In a special interview for Yad Vashem Jerusalem, Dr. Offer recounts the extensive research process she conducted for the book, the difficulties and the discoveries, and its relevance to the contemporary world.
What is your background, and why did you decide to research this topic?
Growing up in a home with parents who experienced firsthand the events of the Holocaust [her mother was born in Hungary and sent to Auschwitz, and her father was drafted into the Polish army and fought for the defense of Warsaw] – and when one's grandparents and most of one's family were murdered in the extermination camps – there is an emotional need and intellectual curiosity to investigate the development of the most difficult event in history. When I entered academia, my in-laws, survivors of the Šiauliai (Shavli) ghetto in Lithuania, told me about a diary left from that ghetto written by Dr. Aharon Pick, which lay for decades in a drawer in the home of his only son, Tedik (David), in Kibbutz Netzer Sereni. The events described by Dr. Pick led me to focus on my Master's thesis on "Medicine and Physicians in the Šiauliai Ghetto."
As part of my doctorate, I wished to expand my research on Jewish medicine in the Holocaust. The pioneers of research in the field were the doctors who were there, and in the underground archives they left us important documentation about the morbidity and medicine in the ghettos. After the Holocaust, Dr. Mark Meir Dworzecki, a physician and historian who survived the Vilnius ghetto, led the field of medical research in the Holocaust in general and Jewish medical activity in particular. He wrote extensively in the field, and doctors who survived the Shoah, or who had emigrated before the war, in Israel and in the Diaspora, contributed to the commemoration and documentation project – so I had an uncommon basis for inspiration.
At first, I thought to conduct a comparative study between several ghettos in different areas under German occupation. However, after collecting a great deal of material on medicine in the Warsaw ghetto, it seemed that the scope and importance of the material needed separate processing. Isaiah Trunk was among the first to present research on aspects of health and illness in the Warsaw ghetto, and in the 1990s it was Charles Roland's outstanding study that presented a comprehensive picture of medicine in the ghetto. Equipped with these and many studies, I spent several years collecting archive materials, mainly at Yad Vashem and the Ghetto Fighters' House in Israel, as well as in the archives of the ZIH [Jewish Historical Institute] in Warsaw and YIVO in New York.
White Coats in the Ghetto would not have been published without the help of the International Institute for Holocaust Studies at Yad Vashem, which supported me with a scholarship and the guidance of Prof. Dan Michman, [Head of the Institute, and the Incumbent, John Naimann Chair for Holocaust Studies] and of course the professional and dedicated work of the staff in Yad Vashem's Publications Department.
On what documents did you base the study?
The issue of morbidity and medicine is so central in "ordinary" daily life, and all the more so in the conditions prevailing in the ghettos. Therefore, in many archival documents a great deal of reference can be found related to the medical issues. These include, among other things, statistical reports on morbidity and mortality; reports sent to the JDC by the Jewish health organization "TOZ," which also operated in the ghetto; memos sent to the Germans; testimonies and reports written by medical and healthcare staff – nurses, doctors, and hygienists; advertisements published in the ghetto; minutes of meetings; the underground press in the ghetto; and diaries, memoirs and testimonies collected after the Holocaust.
What were the difficulties you had to deal with? Did you encounter any unexpected issues?
The difficulties were many, and there was no shortage of crises. This study was written over a number of years in which I devoted myself entirely to the research, from morning to night. For me it was a kind of life mission. The research required deciphering documents from different languages – Polish, Yiddish, German – collecting and processing a great deal of material, and comparatively examining the issue in broad contexts, such as genocide, Eastern European Jewry, the Holocaust, and medical ethics under siege and existential threats.
Though challenging, the collection, translation and processing of these documents were also accompanied by special surprises, such as the unveiling of new diaries written in the Holocaust – for example, the notebooks of gynecologist Dr. Adolf Polishuk, and a comprehensive report by the TOZ.
What have you learned about this subject, and what do you think still needs to be researched?
It is important to note that this study actually highlights some unique patterns of Jewish society coping with the Holocaust. The research shows that amid the difficult conditions prevailing in the Warsaw ghetto, there was nevertheless a rather hierarchical and disciplined health and medical system, which posed challenges to public health according to modern concepts: sanitation, vaccinations, isolation of infected persons, and more. Inpatient and outpatient services, laboratories, and even a first aid station were also established.
It is clear that despite all efforts, many of the patients could not be saved due to the dehumanizing conditions the Germans imposed on the Jews. Nevertheless, the medical staff and the ghetto leadership acted out of a perception of responsibility for the health of the general public in the ghetto.
Although the results, of course, were very limited.
Usually in cases of persecution and genocide, murder and extermination occur in a rapid period of time, in which we generally witness the collapse of the medical system of the persecuted society; the services provided, if any, rely mainly on external assistance of international organizations. Not so in the Warsaw ghetto. The medical system there did not only deal with emergency medicine or the care of patients, it also continued during this difficult period with "routine" activities: studies, advanced training and research. This was set up by the Jews themselves – that is, the persecuted society – and not by outside forces.
Along with legal activity, they also initiated a series of risky underground endeavors, including scientific studies of great importance on hunger and typhus, as well as the establishment of an underground academic medical faculty in the ghetto for some 500 students. The study also shows that there was a kind of medical network in the Generalgovernment [an area of German-occupied Poland] by activists of the "TOZ" organization, who provided assistance from the central branch in Warsaw at various times to other communities and ghettos in the area.
Another important thing I learned is that the speed of organization of the Jewish medical frameworks that arose in Warsaw and other ghettos did not come "out of nowhere," but rather relied on an infrastructure of Jewish medicine that had developed between the two world wars.
The Jewish community in Poland had developed a medical system designed to serve the three-and-a-half million Jews who lived in independent Poland. This system was based on the principles of public health that developed in modern countries and were also adopted in Jewish society.
In 1931, there were about 4,500 independent Jewish physicians in Poland, who made up about 56 percent of all independent physicians in the country. Despite all the limitations and difficulties, the medical and health system in the Warsaw ghetto clearly reflected a modern society, where there were about 800 doctors. All of these factors, along with the Jewish tradition that emphasized the saving of life as a supreme value, motivated the medical teams in the ghettos to make efforts under impossible conditions in order to alleviate the suffering of the ghetto Jews and save lives as much as possible.
The behavior of doctors as individuals was not significantly different from the behavior of individuals in other positions in the ghetto: They were all faced with unprecedented moral tests. The reality there, like any human reality, was complex. Alongside many brave, heroic acts, some medical staff behaved immorally — described extensively in the book. Collectively, however, the medical and health system in the Warsaw ghetto is a unique phenomenon, unparalleled in history.
Much remains to be studied in the field of Jewish medicine in the Holocaust, for example: writing biographies of individual doctors; aspects of gender, including the contribution of women in the medical and health professions to the establishment of medical systems in the ghettos; comparative research on medicine in many unexplored ghettos; and issues of halachah [Jewish Law] and ghetto medicine.
How is the book relevant to the modern world?
Chapters in the book, such as those devoted to epidemics, education, and medical research, or the chapter devoted to ethical dilemmas, constitute important and relevant material to today's global society. Along with the suffering and dehumanization, one can learn about the power of the human spirit and the medical profession to maintain a value-based and professional commitment to patients even in difficult and extreme conditions. This is in stark contrast to what led to "bio-racial ideas," among doctors, scientists and the healthcare system in Nazi Germany, who were full partners "in white coats" to the horrific crimes and genocide that took place during the Holocaust.
This article originally appeared in the "Yad Vashem Jerusalem Magazine," volume 93.
