Prescriptions for Hope

My Father Encountered The First Of The Physicians in 1941. As the youngest and only unmarried sibling of eight Bursztajns, my father, Abraham, had been left in charge of the family's lumberyards in Lodz soon after the German invasion of Poland on September 1,1939. Most of the members of his family had left for Warsaw, which had been something of a haven during World War I. My father, not having other family responsibilities, volunteered for the dangerous job of overseeing the family's holdings in what was considered an area far more likely to be involved in the fighting.

The Nazis had compiled a list of prominent Jewish families with assets, and my father's family was on that list. In 1941 the Nazis captured him, threw him in jail, and tortured him to reveal his family's whereabouts. He refused.

After a particularly severe flogging, my father fainted. He was surprised to awaken in the jail's infirmary. His interrogators, intent on making him disclose his family's location, had decided to keep him alive for continued questioning—and torture. As he stirred, he realized that standing before him was a doctor, himself a Jewish prisoner, who ministered to the other prisoners. "I will die here," my father told the older man.

"One of us will, but it will be me," the physician replied. "I do not have any way of treating you, but you are young. If you don't give up hope, you will survive."

This physician inspired my father by first acknowledging their shared hopelessness but then instilling in him a determination to survive. My father did his part and survived. When he eventually returned to what was by then the Lodz Ghetto, he was offered a "choice" job—to collaborate with the Nazis by becoming a Jewish police officer. His refusal enraged the Nazi-installed figurehead of the ghetto, Mordechai Chaim Rumkowski, known among those in the ghetto as the King of the Jews. Rumkowski slapped my father, then sought to humil­iate him by assigning him to work on sewage disposal.

Remembering the doctor's words, my father resolved to transform the job into a way to create hope. His first priority was to establish a home for a Jewish Resistance cell. He found willing members among some of his sewerage co-workers, and he recruited others by pulling acquaintances off the train plat­form as they were waiting to embark for Auschwitz. One of the people he recognized was Miriam, the daughter of a furniture craftsman he knew from his family's lumber trade.

Miriam had given up hope after her father's death from starvation, and she was already on the train, knapsack on her back. But when my father talked with her, she agreed to his plan. My father approached the Nazi officer supervising the deportation. "She is one of the sanitation workers who has been ordered to stay in the ghetto until the last," he said. "She needs to come with me." When the officer looked skeptical, my father played his final card: He flashed a family photograph given to him by a high-ranking German officer with anti-Nazi leanings. The officer in charge let Miriam go.

Running for Cover

By 1944 my father and the other members of the Resistance cell were convinced the Nazis were planning to kill those who remained in the Lodz Ghetto. But the resistors had no weapons with which to mount a revolt, and by that time they had heard of the carnage suffered by those living in the Warsaw Ghetto during its 1943 uprising. After much debate, they decided to resist by going into hiding. But where? The Nazis had been employing dogs to sniff out other Resistance hiding places. My father realized that the sewer system itself, if waterproofed areas could be created, offered a natural hiding place. The stench of the sewers would confuse the dogs.

The challenge was obtaining the cement necessary to build a watertight bunker in the sewer system. The only available cement was in a well-secured Nazi warehouse outside the ghetto walls. My father and one of his comrades decided to risk a night raid.

The raid was an initial success. While carrying 100-pound bags of cement back to the ghetto, however, my father and his colleague were shot at, and a Nazi patrol gave chase. Zigzagging at a sprint, my father evaded the automatic weapons fire until a bullet struck him in the shin. Injured and bleeding profusely, he could no longer run. With the enemy closing in, he looked for a refuge. He spotted a nearby dumpster and, still clutching his bag of cement, jumped in, pulling the cover over him. The Nazi patrol rushed past.

When the area cleared, my father staggered with the heavy bag back to the Resistance's rendezvous. Now that the cement had been saved, he needed to save himself. Surely that morning the Nazis would investigate, notice the blood on the bridge, and look for absentees from the morning's work detail to inter­rogate as suspects in the raid. My father's comrades contacted one of the few doctors still left in the shrinking ghetto.

In the hours before dawn, the doctor risked his life to visit my father. He no longer had surgical instruments, so he straightened a coat hanger to fashion a crude probe. Sterilizing it as best he could, he used the makeshift tool to extract the bullet. He had little time, and few words were exchanged. In the absence of anesthesia, afterward the surgeon gripped my father's shoulders with affection to help quiet the searing pain. When they parted, my father kissed the hands that had saved him. That morning my father was able to appear for the roll call with a baggy pair of pants hiding the dressing on his wound.

Working at night, the members of the Resistance cell used the precious cement to construct a bunker in the sewer system. Concealed by water, the bunker had pipes that brought in air, water, and electricity. For the final six months of the Nazi reign of terror, 14 people hid in that space—and survived. By then, my father had helped spread the word about the sewer system, and many others found shelter there or used it as an entryway into the basements of abandoned houses.

The Gift of Life

My father could not save his family of origin. But he and his comrades in the Resistance cell, including Miriam—who later became his wife and my mother—did save the lives of others. The memories of his family, of his comrades in the Resistance, and of the physicians who had saved his life had become hope-sustaining assets that neither the Nazi terror nor the passage of time could obliterate.

The Lodz Ghetto was liquidated in August 1944, and for each night after, as he emerged from the bunker to forage for food, my father felt as if the dead were keeping watch. Finally, the living, in the form of the Russian Army, came to the rescue. The soldiers found more than 800 Jewish survivors of the ghetto holding on in the sewer system.

My father never saw either physician again. Decades later, his eyes would fill with tears when he recounted learning that the doctor who had removed his bullet had been found in hiding in the evacuated ghetto and was murdered along with his family.

Beyond carrying personal meaning for me, my father's story of survival has resonated with me professionally. It reminds me that physician integrity can be maintained in the most trying situations. If the physicians my father encountered during the Holocaust could preserve the decency of authentic doctoring, then so can we all, whatever the circumstances. Supporting our patients' hope and autonomy—even in the most resource-limited conditions and against all odds—is our fundamental duty, even when we face with them the most hopeless of realities. ■

Harold J. Bursztajn ‘76 is an HMS associate clinical professor of psychiatry at Beth Israel Deaconess Medical Center and a co-founder of the Program in Psychiatry and the Law at Harvard Medical School. As a child in Lodz he remembers people rushing up to his father to thank him for saving their lives. (The author's original essay appeared in the Winter 1996 issue The Journal of Clinical Ethics. This adaptation appears with permission of the journal, which retains rights)