was taken first to the Strafkompanie [penal company] and then he became a Blockführer in Gross-Rosen. He granted our request and thus both elderly, most respected generals were given the post of Scheisskapo. We almost wept for joy and bitterness at the same time. They were safe!¹ By the way, both of them had been arrested for administering the military oath to partisan soldiers of the Polish Home Army.

Not all the prisoners were so lucky. Even seriously ill people found it difficult to be admitted to hospital. There were many obstacles on the way, and it was a dreadful ordeal to arrange an appointment with a doctor. On the other hand, it was a transgression against the rules and regulations when a sick prisoner stayed in his living block. Transgressors were turned into phosphorus-rich dust to fertilize the magnificent flower beds and vegetable patches where the SS greens were grown. Gross-Rosen was actually famous for its exceptionally fertile soil and carefully tended multicolour flower strips.

When you went through the gate of the camp, noticing, of course, the floodlights and the machine guns, you might have had an impression that you had just got into a neat and sweet holiday village. You forgot the grim pictures of grey and craggy stone pits you had seen on the way from the railway station. That illusion of Eden was shattered after just a few moments when you met the SS men supervising the camp and the howling horde of the functionaries. The new arrivals, bewildered, received the first blows of the baton and whip, and the first boot-kicks, not for any particular reason, but just to help them figure out they were in a concentration camp. They entered a path of affliction and annihilation.

I have already described our most devoted, miracle-working doctors, but I would like to say more about our own “therapies” which we resorted to. Given that the prisoners had different educational and family backgrounds, they would use the strangest remedies, sometimes just to pretend they were trying self-help.

The only sure disinfectant that was commonly available was fire, and we had little heating stoves in the blocks, but of course, we could use them only in winter; from spring until late autumn we were forbidden to do that. If any smoke or sparks were noticed over the chimney by the guards watching the camp from the wooden towers, the case was investigated and the inhabitants of that particular block were severely punished. However, we soon learned how to deal with that problem. One of the prisoners had to keep an eye on the stove and, using a wet cloth, to control the smouldering fire at all times. In this way, when we worked the night shift, for instance in the Siemens workshops, and when the Kapo did not mind, we were able to simmer potatoes we had filched or to heat up soup; on one exceptional occasion I cooked a piece of meat that my friends had given me, something I had not tasted for months.

It was a really disgusting meal, underdone and rubbery, but it was real meat! I devoured it greedily – for such food was an exotic delicacy in the camp – undeterred by the fact that chewing it up was quite an achievement. Yet, when my mates told me I had just tried cat flesh – and they had put so much effort into ensnaring and preparing Mulli, the Blockführer’s pussy – I threw up, though I had appreciated the refreshment just a moment before. My friends concluded that obviously I was not starved at all. At that point all my body was swollen due to a long spell of malnutrition and vitamin deficiency: when I pressed my finger hard against my thigh, the dimple would disappear only when I massaged the muscle all over for a long time. I think that was the first and last occasion when I had some meat in the camp.

The stove had multiple functions. Importantly, it warmed the block: the prisoners were usually chilled to the marrow and their clothes were sodden. Even when you got wet during work or at roll call in the snow or rain, your clothes had to be folded the right way when you went to sleep. In the morning, you put your drenched gear on again.

Another difficulty was our footwear – the camp wooden clogs. Although they were open at the heel, thanks to their thick soles we did not get our feet wet when standing for hours on end in the roll call square. They were not warm, and yet a pair of clogs was an object of desire. However, it was practically impossible to march or run without losing one in the process, and doing that during a parade march, when we had to strut in properly aligned fives in front of SS men, was an absolute disaster. The only way out of that one was to invest at the camp’s “stock exchange,” where the “upper crust” prisoners and those who were allowed to receive parcels from their relatives could buy or rather barter all kinds of goods to their hearts’ content. There were, at the most, about a few hundred so fortunate in the camp, whose population reached five-digit figures. We also had shoes with textile uppers, but as their soles were shoddy, they tended to get so dank that it was no mean feat to take them off. You had to be a Blockführer’s toady to get permission to enter the Schlafraum with your shoes on, then leave them next to your bunk or hide them under your straw mattress. The rest of the prisoners had to walk in in their socks, having left their clogs at the door that joined the wings of the block. Any change or theft of clogs resulted in the owner’s dejection or even desperation.

