“It was horrible, in terms of hygiene this was the worst equipped ward in the whole of Terezín. Sick, mostly old women, who had fallen ill due to the prevailing hardship, were lying in a cold room, formerly a horse stable, on a stone floor, at first without straw, without covers, in their own excrements. I had a night duty on the very first day […] seven people died during that night. I was afraid I would go insane myself. However, one can get accustomed to anything, if you just knuckle under. And I also got used to the nightmare, while the conditions kept improving, even though slowly. At least to such an extent that each patient had one´s own bed, cover and pillow. In other respects, the situation was still desperate. In addition to their mental illnesses the patients also suffered from other ailments, mostly diarrhea, all kinds of ulcers, rashes, typhoid fever, and lice everywhere. There were so precious few expedients for them […]”[1]
The fortress town, built by Emperor Joseph II at the end of the 18th century, was selected by the Nazis as a suitable site for concentrating Jews from the Protectorate prior to their deportation to the East and also for what was called Ghetto for the Elderly (Altersghetto), war veterans and heroes, notables and high-ranking officials from Germany and Austria, so that – as Heinrich Himmler, the Reichsführer of the SS, euphemistically envisaged in 1943 – the Jews in Terezín “could live and die in peace”.[2] There were at least 586 inmates suffering from mental and nervous disorders, who had been singled out to die either at the psychiatric ward of the Terezín hospital, situated in the fortified section called Kavalír VIII, or following their deportation to the East. These patients had been previously kept for short-term or long-term treatment in some of the regional mental homes or private sanatoria in the Protectorate.[3] Furthermore, some 889 mentally ill inmates, deported to the Ghetto from Germany and Austria, together with other persons from the Protectorate without any previous mental hospital care or treatment were also left “to live and die in peace” in Terezín´s Kavalírka. Altogether, those at least 1 475 mentally ill inmates thus proved to be the easiest targets and victims of the Nazi extermination machinery; these people were quite helpless, legally incapacitated already during the prewar period, frequently apathetic, unaware of their real situation, incapable of fighting for their own life, without any chance of passing through “selection” after their arrival in a death camp. A comparison of the lists of mentally ill patients hospitalized for short-term or long-term treatment with the lists registering Holocaust survivors kept in the Ghetto shows that only six mentally ill persons from the Protectorate lived to see their liberation in Terezín.
Among the several dozens of houses and barracks serving for the accommodation of the thousands of inmates in Terezín there were objects set aside by the Jewish Self-administration for special purposes. Incarceration of mentally ill inmates in the Ghetto was inseparably linked with the cheerless premises of the left wing of the former military depot (Kavalier VIII) with its dark, inhospitable rooms – during the time of the Ghetto known as Kavalírka (Kavlier Kaserne). This was used primarily during the first half of 1942, from February to June of that year, as a “Schleuse” (checking point) for outgoing and incoming transports.[4] Before moving the psychiatric ward to Kavalírka and then, at least until June 1942, its part was located in the former chapel of the divisional hospital in the Hohenelbe Barracks.[5] The exact date of the establishment of the psychiatric ward in Kavalírka is not known. According to the Order of the day No. 98 on April 12, 1942, Kavalírka was separated from the medical administration of the Hohenelbe Barracks (E VI) and designated as a self-contained health-care unit.[6] By the end of September 1942, Terezín´s mental hospital had at its disposal in its rooms a total of 130 regular beds and 92 places for emergency accommodation – i.e. in all, 222 beds for its patients.[7]
One of the aspects adding to the special mosaic of the hitherto unexplored system of care for mentally ill inmates in Terezín is the existence of the psychiatric room (A II Psych) in the so-called Hunting Barracks [Jäger Kaserne].[8] These served as a “Schleuse” for incoming transports, bringing elderly Jews from Austria and Germany; a separate room for mentally ill patients was most probably furnished in that object; such inmates were placed in the room for their mandatory quarantine and delousing. Between January 1942 and January 1943, the Hamburg Barracks (designated in the Ghetto as CIII) reserved its room No. 162 for abnormal patients, popularly known as “unsere cvokárna (our madhouse)”.[9]
