In the late 1980s I heard a talk by the eminent Danish psychiatrist Erik Stromgren, at the Institute of Psychiatry in London, in which he recounted how many German psychiatrists turned up for work wearing Nazi uniforms the day after Hitler's appointment as Reich Chancellor on 30 January 1933. We know what followed in the name of racial purity, with a programme of forced sterilisation, and eventually ‘euthanasia’, i.e. murder, of at least 180 000 German psychiatric patients in Nazi Germany (more died in the occupied countries). German psychiatry had blood on its hands.
With this in mind, it is a real delight to read this rediscovered book by Friedrich Deich, the pen name of Dr Friedrich Weeren, a military psychiatrist and later medical journalist, whose humanity was preserved in this dark time. This humanity shines through in this novel, set around the career story of a fictional Luftwaffe psychiatrist Dr Robert Vossmenge. Weeren is clearly drawing on his own professional experiences, but the novel is far from an autobiography, as the ending will reveal. Like the protagonist, Weeren was found unsuitable for the Nazi party anyway and would not have been allowed to join.
Hearing that at one point Eichmann and Himmler were seriously considering sending all Jews to an island (Madagascar), leaving the question of what should become of half-Jews, Vossmenge responds by suggesting that they should be sent to a peninsula. He, and the one colleague who laughed at this joke, are debarred from the Party. Vossmenge subsequently has to leave Germany in a hurry after detaining a paranoid industrialist, a silk manufacturer, inadvertently interrupting this man's donations to the Nazi party. He is warned that the Gestapo are coming for him and manages to go to North Africa, and then Italy, to serve as an air force psychiatrist.
The book has many comedic moments. The deluded female patient who believes herself rich and, on whose behalf, the ‘Orange’ Pastor – the other principal character in the novel – naively orders an excess of oranges to distribute within the asylum. Eventually the trucks of oranges are cancelled on the realisation that the funds do not exist to repay the Pastor. Vossmenge's instrumental use (at personal risk) of psychiatric diagnosis to spare Italian deserters who had fled during the collapse of the Italian Army – a death sentence in the face of Nazi justice – or to help sideline some superior officers on behalf of even more superior officers is brilliantly described. Similarly, the account of the bureaucratic steps needed to acquire petrol for essential car journeys by a Luftwaffe officer to check on a communications network is black comedy at its finest. The satire echoes the slightly later Catch 22 by Joseph Heller, and has elements of the much earlier and unfinished The Good Soldier Švejk by Jaroslav Hašek, in sending up an unbending military mindset.
A lot of psychiatric knowledge can also be gleaned by reading this novel. There are numerous case vignettes throughout that illustrate the main categories of psychiatric diagnosis. The fixity of delusions is shown near the beginning, when Vossmenge examines a cellar with a female patient who believes her son is being tortured there. In response the patient alters the perceived location of the screams and torture to a nearby wood. Later in the novel, there is a case of a First World War ace pilot who is overwhelmed by the task he now faces in coordinating an airbase in Italy towards the end of the current war. Vossmenge is called to intervene, as he is nearby, when this war hero collapses in the office of a General and is behaving bizarrely. The General sees his officer's plea to be relieved of his duties as cowardice in face of the enemy and in the heat of the moment shouts about court martialling his ‘hysterical’ Colonel, who is writhing on the floor. Vossmenge gets the Colonel into psychiatric care and explains to the General how such a reaction can arise in even the bravest of men under certain circumstances.
The translation into English from the 1950s is by Robert Kee – a few uses of the word ‘die’ instead of ‘the’ that have crept through reminding us of its German origins – and the introduction by Sinclair Mackay and afterword by Dr Chris Maloney (a general practitioner, psychiatrist and psychotherapist) all add up to an excellent package. Dr Maloney has been an advocate for this book as a lost classic for many years and this ‘Recovered Book’ deserves to be read and would be an excellent volume to discuss in any psychiatric book club.
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