The boy in the ice-cream shop

Was Hans Asperger a benevolent and humane doctor? Or was he deeply implicated in Nazi psychiatry and its darkest episode, euthanasia?

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Hans Asperger: Sometimes depicted as compassionate, but he participated in the Nazi euthanasia programme (© Wilhelm Hlosta/APA/Press Association Images )

One day, in the early 1980s, I was queuing up for an ice cream. There was a young man ahead of me. I watched, astonished, at the way he spoke to the young woman at the counter. He wasn’t just rude. She was evidently upset and yet he was completely indifferent to the effect his behaviour had on her. His mother sat outside. I suggested she speak to him about his behaviour. “You evidently haven’t heard of Asperger’s Syndrome,” she said.

She was right: I hadn’t. Lorna Wing had only just published the journal article which introduced the term, “Asperger’s Syndrome”.  That year (1981), one in 2,500 children in America were classified with autism spectrum disorders, including Asperger’s. By 2016 this had risen more than 35-fold to one in 68.

At the same time, a wave of books appeared about Nazi doctors and psychiatrists, including Robert Jay Lifton’s The Nazi Doctors (1986), Benno Müller-Hill’s Murderous Science (translated 1988), Robert Proctor’s Racial Hygiene: Medicine Under the Nazis (1988) and Michael Kater’s Doctors Under Hitler (1990). Martin Amis acknowledged the importance of Lifton’s book for his novel about a Nazi doctor, Time’s Arrow (1991). 

Asperger’s Children
explores the career of the man behind Asperger’s Syndrome. Who was Hans Asperger, now regarded as one of the most famous psychiatrists of his time? Was he a benevolent and humane doctor? Or was he deeply implicated in Nazi psychiatry and its darkest episode, euthanasia?

This is Sheffer’s central charge. During the Second World War, the Nazis killed between 5,000 and 10,000 children as “unfit”. This led to an even more murderous adult euthanasia programme. As Sheffer writes, these adult killings “soon moved to mass selections and wholesale deportations from asylums and hospitals to six major killing centers in the Reich”. The second-largest killing centre in the Reich was Spiegelgrund in Vienna and one of the key psychiatrists there during the early years of the war, deciding who should live and who should die, was Hans Asperger. 

Asperger’s Children is not a biography. Sheffer uses Asperger’s career and work as a way of looking at the history of Nazi psychiatry in the Reich. His ideas were radicalised by the rise of what Michael Burleigh and Wolfgang Wippermann called “the racial state”, the biologising of categories of belonging and non-belonging. Autism was at the heart of this and Asperger was a rising star in the debates about autism. 

It is a complicated story. First, as Sheffer points out, “Asperger is often depicted as compassionate and progressive.” He was a practising Catholic and never joined the Nazi Party. However, the archives tell another story. “Files reveal,” she writes, “that Asperger participated in Vienna’s child killing system on multiple levels. He was close colleagues with leaders in Vienna’s child euthanasia system and, through his numerous positions in the Nazi state, sent dozens of children to Spiegelgrund children’s institution, where children in Vienna were killed.”

Born in 1906, Asperger was brought up in a small village in rural Austria. He grew up in a devout Catholic family, who had been farmers for generations. This is important for several reasons. Catholics were later passionately opposed to Nazi euthanasia. At the same time, Austria was a hotbed of Nazism: 14 per cent of the SS membership and 40 per cent of personnel in extermination programmes were Austrians.
Asperger studied medicine at the University of Vienna and like contemporaries such as Eichmann and Heydrich he was in his mid-twenties when Hitler came to power. He did not join the Nazi Party, which proved crucial in clearing his reputation after the war, but he joined the Fatherland Front and supported the new Austrofascist regime in the mid-1930s. The Vienna medical school removed three-quarters of its personnel, most of them Jews, and as they escaped into exile, Asperger rose through the ranks.

Vienna had been a centre of research into what Leo Kanner later called autism. But what interests Sheffer, in particular, is how earlier debates about eugenics and autism changed dramatically as the Nazi regime took over psychiatry and medicine. They produced a mix of moralising judgments and biological assumptions about the “unfit”. Above all, they were preoccupied with the idea of a Volksgemeinschaft, a unified, homogenous national community, and the crucial distinction became between those children who fitted in and those who did not or could not. This is why autism became so important. Nazi psychiatrists like Asperger became interested in anti-social children, those who did not have social feeling. Asperger wrote about one boy, Harro, that he resisted the “important social habits of daily life”. In some cases, such children could be teachable, they could learn to become sociable. But many could not. And as the Nazi regime moved towards euthanasia this became a death sentence for them.

Sheffer follows Asperger’s career from 1930s Vienna to the war years and beyond. She looks at how his ideas changed to fit in with Nazi psychiatry and shows how he became involved in a group of leading Nazi psychiatrists whom he met at conferences and worked with in Vienna. There are, however, worrying gaps in her account. The period 1925-31 passes unnoticed. There is little about his war service in Croatia, 1944-45. There are troubling questions. Why didn’t Asperger join the Nazi Party? How did he reconcile his Catholicism with the Nazi euthanasia programme? How original were the debates about autism in interwar Vienna compared to contemporary debates in Britain, France and the US? Sheffer has done a considerable amount of research and yet much of her language is speculative (“It may well have been”, “It appears that”, “Whether or not he intended it”). This can feel slippery and uncertain. There is also too much guilt by association. Many of Asperger’s colleagues did terrible things. Did he? How does Asperger compare with them? Sometimes we run out of evidence. There is a chapter on Asperger’s patients but Sheffer only writes about four main case histories. How representative are they?

There is one particularly unsettling question. Sheffer is keen to put Asperger’s ideas about autism in the context of changing Nazi ideas. But I keep thinking about that boy in the ice-cream shop 35 years ago, and Asperger’s accounts describe him very well. Too often, Sheffer is a voice for the prosecution. But her book doesn’t help us understand why his ideas seemed so relevant in late-20th-century Britain and America, half a century after the war. If his writings on autism were a response to Nazi ideas, why did they speak to parents and psychiatrists in liberal societies decades later? Sheffer is very good at looking at Asperger in context, but perhaps she loses sight of his originality along the way.