This “madhouse” in Kavalírka also served as a “correctional facility”. As a matter of fact, the deportees to Terezín also included Jewish half-breeds who refused to be treated by Jewish physicians, and the Self-administration, wanting to avoid sending reports to the SS Command concerning cases of “endangering camp discipline”, had to lock up the inmates involved into Kavalírka´s closed sections for two or three days under the pretext of their temporary loss of sanity. No records were kept on such cases, everything proceeding on the basis of oral instructions.[10]
In all, seven children suffering from diagnosed mental illness died in the Terezín Ghetto. The youngest inmate among them was the severely mentally retarded Hilde H. (b. 1935), kept in the Bendorf-Sayn Institute in Germany before her deportation. In the Ghetto she was initially placed in a hospital bearing a somewhat cynical name Krankenhaus Grandhotel Q 403.[11] According to the death certificate, Hilde H. died of pneumonia in the psychiatric ward in Kavalírka in January 1943, after six months of imprisonment.[12] A special facility in the Terezín Ghetto was its home for emotionally impaired children; it was led by psychiatrist Dr. Gertruda Bäumlová, head of the social education division of the Youth Care Department.[13] She was known for her work in children´s homes, examining drawings by girls in order to detect signs of eventual sadomasochistic tendencies in her charges that could emerge as a result of the stressful conditions in the Ghetto disturbing their psychic development.[14] According to an accommodation plan, drawn up by the Youth Care Department in October 1943, a document we have at our disposal, in the yard section of house L 216 there were rooms No. 014 and No. 015 providing a total of twelve places for educationally handicapped children in the Terezín Ghetto.[15]
One of the doctors in the detached psychiatric ward in the Kavalier Barracks was Armin (Artur) Steier deported to the Ghetto by transport X-724 as a male auxiliary nurse (Sanitätsgehilfe). Even though he signed official documents in Terezín using the title MUDr., in actual fact he had never obtained that degree. In his prewar application for a production license he gave his original profession as a chemist and pharmacist; however, during the previous 21 years he had earned his livelihood as a psychotherapist and artist known under his assumed name To Rhama. Under this pseudonym he gave his experimental lectures on self-control and on his method of fascinating animals by staring them down. In fact, he was also known in the Prague community of psychiatrists for his skills in teaching self-control and psychagogic. As evidenced by associate professor Dr. Bruno Fischer, Steier allegedly managed to improve the mental state of hypochondriac patients.[16]
In a similar vein, there was another doctor who seemed professionally out of place in the psychiatric ward in the Kavalier Barracks: Dr. Armin Knöpfelmacher´s original specialization was dentistry.[17]
The report summarizing the status of health care in Terezín, as of the key date December 1, 1943, comprised statistics on the number of patients and medical personnel in all the wards of the hospital E VI. This document makes it clear that it was the psychiatric ward that had the most unfavorable doctor-patient ratio (1:23.8) and nurse-patient ratio (1:5.1).[18]
According to the preserved sources, at least 1 011 people, out of the total number of 33 430 (i.e. three percent) of the deceased in the Terezín Ghetto from November 24, 1941 to April 20, 1945, died in the psychiatric ward in the Kavalier Barracks or were known to suffer some kind of mental illness at the time of their death. Out of this number, 274 persons came from the Czech lands. The real number of inmates was probably higher since not all the period documents are available.
Proceeding from the current state of research, we can assert that at least 446 mentally ill inmates, kept either for short-term or long-term treatment in some of the psychiatric institutes in the Czech lands or in the ward for mentally ill patients in the Ghetto, were deported from Terezín to the East. None of this group of inmates survived deportation to the East.
