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New Hyde Park, NY
Dr. Rosen is President, American College of Chest Physicians, and Chief, Divisions of Pulmonary Critical Care and Sleep Medicine, North Shore University Hospital and Long Island Jewish Medical Center, and Professor of Medicine, Albert Einstein College of Medicine.
Correspondence to: Mark J. Rosen, MD, FCCP, 410 Lakeville Rd, Suite 107, New Hyde Park, NY 11040; e-mail: mrosen{at}nshs.edu
On June 1, 2007, Stephen S. Lefrak, MD, FCCP, Professor of Medicine, Associate Dean and Director of the Humanities Program in Medicine at Washington University School of Medicine, wrote to Richard S. Irwin, MD, FCCP, CHEST Editor in Chief, about setting the record straight on the American College of Chest Physicians (ACCP) having given a "Master Clinician Award" to Friedrich Wegener, MD, at the ACCP Convocation in 1989. Dr. Wegener is renowned for his description and investigations of the necrotizing granulomatous vasculitis that we know as "Wegener granulomatosis." What we did not know is that Wegener had ties with the Nazi party at its inception, and that he was an official in the army and a pathologist in Lodz, the site of a notorious Jewish ghetto from the time of the German invasion of Poland in 1939 until he fled with thousands of other Germans in 1945. Dr. Lefrak asked that we set the record straight "for the historical record as well as the College’s integrity." I will present the facts as we know them and what the ACCP leadership has done thus far regarding them.
Dr. Irwin forwarded that letter to me and to Alvin Lever, ACCP CEO and Executive Vice President. First we checked the facts. There are a few articles on the subject in the peer-reviewed literature, and this summary of the facts is abstracted from two articles in the peer-reviewed literature, both by Dr. Alexander Woywodt and colleagues.12 Their research revealed the following: Friedrich Wegener was born in 1907 in a small town in Germany, and his father was a surgeon. Dr. Wegener’s career and the rise of the National Socialist party proceeded in parallel as follows: Wegener completed his medical studies in 1932, and in September 1932, he became a member of the Sturm Abteilung, or "brownshirts." Hitler seized power on May 1, 1933, and Wegener joined the National Socialist party on the same day; that year, he assumed his first academic position as "junior assistant" in the Department of Pathology at the University of Kiel. His chairman and mentor was Dr. Marin Staemmler, who had strong ties to the regime and published and lectured extensively on racial hygiene. While the Nazis consolidated their power, started to implement their ideology, and brought on World War II, Wegener studied and published on necrotizing granulomatous inflammation.
Wegener served as an army pathologist in Lodz, arriving there on September 19, 1939, 18 days after the start of the German invasion of Poland. On December 10, a Jewish ghetto was established in Lodz, with the goal of deporting Jews and making the city Judenrein (free of Jews); in fact, most of the deportations were to the death camps, the remaining population becoming a source of slave labor. There are apparently conflicting reports as to whether Wegener also served as a pathologist in the municipal health office (Gesumdheitsamt); that agency issued reports on 50 to 100 autopsies each month, the same time that ghetto residents suffered from the cold, disease, and famine, of which an estimated 43,000 people in the ghetto are believed to have died.
Wegener contracted diphtheria in 1944 and stopped work for a year, after which he assumed the role of field surgeon until he was captured by American forces. While several of Wegener’s contemporaries were implicated in selecting victims to be killed, or actually participating in atrocities, he was not. Wegener’s name appeared on a Polish Ministry of the Interior registry of war criminals, but he never faced charges, and his files are no longer recoverable. Our own inquiries to the National Archives and Records Administration, which include the records of the Berlin Document Center and the Simon Wiesenthal Center, yielded no evidence of Wegener’s participation in war crimes.
Wegener spent a short time as a prisoner of war, followed by agricultural work, and later he resumed his career as a pathologist in Lübeck, Germany. An article on "Wegener’s granulomatosis" was published in 1954, Wegener resumed an academic career in 1964, and he published his own review of "his" disease in 1967, before transitioning to private practice in 1970. He went on to attend scientific meetings and start a patient support group. The ACCP gave him an award in 1989; the only record of this occurrence is in the Convocation Program printed that year. Wegener died in 1990.
