A day not easily forgotten

Editorial from Patient Care, September 15, 1995

A few months ago I traveled to New York City -- less than an hour from Patient Care's offices -- to attend a meeting sponsored by an organization called Physicians for Human Rights (PHR). Coincidentally, I had just hear from Harold J. Bursztajn, M.D., a psychiatrist at Harvard Medical school, who had served as a consultant for an article I prepared on posttraumatic stress disorder. Dr. Bursztajn was going to be in New York for a few days to visit his father, and perhaps he would have time to see me as well. Only later did I realize the connection between PHR and Dr. Bursztajn's visit.

The PHR was cosponsored by the Center for the Study of Society and Medicine at Columbia University College of Physicians and Surgeons and by the Committee on Human rights of Scientists of the New York Academy of Sciences. The theme of the meeting -- medical documentation of human rights abuses -- had intrigued me, but as I walked into the room, I felt I had stepped into the maw of the beast. Prominent on the agenda was a session on "physical and psychological evidence of trauma and torture." I wanted to cover my eyes and ears.

We tend not to think much about torture in this world, yet United Nations studies estimate that it is systematically practiced in at least 30 countries. The very nature of the obscenity makes it difficult for us to acknowledge its existence, let alone respond humanely and effectively to its victims. yet the meeting had drawn more than 100 doctors who wanted to learn what individuals could do.

Since 1986, members of PHR have been working to prevent medical complicity in torture and to facilitate U.S. asylum for its victims. Basing its actions on the Universal Declaration of Human Rights, PHR states unequivocally that doctors who participate in human rights abuses violate the ethic of primum non nocere.

To accomplish the first goal, PHR directs a spotlight on physicians who certify that prisoners are healthy enough to continue with interrogation. The organization lets physicians know that collaboration in such efforts will come under public scrutiny. On the positive side, medical verification of injuries can provide powerful testimony to its occurrence and focus international attention on human rights abuses even as they are strenuously denied.

Victims of such abuses often seek political asylum in the United States, fearing further persecution should they be forced to return to their native countries. PHR maintains a network of primary care physicians who volunteer to examine and testify on behalf of applicant for political asylum. Their medical testimonies substantiating abuses can play a crucial role in the outcome of asylum claims.

As I listened to the presentations, Dr. Bursztajn was a few clocks away visiting his father, Abraham, 79 years old and a Holocaust survivor. The day before, the elder Bursztajn had spent three hours being interviewed by the Survivors of the Shoah Visual History Foundation. The gentleman has posttraumatic stress disorder, and his son knew that the experience of being interviewed could bring back horrific recollections of being interrogated under torture. Dr. Bursztajn stood close by throughout the interview to ground his father in reality.

In the moving scene at the end of Steven Spielberg's film, Schindler's List, a procession of aged men and women -- Holocaust survivors -- passes haltingly across the screen. Those people inspired Spielberg to create what he calls "my most important work" -- the survivors of Shoah Foundation, dedicated to chronically the Holocaust's horrors. As Spielberg says, "It is essential that we see victim's faces, hear their voices."

The quarter of a million Holocaust survivors are an aging and dying population. Spielberg sees the Shoah project as a race against time. He hopes to accumulate tens of thousands of personal testimonies by 1997. A multilingual team is interviewing survivors around the world for firsthand accounts of their experiences during and after the Holocaust. Photographs, maps, and official papers along with the unedited videotape personal histories. All of these will be assembled in an multimedia, on-line database.

The collection will initially be made available to five repositories via the Internet: the Fortunoff Video Archive for Holocaust Testimonies at Yale University; the Living Memorial to the Holocaust - Museum of Jewish Heritage in New York City; the Simon Weisenthal Center in Los Angeles; the U.S. Holocaust Memorial Museum in Washington, D.C.; and the Yad Vashem Holocaust Martyrs' and Heroes' Remembrance Authority in Jerusalem. Beyond that, access will develop as needed. A children's museum, for example, might have a simple touch screen that will enable a child to speak to a survivor.

The day I went to New York, I journeyed from the comfort of my office to the rim of the human abyss. By the day's end, however, I felt heartened by the willingness of concerned doctors to work relentlessly to rescue brave, imperiled souls around the world. I felt encouraged by the fact that Spielberg's project will shine light on a shameful segment of our history in the hope that understanding will bring change.

The Shoah foundation now has on videotape Abraham Bursztajn's memories of the Lodz, Poland, ghetto and his role in the Jewish resistance. Abraham says he cherishes the memory of a physician who appeared at his side after he recovered consciousness after being whipped by Nazis. That good doctor, himself a prisoner, assured him, "If you don't give up hope, you will survive." Those words gave him -- indeed, give all of us -- the will to go on.

-Dorothy Pennachio
Senior Associate Editor