Tomáš Fedorovič
[1] Archive of the Jewish Museum in Prague (hereafter AŽMP), collection: Documents on persecution, inv. no. 80, recollection of E. F. (b. 1902).
[2] Miroslav Kryl, Osud vězňů terezínského ghetta v letech 1941–1944 (Fate of Terezín Ghetto Inmates in the Years 1941-1944), Brno 1999, p. 75. (in Czech) Quote has been taken from the document printed in Hans G. Adler, Die verheimlichte Wahrheit, Theresienstädter Dokumente, Tübingen 1958, p. 299 (in German).
[3] The data concerning Jewish mentally ill patients from the Czech lands, respectively those kept in the Terezín Ghetto, come from the dissertation (PhD thesis): Tomáš Fedorovič, Mezi “eutanazií” a holokaustem – židovští duševně nemocní pacienti z českých zemí a Slovenska v “konečném řešení židovské otázky” (Between “Euthanasia“ and the Holocaust – Jewish Mentally Ill Patients from the Czech Lands and Slovakia in the “Final Solution of the Jewish Question“. Dissertation – J. E. Purkyně University in Ústí nad Labem, Faculty of Arts, 2018 (in Czech).
[4] Richard Feder, Židovská tragédie: dějství poslední (Jewish Tragedy: Final Act), Kolín 1947, p. 64 (in Czech).
[5] National Archive in Prague (hereafter NA), collection. Jewish registers (HBMa), cart. 1, Death certificates – Terezín Ghetto, vol. 3 (2. 5. 1942 – 16. 6. 1942).
[6] Anna Hyndráková – Raisa Machatková – Jaroslava Milotová (edd.), Denní rozkazy Rady starších a Sdělení židovské samosprávy Terezín 1941-1945 (Order of the Day of the Council of Elders and Communications of the Jewish Self-administration (Regesta), Prague 2003, pp. 134–135 (Order of the day No. 98, 12. 4. 1942).
[7] The number of rooms used by the psychiatric ward in Terezín, as established by an analysis of TFA, does not add up to the number of 8 rooms given in a monthly activity report for September 1942. PT, A 20/2005, Ghetto Theresienstadt, Tätigkeitsbericht 1. 9. – 31. 9. 1942 (= Activity for the period from Sept. 1 to 31, 1942), p. 34.
[8] NA, f. Jewish registers HBMa, cart. 5, Death certificates – Terezín Ghetto, vol. 5 (29. 8. 1942 – 1. 9. 1942).
[9] Terezín Memorial, PT 5424, Memorial album: 1 Jahr Hamburger Kaserne. Part Es spricht die Ubikationskanzlei …
[10] Email message from W. Murmelstein to the author, 8. 11. 2005.
[11] AŽMP, f. Terezín, inv. no. 173/3, Housing management: lists of objects in Terezín, 1. 10. 1943.
[12] NA, f. Jewish registers HBMa, vol. 70, Death certificates – Terezín Ghetto, Hilde H., 18. 1. 1943.
[13] Elena Makarova – Sergei Makarov – Victor Kuperman, University Over The Abyss. The story behind 489 lecturers and 2309 lectures in KZ Theresienstadt 1942-1944, Jerusalem 2000, p. 372.
[14] Egon Redlich – Miroslav Kryl (ed.), Zítra jedeme, synu, pojedeme transportem (Tomorrow, my son, we´re going away in a transport), Brno 1995, pp. 184–185 (entry dated 1. 4. 1943) (in Czech).
[15] AŽMP, f. Terezín, inv. no. 300, various documents concerning the activities of the ward 1943–1944, 31. 10. 1943.
[16] NA, f. Police Directorate Prague 1931–1940, cart. 11137, sign. S 6218/9 Steier Armin, 1894.
[17] Ibid, cart. 5325, sign. K 2670/2 Knöpfelmacher Armin, 1900.
[18] Archive Beit Theresienstadt, f. 53/I/29 (Health), comments on the number of health-care staff and its effect on granting extra food portions, p. 6.
