Walther Birkmayer, Co-describer of L-Dopa, and His Nazi Connections: Victim or Perpetrator?

Herwig Czech & Lawrence A Zeidman. Journal of the History of the Neurosciences. Volume 23, Issue 2, 2014.

Introduction

Walt(h)er Birkmayer (May 15, 1910-December 10, 1996) was an Austrian neuroscientist, well-known as a codiscoverer of L-Dopa (levodopa) treatment for Parkinsonism in humans. Born and trained in Vienna, his biography reflects the contradictions and fault lines of twentieth-century history in Austria and beyond. As a young adult, he joined the ranks of the Nazi movement and became a staunch supporter of its racial hygiene agenda. For several years, he combined scientific and clinical work with political activism aimed at Austria’s incorporation into a Greater Germany under the leadership of Adolf Hitler. However, more than a year after Austria had been annexed by the German Reich, and political terror and persecution of the Jewish minority had become the norm, Birkmayer was confronted with doubts over his ancestry that ultimately led to his dismissal from the SS [Schutzstaffel, Nazi elite paramilitary organization] and the loss of his other Nazi memberships and positions. He spent the war years in a somewhat precarious and ambivalent position, trying to defend his professional and political status. After the war, this allowed him to present himself as a victim and resistor and, over time, to all but erase the extent of his former Nazi involvement from the public record.

Birkmayer’s later discoveries cannot be dissociated from the first formative phase of his career under National Socialism, during which his allegiance to the regime opened professional opportunities and access to research material in the neurological field hospital he was directing. Therefore, after first giving an overview of Birkmayer’s scientific work, we turn to the main topic of this article, namely Birkmayer’s involvement with the Nazi regime, his alleged fall from grace because of his ancestry, and his subsequent attempts to rewrite his political past.

Contributions to Neuroscience

Birkmayer was born in Vienna into a family of ballet dancers, though his father was a senior postal official. His mother, Franziska Margarethe Birkmayer née Jenisch (1886-1957), suffered from Parkinsonism late in life. He was interested in sports, which along with his academic aptitude, led him to pursue both medical and physical education when he enrolled in 1930 at the University of Vienna. After receiving his medical doctorate in 1936, he was appointed to the Neurology and Psychiatry Clinic under Prof. Dr. Otto Pötzl (1877-1962), where he began a prolific neurological career (Foley, 2001). By the end of 1940, he had published 29 papers on a wide breadth of neurological, psychiatric, and other topics.

He only published two papers in 1941, and published none in 1942, while serving on the war front. Interestingly, a biographical sketch (Foley, 2001) mentions that Birkmayer only published 26 papers by the end of 1940, but this is because Birkmayer apparently omitted three papers from his later 1952 publication list compared to the 1943 list. Two of these papers (Birkmayer, 1938a, 1938b) were written for the Wiener klinische Wochenschrift [Viennese Clinical Weekly] as SS-Untersturmführer for the Schulungsabende des SS-Oberabschnittes ‘Donau’ [evening training sessions of the SS section ‘Danube’] regarding “Character and inheritance” and “Inheritance of nervous diseases.” The third (Birkmayer, 1939d) was written as the Gau-Hauptstellenleiter [a position in the Nazi party, see below] regarding “How far can and should the law influence population policy?” We will discuss these latter papers in more depth below.

Birkmayer volunteered for military service and after serving as a troop doctor in France was transferred to the Russian front. He was transferred back to Vienna in 1942, where he headed a hospital for soldiers with traumatic brain injuries until the end of the war (Foley, 2001). While at this hospital, he published on vegetative and functional neurological disturbances (Carlsson, Riederer, & Stern, 1997). Per his publication list from 1952, he published 12 papers in 1943 and 1944 but did not publish any papers in 1945-1946. He later published a book in 1950 (Hirnverletzungen, also published in English in 1952 as Brain Injuries), on 3000 injuries he had seen during the war. In 1954, Birkmayer became Neurology Head at the Vienna Geriatric Hospital in suburban Lainz, as well as Lecturer in Neurology and Psychiatry at the University of Vienna. At the Geriatric Hospital, the neurology division mostly contained patients with Parkinsonism (60 in number), multiple sclerosis, and dementia. He was influenced by emerging evidence in the 1950s regarding the biochemical basis of neurological function and also became convinced from other work that the “vegetative ataxia” he had seen in brain-injured patients could be seen in noninjured patients also (Foley, 2001). None of Birkmayer’s geriatric home Parkinsonism patients (idiopathic and postencephalitic) became hypotensive when administered alpha-methyldopa, which he referred to as “vegetative rigidity” (Birkmayer & Weiler, 1957).

