Book Review: Asperger’s Children: The Origins of Autism in Nazi Vienna. By Edith Sheffer. Norton & Company.

Historian Michael Burleigh’s book, Death and Deliverance, a detailed indictment of the Nazi euthanasia programme, known as T-4 from its Berlin address, provides the background to this book. Sheffer’s work, an examination of the career of the Austrian doctor, Hans Asperger, who gave his name to a form of high-functioning autism, provides local detail to Burleigh’s earlier research.

Indeed, it is a devastating attack on the whole Viennese medical profession during the Third Reich.

Concerned with the deliberate mistreatment - sometimes the murder - of children in a designated hospital, Am Spiegelgrund, in the Vienna suburbs, it makes particularly painful reading. The author shows how the Austrian medical establishment, purged of its large Jewish element, swore a loyalty oath to Hitler. Depressingly, she records that “Medicine came to be one of the most Nazified professions in the Third Reich.”

What especially taints the name of Asperger is that his diagnosis of “autistic psychopathy” was deeply influenced by Nazi values. His famous 1944 paper on autism, discovered and publicized in 1981 by a British psychiatrist who first named it “Asperger’s syndrome”, described young people who appeared to be closed in on themselves.

They were fatally lacking in the Nazi virtue of “Gemut”: a sense of collective belonging, community feeling or social spirit.

Indeed, the description came to include children and adolescents who, by today’s standards, would not be considered autistic at all; they simply lacked the ability to adapt to organisations such as the Hitler Youth because of behavioural problems, often influenced by poor, inadequate or neglected backgrounds.

Typically brutal, the Nazi attitude was that one merged with the “Volk” – or was purged.

Sheffer’s book is excellent on the background to Viennese social and medical attitudes, pointing out that its Public Welfare Office theorised about forced sterilisation of “the inferior” and possibly their “extermination” in the 1920s – well before the Nazis came to power.

Where it is weaker is on the background, private and family life of Asperger himself. We only see him through his quoted remarks in his scientific papers, or in his role at the Curative Educational Clinic at the University of Vienna’s Children’s Hospital. Although he was married with five children, we never even learn the name of his wife.

Occasionally (and irritatingly) Sheffer describes him as a “devout Catholic”, but provides no evidence of this.

She does raise the intriguing question: did Asperger suffer from the syndrome that became associated with him? That he seemed abnormally detached from reflecting on the consequences of his referrals of children to the killing pavilions at Am Spiegelgrund is clear. However, to associate him with those people on the spectrum of social and communicative disorders does the latter an injustice.

From all that Sheffer tells the reader, it is clear that Asperger was skilled at distancing himself from compromising situations, clever at adjusting his psychiatric language to suit the Nazi ideology and practised in defending his morally ambivalent behaviour. Cold-blooded rather than autistic would be my own diagnosis.

After all, Asperger thrived in his career in Vienna during the Nazi period, especially when Jewish doctors vanished. Although he did not join the Nazi Party (a shrewd move) it proved no obstacle to his advancement and he got on exceptionally well with his more notorious Nazi medical colleagues, in particular, Max Gundel, Erwin Jekelius and Franz Hamburger.

Jekelius was deeply implicated in the T-4 euthanasia programme; tellingly, Viktor Frankl, famous Holocaust survivor and psychiatrist, was to write of him, “He was the only man I ever encountered in my whole life whom I would dare to call a Mephistophelean being, a satanic figure.”

Asperger, conscientious, white-coated, unsmiling behind his glasses, is known to have been responsible for sending at least 44 children to their certain death at Am Spiegelgrund, and probably many more for whom the paperwork is too patchy for certain proof.

Altogether, at least 789 children and adolescents were murdered there during the Nazi period. These killings began on August 25 1940. They included deliberate neglect to the point of actual starvation and regular barbiturate injections; of the many nurses involved in these gruesome proceedings, almost none seemed to have maternal or life-saving instincts. “Impassive” and “compliant” are Sheffer’s words to describe them.

Her verdict on Asperger is damning: although he may have felt pressured into accepting these deadly “treatments”, nonetheless “he chose his milieu and colleagues. He had numerous volitional ties to the euthanasia program, and it pervaded his professional world.”

Although he complained that his anti-Nazi reputation had delayed his promotion to associate professor, “he still attained the position in October 1943 at thirty-seven, a young age.”

Asperger was not put on trial after the war, like some of his colleagues who actually worked at Am Spiegelgrund; his culpability was at a remove. Against the odds he remained a highly respected doctor – yet it cannot be denied that he was an integral link in the chain of death warrants for children who tragically didn’t fit into Nazi society.

Francis Phillips writes from Buckinghamshire in the UK.