The Unsettling Legacy of a Disgraced Doctor

Posted May 9, 2018 5:09 p.m. EDT

Edith Sheffer has written a book that defies easy categorization — an appropriate, if perhaps inadvertent, response to her fascinating and terrible subject matter. In “Asperger’s Children: The Origins of Autism in Nazi Vienna,” she shows how the Third Reich’s obsession with categories and labels was inextricable from its murderousness; what at first seems to be a book about Dr. Hans Asperger and the children he treated ends up tracing the sprawling documentary record of a monstrous machine.

It wasn’t long ago that the autism community considered Asperger a hero, a Nazi-era pediatrician who championed neurodiversity and the special talents of his “high-functioning” patients in order to save their lives. In 2015, Steve Silberman’s best-selling “NeuroTribes” depicted Asperger as a courageous figure who emphasized his patients’ potential usefulness to the Nazi war effort. According to that narrative, Asperger’s diagnosis saved children from the regime’s eugenicists, amounting to a kind of Schindler’s list.

Barely six months after the publication of Silberman’s book, the Asperger story took a hairpin turn: John Donvan and Caren Zucker published “In a Different Key,” citing work by the Austrian scholar Herwig Czech, who found documents in Vienna’s municipal archives that “left the hero narrative in tatters.” (Silberman, who has said that Czech kept promising to share his research with him but didn’t, has since updated the paperback edition of “NeuroTribes” to account for the new information.)

Donvan and Zucker devoted only a brief section to the Asperger controversy. Their book, like Silberman’s, recounts the long story of autism, whereas Sheffer’s revolves around Asperger and the Austrian medical system of the 1930s and 1940s. Despite its subtitle, “Asperger’s Children” is less about “the origins of autism” than it is a historical case study of complicity in the Third Reich.

Sheffer’s stake is personal as well as professional. A historian of Germany and Central Europe, she also has an autistic son. Her previous book, “Burned Bridge,” examined how Cold War divisions in a German town were not so much imposed on ordinary people as they were actively — and sometimes enthusiastically — propagated by them. “Asperger’s Children” similarly explores how people deal with their political environment through their daily routines.

“Caught in the swirl of life,” Sheffer writes, “one might conform, resist and even commit harm all in the same afternoon.”

That sentence, which comes toward the end of Sheffer’s book, makes it sound as if the Hans Asperger she presents is a complex figure, full of ambiguities and contradictions, hard to characterize with any certainty and impossible to pin down. For most of “Asperger’s Children,” however, she seems interested less in a complex biographical portrait than an indictment, as she methodically marshals her evidence and lays out her argument.

She acknowledges Asperger’s “well-known support for children with disabilities” and the “two-sided nature to his actions,” but the overall sense you get is that Sheffer judges Asperger’s ambivalence woefully insufficient. If anything, his mixed record suggests to her that he knew better, rendering him ultimately responsible for the ignominious decisions he made. His life, in her telling, begins with his career at the Children’s Hospital in Vienna. Just 25, he was hired in 1931 by Franz Hamburger, an anti-Semite with an “anti-scientific attitude” who had been purging liberals and Jews from the faculty ranks. In addition to Asperger, Hamburger hired Erwin Jekelius, who would later become the director of Steinhof Psychiatric Institute and then Spiegelgrund, Steinhof’s youth ward, where children deemed physically or mentally “irredeemable” would be sent to their deaths.

“Certainly, many of Hamburger’s protégés went on to be Nazi enthusiasts and leaders in the euthanasia program,” Sheffer writes. That Asperger was neither of these allowed him to rehabilitate his reputation after the war; a devout Catholic, he never joined the Nazi Party, and he stayed at his perch in the Children’s Hospital, away from what Sheffer calls “killing centers” like Spiegelgrund.

But the distance, Sheffer argues, was merely geographic. “Asperger participated in Vienna’s child-killing system on multiple levels,” she writes. After Hitler annexed Austria in March 1938, Asperger helped direct the Motorized Mother Advising program, which purported to dispense advice and care to mothers and children but also served to extend the surveillance powers of the Nazi regime. Staffers “noted children they considered to be disabled or genetically tainted,” Sheffer writes, recording cases of “hereditary feeblemindedness.”

When the Reich decreed the child euthanasia program in 1939, doctors like Asperger assumed extraordinary powers to decide the fates of the children under their care. Certain statements of his read like pleas for tolerance and mercy from an intolerant and merciless regime: “Autistic people have their place in the organism of the social community,” Asperger wrote in 1944, saying it was incumbent on doctors “to speak out for these children with the whole force of our personality.”

But there were children he nevertheless decided couldn’t, and shouldn’t, be helped. He observed “inferiority of almost all organs” in a child who was eventually sent to Spiegelgrund; examining another child, a 2-year-old girl, he concluded that “permanent placement at Spiegelgrund is absolutely necessary.” The girl died two months later.

As Sheffer makes clear, Asperger would have known that such decisions were probable death sentences. At least 789 children died at Spiegelgrund during the Third Reich, most of them from pneumonia, typically brought on by the barbiturates that would be mixed with sugar or cocoa and fed to the children with the express purpose of killing them. Sheffer says that Asperger was involved in the transfer of at least 44 children from his clinic to Spiegelgrund. Those are just the documented cases she found; the actual total is most likely higher.

Sheffer has built an impressive case, though certain questions remain. Did Asperger’s pleas on behalf of at least some of his patients save their lives? Or by emphasizing the potential for “social integration” into the Volk, was he consigning those who didn’t fit into that privileged category to their deaths? Under the brutal boundaries drawn by the Nazi regime, both could be true. Sheffer seems to go back and forth herself, condemning Asperger in the severest terms on one page and slipping in a few caveats about his “drift into complicity” on another.

“It can be misleading to classify people too neatly,” Sheffer writes, trying to explain where historians draw the lines of culpability. It’s a fitting conclusion to a book that raises unsettling questions about who someone was, and what he did.

Publication Notes:

‘Asperger’s Children:

‘The Origins of Autism in Nazi Vienna’

By Edith Sheffer

Illustrated. 317 pages. W.W. Norton & Co. $27.95.