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regular-article-logo Friday, 03 May 2024

Reign of Error?

Body parts, diseases, disorders and tools are often named after great medical figures, but there is a risk inherent, as some people tell Rachel E. Gross

Rachel E. Gross Published 03.07.23, 07:44 AM

istock.com/gorodenkoff

Edith Sheffer’s young son always disliked labels such as Asperger’s syndrome. But in 2016, a psychiatrist told him that he should be proud; his condition was named after Hans Asperger, an Austrian scientist in the 1930s who used his position to help save children like him. By devising a diagnosis that emphasised the children’s intellectual abilities, the psychiatrist said, Asperger tried to spare them from the Nazi campaign to “euthanise” youths with cognitive disabilities.

Sheffer, sitting next to her 12-year-old son, knew this wasn’t entirely true. Now a historian of 20th-century Europe at the University of California, Berkeley, US, she had spent years researching Asperger’s for her 2018 book, Asperger’s Children. Before he became known as a benevolent saviour — “a psychiatric Oskar Schindler”, as Sheffer put it — Asperger marched in line with the Nazis’ medical framework.

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His diagnosis, which he later called autistic psychopathy, was part of the larger Nazi medical effort to divide lives into two categories: worthy or unworthy of living. And, Sheffer learned with horror, he had personally condemned dozens of children to the killing centres.

By the time her book was published, Asperger’s syndrome was no longer listed in the Diagnostic and Statistical Manual of Mental Disorders. In 2013 it was folded into autism spectrum disorder, in part because there was no solid evidence that it warranted its own diagnosis. But shortened versions of the term are still used widely in the autism community, many of whom refer to themselves with terms, such as “Aspie”, derived from the name Asperger’s.

An eponym was once considered medicine’s highest honour. The best-known example is the fallopian tubes, named after Gabriele Falloppio, an Italian priest and anatomist who is credited as being the first to describe them. Others include Alzheimer’s, Parkinson’s and Hodgkin’s diseases, all named after European medical men.

So it was a shock when, in the early 2000s, dozens of eponyms were discovered to be linked to National Socialist doctors who had violated every value of medical consent and human dignity. These offenders could be found lingering in the lungs, attached to common diseases like arthritis and even on craters of the moon. There seemed to be onlyone possible response: purge the Nazis.

“We owe it to our patients, we owe it to their loved ones, we owe it to the victims of these atrocities,” said Dr Eric Matteson, a retired rheumatologist who helped rename a disease of inflamed blood vessels formerly known as Wegener’s granulomatosis.

Beginning in 2000, after hearing a rumour that Friedrich Wegener had ties to National Socialism, Dr Matteson and a colleague spent years combing through World War II archives around the world. They eventually learned that Wegener was a Nazi supporter who had worked three blocks from the ghetto in Lodz, Poland, and might have dissected victims of medical experimentation. In 2011, several major medical organisations moved to replace Wegener’s syndrome with “granulomatosis with polyangiitis” — a mouthful, admittedly.

The hunt for Nazi names was on. Clara cells, a type of cell that lines the lungs and secretes mucus, were found to be named for a Nazi doctor who experimented on soon-to-be-executed prisoners. The cells were renamed club cells, reflecting their bulbous shape. Reiter’s syndrome, a form of arthritis caused by a bacterial infection, was renamed “reactive arthritis” after it was found to have been named for a doctor who performed deadly typhus experiments on prisoners of the Buchenwald concentration camp.

In most cases, the name change fit with medicine’s growing preference for descriptive terms over honorific ones. “Many of us just don’t use eponyms because they’re not anatomically informative,” said Dr Jason Organ, an anatomist at Indiana University, US.

Not all anatomists agree with this slash-and-burn approach. Dr Sabine Hildebrandt, an anatomical educator at Harvard Medical School, US, trained in Germany a few years before the legacy of Nazi medicine began coming to light. To her, eponyms provide an opportunity to remind future doctors of the path medicine must never go down again. “I would like to see them not as badges of honour, necessarily, but as historical markers — as teaching moments,” she said.

In the classroom, Dr Hildebrandt highlights Frey’s syndrome, one of the rare medical eponyms that celebrates both a female researcher and a victim of the Holocaust. The syndrome, a neurological condition that can cause heavy facial sweating while eating, is named for Lucja Frey-Gottesman, a Polish neurologist who was murdered by the Nazis.

Dr Hildebrandt also draws attention to Dr Charlotte Pommer, a name her students probably have not encountered. In 1942 Pommer, a young German anatomist, walked into the laboratory of her department’s director, Hermann Stieve, only to be confronted with the executed bodies of five people she recognised, members of the resistance group Rote Kapelle. Horrified, she abandoned the field.

Many scholars argue that medicine should discard Nazi eponyms but retain those related to victims and resistors, to honour their stories. But the “right” side of history doesn’t stay put; as norms and standards change, and as scholars like Sheffer and Dr Matteson uncover damning new evidence, many more are sure to fall from grace.

“If you pull enough of the threads here, a lot of this stuff’s going to come unravelled,” Dr Organ said.

NYTNS

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