How should we judge Friedrich Wegener today? I have no doubt that this issue will provoke intense controversy among all who care to consider it. It is indisputable that Friedrich Wegener was an early member of the brownshirts and Nazi party. As a pathologist in Lodz while thousands died in the ghetto, it defies reason that he did not know the consequences of Nazi ideology. To our knowledge, he never renounced or expressed regret for his official embrace of the Nazi party or involvement in its machinery. Nevertheless, there is no evidence that he was involved directly in war crimes. By today’s standards, any participation in the evil Nazi enterprise could be considered immoral and reprehensible. In that case, Wegener was either a "true believer" and evil himself or a shameless careerist worthy of our approbation. However, there is no evidence of Wegener being an openly ardent ideologue, and no agency has found evidence of his committing a single "war crime," despite decades of intensive review. I believe that Wegener probably did what millions of other Germans did: he went along with the millions of other Germans living through an economic disaster following the treaty of Versailles, eager to support new and strong leadership on behalf of their country. A recent medical school graduate, he was probably happy to overlook the dark side of the rise of Germany as his own career flourished. Because Wegener the pathologist surely must have known the impact of Nazi policies on the people in the ghetto of Lodz, I believe that he is more culpable than others who looked the other way while the atrocities went on.
What should the ACCP do about the 1989 award to Dr. Wegener? This provoked difficult introspection and debate in the Executive Committee. Many of us spent hours considering this, and I have gone back and forth on the issue myself. First, an investigation of the origin of the award showed that it was conferred only on this one occasion. It seems that a group of Wegener’s friends and colleagues knew that he was approaching the end of his life and wanted to honor his contributions to medicine formally and publicly. For the 1989 Convocation, the ACCP leadership, unaware of his connections with the Nazi party and activities during the war, "made up" a "Master Clinician" award, which was never bestowed before or since. We asked some ACCP members involved in that decision for their perspective, and they insist that they did not know of Wegener’s past, and agree that if they had known, there would have been no such award.
We discussed whether the award should be taken away posthumously. There were passionate and persuasive arguments that Wegener should have not taken a commission in the army, and should have declined or resigned from his appointment in Lodz. Others reflected the Committee’s consensus that revoking an award that reflects Wegener’s indisputable scientific achievements absent evidence of direct involvement in war crimes would not be appropriate. The young and no doubt ambitious Wegener made very poor choices in embracing a heinous movement and serving the German war effort for which his mentor and chairman was an enthusiastic participant. On the other hand, half of German doctors were members of the Nazi party during the war. By analogy, George Washington and Thomas Jefferson were slave owners, but their images are still on Mount Rushmore and our currency. In the end, the Executive Committee elected to inform the membership about the facts of Wegener’s past, about the facts of the award the College gave him, and about what we will do to prevent a similar episode.
Speaking for myself, I can only conclude that Wegener was, at best, deeply flawed and collaborated with very bad people in a bad cause to maintain and advance his career. How can any of us be sure we would not have done the same thing in that situation? I hope I would have had the courage and conscience to resign and end such a career, but how could I know? That Wegener did autopsies and saw the consequences of Nazi philosophy makes him especially culpable. Judging with 21st century sensibilities and perfect hindsight, I am reconciled to the decision that withdrawing an improvised award 17 years after the fact for a person’s actions 45 or 50 years before dignifies the award more than it deserves. It accomplishes little other than to affirm that the ACCP condemns the actions of Nazis and those who supported them, and that should be obvious enough and not need a symbolic action. I personally regret deeply that the College unknowingly bestowed an award to a former Nazi who surely took part in some way in support of the Holocaust and apologize to the families and memories of its victims.
How would current ACCP policies prevent another situation like this? First, I am certain that no ACCP awards committee would ever consider a candidate with ties to the Nazi party or any other hate group. The College also precludes granting awards to scientists who serve the tobacco industry and to any other enterprises that conflict with the core values of the College. In addition, we have learned not to devalue formal ACCP recognition by inventing an award for single use, especially when it is a "gold watch" in anticipation a colleague’s retirement or imminent death.
These have been difficult issues for us to consider. They will probably provoke considerable controversy, and they should. As this will be discussed by the ACCP Board of Regents in October, I invite you to submit comments to me directly at mrosen{at}chestnet.org. We will publish some of these comments in future issues as best as we can.
Footnotes
The author has no conflict of interest to disclose.
References
This article has been cited by other articles:
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  M. J. Rosen and R. Irwin Dr. Friedrich Wegener and the ACCP, Revisited Chest, December 1, 2007; 132(6): 1723 - 1724. [Full Text] [PDF]
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R. H. Savel, E. B. Goldstein, I. Savel, and H. Savel Time Does Not Heal All Wounds: Medical Luminaries, National Socialism, and the American College of Chest Physicians Chest, December 1, 2007; 132(6): 2064 - 2065. [Full Text] [PDF]
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S. S. Lefrak and E. L. Matteson Freidrich Wegener: The Past and Present Chest, December 1, 2007; 132(6): 2065 - 2065. [Full Text] [PDF]
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M. Emmett On Wegener and the ACCP Chest, December 1, 2007; 132(6): 2066 - 2066. [Full Text] [PDF]
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