The Discovery of Dopamine Depletion in Parkinsonism and L-DOPA Therapy

Another critical discovery at the time was the 1957 report (Carlsson, Lindqvist, & Magnusson, 1957) by Arvid Carlsson’s (b.1923) group in Sweden that L-3,4-dihydroxyphenylalanine (L-DOPA, or levodopa) antagonized the effect of reserpine. Since reserpine was used at the time in psychiatric institutions as a sedative, with obvious Parkinsonian side effects (due to central dopamine depletion), its reversal by L-DOPA was of clear clinical interest (Foley, 2001). Oleh Hornykiewicz (b.1926), a Viennese pharmacologist who had trained at Oxford on measurement of tissue catecholamine concentrations, published a paper in 1960 (Ehringer & Hornykiewicz, 1960) with his assistant regarding dramatically reduced dopamine concentrations (compared to normal patient brains) in the caudate, putamen, and pallidum in postmortem Parkinsonism brains (idiopathic and postencephalitic). Birkmayer thought reduced brain serotonin concentrations were actually responsible for Parkinsonian symptoms, but Hornykiewicz suggested the use of dopamine to him, given the results from Ehringer’s and his 1960 paper (Hornykiewicz, 2004). And given that only catecholamine precursors had been shown to cross the blood-brain barrier, Hornykiewicz suggested to Birkmayer that he try L-DOPA instead, using the same protocol followed in Frankfurt by Degkwitz et al. (Foley, 2001). Hornykiewicz only reluctantly sought out Birkmayer as he needed a neurologist to run the clinical trials, but

Birkmayer had many enemies in Vienna’s medical faculty (especially because of his political past); therefore, it required an act of balance to work with him and yet remain on good terms with the others. (Hornykiewicz, 2004, p. 257)

Hornykiewicz had a store of 2 g of L-DOPA that he had received from Hoffman-LaRoche pharmaceuticals, a very valuable substance at the time considering that it was difficult and expensive to produce the pure L-enantiomer (Foley, 2001). But Birkmayer was reluctant to use dopamine because of his persistent belief in reduced hypothalamic serotonin as the etiology of Parkinsonism (which Hornykiewicz rejected “because it lacked scientific stringency”), and because “at that early time, dopamine as a chemical compound of physiological interest, as well as its possible involvement in basal ganglia function, was quite alien to Birkmayer’s thinking” (Hornykiewicz, 2004, p. 258). In July 1961, after several reminders and pressure “from above,” nearly nine months after Hornykiewicz proposed it to him, Birkmayer administered 50 mg of L-DOPA intravenously to a test patient, and she dramatically improved, countering any doubts he had. This method was repeated on 20 patients overall, at doses up to 150 mg. Patients with moderate or severe Parkinsonism (idiopathic, postencephalitic, and vascular) were included with the vascular group responding least to L-DOPA. Birkmayer and Hornykiewicz presented their work at the Viennese Medical Society in November 1961, and the paper on the effects of L-DOPA on Parkinsonian akinesia (Birkmayer & Hornykiewicz, 1961) was published at the same time:

The effect of a single intravenous injection of L-DOPA in Parkinson’s disease was, in short, a complete abolition or substantial relief of akinesia. Bedridden patients who were unable to sit up, patients who could not stand up from a sitting position, and patients who, when standing, could not start walking, performed all these activities after L-DOPA with ease. … The voiceless, aphonic speech, blurred by palilalia and unclear articulation, became forceful and clear again as in a normal person. (Birkmayer & Hornykiewicz, 1998, p. 60)