What was most desired and sought after was any source of warmth, such as … the sun. But there was one point at issue. It is true that wounds healed faster when exposed to the sun, so they were eagerly laid bare for a sunbath. However, only the doctors knew that the sun was the archenemy of those who had contracted TB. Due to intense sunlight, any tubercles and scarring in the lungs quickly turned into cavities, because the prisoners were extremely emaciated. Some phrases describing the disease sound really innocent now, for instance when we say that it “spreads through the air,” but I can still remember thousands of people persistently coughing, hawking up phlegm from their throats, and breathing huskily into each other’s faces on the bunk they had to share. Handkerchiefs were a thing of the past, and our shirts, though long since dirty, also served as our towels. To save water during their morning wash, all the prisoners from one wing of the block used only as much of it as had trickled from the few taps to fill the trough in the Waschraum. Also, you had to hurry up. Move it! Move it! Raus! So, between us, we had tuberculosis, trachoma, and scabies, and abscesses all over our bodies. For what was the use of rubbing on Mitigal, the anti-scabies ointment that the doctors sometimes managed to wangle, when the shirts, underwear, blankets, and bolsters were never changed? One of the recommended methods was to wash scabies-infected body parts with your own urine. I did not try that one but no doubt it could relieve the itchiness.

In concentration camps, urine was the panacea to treat festering wounds, minor cuts, boils, all kinds of skin damage and rash. It was even used to control trachoma. Urine compresses were placed on infected, suppurating eyes with white lumps under the eyelids. I do not know whether such procedures stemmed from the common but false belief that a handkerchief soaked in urine may temporarily replace a gas mask, or from the long-cherished idea of the peoples of the East that urine is a powerful medical reagent and disinfectant. One way or another, it was pointless to tell the prisoners such “therapies” were ineffectual. Urine compresses and baths were applied to myriads of oozing wounds and trachomatous eyes, thanks to the joint efforts of the interested party and his fellow-prisoners.

It would be a lie if I claimed those pseudo-cures never helped. I cannot say if the effects were long-lasting, but even some temporary relief was welcome. In his autobiographical book Seven Pillars of Wisdom, the British World War One intelligence officer T. E. Lawrence writes that the entire Arab world uses urine as the strongest and most efficient substance to disinfect open gunshot or blade wounds, which otherwise would get infected in the inhospitable climate of the Orient, what with the scarcity of water, few doctors, and swarms of flies. Yet infections occurred rarely and wounded people did recover, those were the facts. Even in Poland, especially in the easternmost regions, lacerated wounds used to be covered with dressings that were first soaked in liquid manure. It may have ended in gangrene and death, but during my summer military training in remote provinces, I often saw scar tissue forming over the wound. The army doctors got really upset with such primitive methods which later, in some measure, penetrated into the camp. Understandably, they often brought torment and death, and release from the camp through the crematorium chimney before the poor man managed to get into the hospital ward to see a Polish doctor.

What gave us true respite was the removal of pus from bursting, painful boils and abscesses, which was always done with dirty hands, so the discomfort was alleviated only until the infected area grew larger. Yet, thought-provokingly, that “medicine,” developed in the middle of the Hitlerite hell, sometimes produced positive results. This aspect of the average detainee’s life still needs to be insightfully researched and described.

I am only citing those instances I knew and witnessed personally, as a layman. Since prisoners in the camp were able to overcome their dread of beating and punishment in order to pick and chew on any leaf or blade of grass, such instinctual behaviour could not have been just a symptom of starving. They must have felt a deep need to fortify their system with vitamins, an inner, inborn, and involuntary predilection that can be observed in animals. For example, dogs, even when they are full, occasionally ingest certain species of grass to help their bodies function properly. I can recall that when we were in the camp, our hair and nails grew very slowly, but as soon as we were regularly fed they went back to normal.

Another important “medicine,” besides luck, was the power of placebo and one’s trust in the effectiveness of a single pill when administered by a person we relied on. In the camp we had practically none of the necessary medicines, so any pilule given by a Polish doctor was swallowed contentedly in the belief that it would work wonders. That feeling had an enormous influence on the sick person, and therefore on the course of treatment and its outcomes. Since it had a considerable impact on educated prisoners, who were sceptical about everything and distrusted everyone, then even more so on simple, unrefined, terrified souls.

End of Part Two

Translated from the original article: Niewiarowicz R., Medycyna in articulo mortis w hitlerowskich więzieniach i obozach koncentracyjnych Przegląd Lekarski - Oświęcim, 1973.

Notes:

a. A stronghold of sorrow and death (Latin). In the 16th and 17th centuries a castrum doloris was an elaborately decorated bier and its accessories erected in a church for the funeral of a VIP.