Don’t Be an Adler

Don’t Be an Adler

SPOILER ALERT: If you are even farther behind the times than me, this post will ruin a small subplot from Season 2 of the Amazon Original Series, The Man in the High Castle.

I know what Nazi doctors like Józef Mengele did in Auschwitz, but that does not make it any easier to stomach Dr. Gerhard Adler.  Adler is the “kindly” old physician in the Amazon series The Man in the High Castle, the disturbing alternate reality drama in which the Nazis and Japan won World War II and divided the United States between them.  Season 2, Episode 3 finds Adler in a well-appointed study on Long Island, pronouncing a death sentence.

“You don’t need me to tell you.  Withholding his diagnosis is a crime against the state,” he reminds Obergruppenfuhrer John Smith (talk about the banality of evil – a Nazi officer named John Smith).  Smith’s son, Thomas, the perfect specimen of the Hitler Youth, is not so perfect, after all.  He has inherited the crippling neuromuscular disease that put Smith’s brother in a wheelchair before the war, when America was still the America those of us in this version of reality would recognize.  In other words, Thomas is “defective,” and must be removed from the gene pool before he becomes a burden to society – or worse, before he reproduces and makes more defectives.

“I’m sorry, John,” sighs Adler, “but if you don’t take care of this today, I’ll have to do it tomorrow.”  “Take care of this,” as in “euthanize your son.”

It is a strange observance of Holocaust Remembrance Day[i] to watch this drama.  It is a perverse reminder of how much worse the already unfathomable tragedy could have been.  Yet I am strangely able to turn it off and go to sleep without nightmare visions.  It is chilling but reassuringly distant.

Adler’s character, however, undoes me.  He hides a monster, the medical arm of Hitler’s killing machine, under impeccable bedside manner.  The Reich was replete with Adlers.  They packed “defectives” into woodsheds and piped in car exhaust until carbon monoxide poisoning did its service to the “Master Race.”  They measured skulls with calipers to suss out “Aryans” from “Slavs” or “Semites.”  They infamously tortured one of a pair of twins to find out if the other would experience the pain. 

What unsettles me is that Nazi Germany did not have a monopoly on co-opting healers to do harm.  The Nazi eugenic program was Made in the USA – the same country where the Tuskegee experiments were conducted, where doctors conducted forced sterilizations of thousands of “imbecile” women, and psychiatrists ran Cuckoo’s Nest asylums for decades.  It is no consolation to know that doctors in China may support the harvest of organs from unwilling donors, or that doctors in Myanmar have helped to dehumanize the Rohingya minority by denying them medical care.  The same system that grew me into the doctor I am harbored and even celebrated those criminals against humanity.

The unofficial motto of this day has always been, “Never Again.”  Sadly, we know how quixotic that motto is: genocide has happened again, ethnic cleansing has happened again, anti-Semitism has happened again, and global indifference to all of them has happened again.  Perhaps we should start more modestly: Never Again will we who heal for a living be instruments, either willing or unwitting, of oppression, dehumanization, or extermination.  Can we handle that?

By “handle that,” I mean, can we remind ourselves even when we are working where it is hardest, treating enemy combatants on the battlefield or practicing in a maximum security prison, that the lives in our hands are human lives, capable of love, fear, anger, and all of the other thoughts and feelings that make their doctors human? 

I mean, can we question ourselves when we call Child Protective Services whether we are, in the act of protecting an innocent child, also contributing to the disproportionate number of minority kids in the foster care system by judging parenting on a double standard? 

I mean, can we honestly say that our mental health assessments and alphabet soup labels of behavior do not help grease the wheels of the school-to-prison pipeline?  How else should I understand the psychiatry attending who told my med school class in lecture, “The cure for antisocial personality disorder is prison,” and then proceeded to tell us that pediatric conduct disorder was just the immature form of antisocial personality disorder? 

I mean, can we be sure that our biases aren’t the reason that people of color get less pain control when they have appendicitis, a lower percentage of recommended care for their heart disease, diabetes, or almost any other chronic disease compared to white folks, or poorer care for their skin because all of us learned from textbooks that only showed rashes and moles occurring on white skin?

I mean, forget about the nightmares from watching Nazis-in-America fictional dramas – can we really sleep easy at night knowing that the cost of our services is directly responsible for the widening gap between the haves and have-nots in America, where the majority of personal bankruptcies are caused by medical debt?

You can stop reading now if you want to skip the spoiler.  You’ve been warned.

Toward the end of the episode, Smith takes Thomas and the euthanasia meds to the lake for a fishing trip.  Thomas is blissfully unaware and begins to soften his father up to get permission to go on a camping trip – a trip where there will be a bunch of friends, but especially a girl he likes . . . Smith’s eyes glaze over and the viewer dreads what we think is coming next.

The scene shifts.  What’s coming next is Smith, back in the suburbs, in the ruthless officer’s most redeeming moment of the series (so far – remember I’m behind), luring Adler into a car and plunging the syringe of euthanasia meds into the doctor’s thigh instead of Thomas’s.

Let us figuratively do away with the Adler within us.  Today, and every day, remember to Never Again be an Adler.


[i] Holocaust Remembrance Day in the US is January 27, the anniversary of the liberation of Auschwitz.  On the Jewish calendar, however, we observe Yom HaZikaron Lashay v’LaGvurah, Holocaust and Heroism Remembrance Day on the 27th of the month of Nisan, 5 days after the conclusion of Passover.  Tonight, May 1, 2019, begins that date for the current year.

Dr. Jonathan Weinkle

Dr. Jonathan Weinkle is an experienced primary care physician seeking to fix our broken healthcare system by returning the focus to the relationship between human beings. His new book, Healing People, Not Patients, gathers together ancient wisdom, medical science, and the experiences of one doctor to draw a portrait of a partnership—a medical covenant—not just between doctor and patient, but also including receptionist, nurse, transporter, and radiology technician.

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