The Viennese news media reported on the “The wonder of dopamine” (Anonymous, 1961) two days after Birkmayer and Hornykiewicz’s presentation. The two received positive comments from their colleagues, some of whom had already been using L-DOPA on their patients also; however, the director of the University of Vienna Neurology and Psychiatry Clinic Dr. Hans Hoff (1897-1969) emphasized that L-DOPA appeared only to alleviate Parkinsonian symptoms but not cure the disease, a point on which Birkmayer conceded (Foley, 2001).

By 1967, with cost issues abound and the short unpredictable effect of the labor-intensive intravenous L-DOPA causing doubts about its use, its future was in question; in fact, its use was even stopped at the University of Vienna Neurology Clinic in the mid-1960s by director Hoff (Foley, 2001, pp. 557-574). Oral L-DOPA therapy was introduced at this time, which to a great extent overshadowed much of Birkmayer’s and others’ work in Vienna. In a series of papers in the New England Journal of Medicine that received international attention from 1967-1969, George Cotzias (1918-1977) at Brookhaven National Laboratory in New York demonstrated that using large doses of oral L-DOPA (initially both D- and L-DOPA) in incrementing dosages over several weeks produced successful lasting therapy of Parkinsonism. But in 1967, Birkmayer successfully initiated the idea of coadministration of L-DOPA with a dopa decarboxylase inhibitor (Birkmayer & Mentasti, 1967), which started the chain of events leading to modern levodopa preparations. The introduction in 1964 by Hoffman-LaRoche pharmaceuticals of the stronger decarboxylase inhibitor benserazide (compared to the only previously available one, alpha-methyldopa) provided the basis for Birkmayer’s 1964 combination trial in 15 patients. The combination of L-DOPA and benserazide intensified and extended the effect of L-DOPA, found later by researchers at Hoffman-LaRoche to be secondary to benserazide’s inability to cross the blood-brain barrier and to act almost entirely peripherally to block L-DOPA conversion (compared to alpha-methyldopa which acts centrally and peripherally; Foley, 2001, pp. 525-542). Birkmayer published his results in 1967 (Birkmayer & Mentasti, 1967), only after this biochemical rationale was published. The decarboxylase combination was Birkmayer’s second major contribution to Parkinsonism therapy. L-DOPA combination therapy in Europe with benserazide was launched in 1973 as “Madopar 125,” and in the United States with Carbidopa as “Sinemet” in 1972 (Foley, 2001, pp. 619-688).

Birkmayer’s third major contribution to Parkinsonism therapy came in the 1970s. Birkmayer had since the early 1960s used MAO-inhibitors in combination with L-DOPA, which prolonged the dopamine effect by slowing central catecholamine metabolism. However, 10% of cases had such severe side effects such as paranoia and hallucinations that the drug had to be discontinued; but in patients in whom the combination could be continued, the effect of levodopa was potentiated (Foley, 2001, pp. 651-720). Later it was discovered that MAO-inhibitors only prevented rapid catabolism of dopamine produced from exogenous levodopa in the Parkinsonian brain, as endogenous dopamine was not produced rapidly enough that an MAO-inhibitor would make a difference in central nervous levels. The breakthrough discovery by 1968 that MAO occurs as two distinct isozymes, and that selective MAO-B inhibitors could reduce central dopamine catabolism without affecting peripheral tyramine levels or central noradrenaline and serotonin levels (Foley, 2001, pp. 619-688). Birkmayer and his young colleague, biochemist Peter Riederer (1942-), became convinced a selective MAO-B inhibitor could help reduce on-off motor fluctuations associated with levodopa therapy. L-deprenyl (“Selegiline”) was procured from one of Riederer’s colleagues and Birkmayer and Riederer discovered that up to 10 mg was safe and abolished on-off periods in many Parkinsonian patients. The results were presented and published in 1975 (Birkmayer et al., 1975).

