His medical assessment was grim.
The child, not yet 3, showed signs of mental and physical impairment after an illness that caused inflammation in the brain, he said.
“Severe personality disorder,” Austrian pediatrician Hans Asperger wrote in a diagnostic report in summer 1941. “Most severe motoric retardation; erethic idiocy; seizures.”
An old black-and-white photo showed the small girl, identified as Herta Schreiber, with her hair buzzed, crying and staring into the camera.
“At home the child must be an unbearable burden to the mother, who has to care for five healthy children,” Asperger wrote in his report.
He concluded that permanent placement at Am Spiegelgrund — the notorious reformatory and psychiatric clinic where nearly 800 children were killed under Nazi rule — seemed “absolutely necessary.”
On Sept. 2, 1941, only a day after her third birthday, Herta died of pneumonia, “the most common cause of death at Spiegelgrund, which was routinely induced by the administration of barbiturates over a longer period of time,” according to an academic paper published Thursday in the medical journal Molecular Autism. The report comes during National Autism Awareness Month and just in time for Adolf Hitler’s birthday.
The author, medical historian Herwig Czech, argued that Asperger — a pioneer in the study of autism and related disorders — ingratiated himself with the Nazi regime and “actively cooperated” with the Nazi eugenics program by helping to send severely disabled children to Spiegelgrund, which was known as “a concealed killing center.”
“We see someone who could have easily avoided this work altogether but seemingly participated without qualms,” Czech said Thursday about Asperger in a phone interview with The Washington Post.
Czech acknowledged that it would have been difficult for Asperger to keep those children alive, but he said that the pediatrician “certainly could have avoided sending them to their death.”
Asperger became famous for his work in the mental-health community and is credited with diagnosing a condition that would later be named after him — Asperger Syndrome, a high-functioning form of autism.
Some historians have speculated throughout the years that the doctor had been a defender of mentally disabled children, seeking to shield them from a regime that forcibly sterilized hundreds of thousands of people who were believed to have mental illnesses and other related conditions.
Over the past decade, Czech, a historian at the Medical University of Vienna, said he has been searching through archives, reading Asperger’s personnel files and patient records, to determine whether the pediatrician had tried to protect children’s lives or help send them to their deaths.
“When I started digging,” he said, “I simply found that the picture is much more complicated.”
Czech said in the study that Asperger, who was politically conservative but not politically active, was part of a commission convened to classify 200 children in a psychiatric hospital according to their potential for future development. That committee, Czech said, earmarked 35 children as hopeless cases, labeling them as “uneducable” and “unemployable” — which he must have known would be a death sentence.
Some children earmarked as hopeless cases under the Nazis died by lethal injection.
Others died from poisonous gas.
However, it’s unclear what specifically happened to those 35 children, according to the study.
Furthermore, Czech said, there are two documented cases in which Asperger himself sent severely disabled children to Spiegelgrund.
The narrative of Asperger as a principled opponent of National Socialism and a courageous defender of his patients against Nazi ‘euthanasia’ and other race hygiene measures does not hold up in the face of the historical evidence. What emerges is a much more problematic role played by this pioneer of autism research. Future use of the eponym should reflect the troubling context of its origins in Nazi-era Vienna.
Indeed, Asperger did not start out that way.
Leading up to World War II, Asperger had seemed reluctant to label children, writing in 1937 that “it is impossible to establish a rigid set of criteria for a diagnosis,” historian Edith Sheffer wrote last month in an op-ed for the New York Times. But by 1938 — the same year German troops moved into Austria, where Asperger was practicing medicine at University Children’s Hospital in Vienna — he had coined the term “autistic psychopathy” in diagnosing children with social-attachment issues.
“As Asperger sought promotion to associate professor, his writings about the diagnosis grew harsher. He stressed the ‘cruelty’ and ‘sadistic traits’ of the children he studied, itemizing their ‘autistic acts of malice.’ He also called autistic psychopaths ‘intelligent automata,’ ” said Sheffer, who has written a forthcoming book on the subject called “Asperger’s Children: The Origins of Autism in Nazi Vienna.”
“Some laud Asperger’s language about the ‘special abilities’ of children on the ‘most favorable’ end of his autistic ‘range,’ speculating that he applied his diagnosis to protect them from Nazi eugenics — a kind of psychiatric Schindler’s list,” she added. “But this was in keeping with the selective benevolence of Nazi psychiatry; Asperger also warned that ‘less favorable cases’ would ‘roam the streets’ as adults, ‘grotesque and dilapidated.’ Words such as these could be a death sentence in the Third Reich. And in fact, dozens of children whom Asperger evaluated were killed.”
Similarly, Czech said he discovered that during that time, Asperger tried to “prove his loyalty” to the regime.
In public lectures, Asperger spoke of “race hygiene,” Czech wrote in his paper, and he concluded his diagnostic reports with the words “Heil Hitler.”
“Asperger managed to accommodate himself to the Nazi regime and was rewarded for his affirmations of loyalty with career opportunities,” it said.
Richard J. Evans, a British historian and visiting professor at the University of Richmond in Virginia, said such questions regarding Asperger and his involvement in one of the darkest periods in history have been posed in the past. But, he said, Czech’s research takes the conversation to a much deeper level.
Evans told The Post that comparatively, Asperger “was not a Nazi criminal” but was ultimately “like so many others at the time who tried to preserve their careers by going along with Nazism.”
“The enduring mystery is why the overwhelming majority of doctors did not pay any attention to the Hippocratic oath, which requires them not to kill,” he said.
In an editorial published Thursday in the journal Molecular Autism, the editors applauded Czech’s research into the prominent doctor and the psychiatric clinic, where “children were killed as part of the Nazi goal of eugenically engineering a genetically ‘pure’ society through ‘racial hygiene’ and the elimination of lives deemed a ‘burden’ and ‘not worthy of life.’ ”
“The degree of Asperger’s involvement in the targeting of Vienna’s most-vulnerable children has remained an open and vexing question in autism research for a long time,” the editors wrote, noting that the newly published research “establishes the necessary evidentiary framework for future discussion.”
This story has been updated.