There was some degree of controversy regarding who discovered levodopa therapy for Parkinsonism, and this controversy later ended the friendship between Hornykiewicz and Birkmayer. In a 1969 German medical newspaper, Birkmayer referred to Hornykiewicz as his “assistant,” though Hornykiewicz had already heard while in Canada that Birkmayer had been exploiting his absence and claiming sole credit for the L-dopa success (Foley, 2001, pp. 491-526). Regarding this behavior, Hornykiewicz later stated:

The amicable and highly successful working relationship between Birkmayer and me, which could have turned into something like friendship, did not last. In the course of time, Birkmayer, who could have rested on his own major clinical achievements, developed his own version—contrary to historical facts of the events leading to the use of L-dopa. Taught as I had been to respect the academic code and to acknowledge other people’s work and ideas, I found Birkmayer’s behavior discouraging, and I put our relationship on ice. It is amazing to see how often this disregard of intellectual property repeats itself, right to this day, in academic circles. (Hornykiewicz, 2004, p. 260)

Regarding the Nobel Prize, Cotzias claimed his discovery was worthy of it, ushering in a new era of natural neurotransmitter-based treatments for central nervous diseases by administering them in large doses. In contrast, Birkmayer, who in later years tried to emphasize Hornykiewicz’s role and claimed that he had been misquoted earlier, maintained until his death that the triumvirate of Carlsson (discovering the central nervous role of dopamine), Hornykiewicz (for establishing the dopamine deficit in Parkinsonism), and himself (for implementing the logical clinical therapeutic correlate) deserved the praise for discovering levodopa. Cotzias was not nominated for the Nobel, and of the “triumvirate” only Carlsson would be awarded the Nobel Prize, shared in 2000 with Eric Kandel (b.1929) and Paul Greengard (b.1925) “for their discoveries concerning signal transmission in the nervous system” (Foley, 2001, pp. 543-617).

Birkmayer remained active in research until the very end of his career, eventually publishing a total of 444 scientific papers and 19 books (Pubmed lists 172 references). In 1965, he was elected an Honorary Member of the French Neurological Society and in 1982 was elected to the German Society for Neurology and the World Federation of Neurology Research Committee for Extrapyramidal Disorders. In 1981, he founded the “Austrian Parkinson’s Disease Society” and devoted much energy to transforming the Journal of Neural Transmission in to a much respected journal following its rebirth in 1971 (initially founded in 1950; Carlsson, Riederer, & Stern, 1997). During the years up to the Waldheim affair of 1986, the Nazi involvement of Austria’s war generation, of which Birkmayer was a member, was rarely openly discussed in public.

Birkmayer’s National Socialist Involvement

To our knowledge, the only information published in English about Birkmayer’s activities in the National Socialist (Nazi) era is the following from his obituary:

In 1938, a lapse of judgment which he profoundly regretted for the rest of his life, caused Walther Birkmayer to enter the Nazi party; in 1939 he was expelled because he had a Jewish grandmother and he was sent as a medical officer to the carnage of the Russian front. (Carlsson, Riederer, & Stern, 1997, pp. VII-VIII)

However, thorough examination of archival evidence provided a much more comprehensive and accurate picture of Birkmayer’s involvement in the Nazi movement. Birkmayer himself provided ample information on various occasions. In a questionnaire he completed on June 3, 1940, he indicated that he first set out by joining the Hitler Youth in 1931; however, since he already turned 21 that year, his membership presumably was only short lived. In 1932, he joined the SA [Sturmabteilung, Nazi brown shirts or stormtroopers] to which he belonged until 1936. He joined the Nazi Party (NSDAP) in 1933 (contrary to the obituary); his membership number in 1938 was 6,126,574. From (probably April) 1936 until December 1939, he was also a member of the SS, with membership number 309,088. Additional roles listed by Birkmayer during the illegal period of Nazi membership in Austria (1933 to 1938) included being a leader (Kameradschaftsführer) in the National Socialist students’ league and Nazi Party block warden (Blockwart). In the SS, he headed the physicians’ study association (Studiengemeinschaft) and worked as an SS medical officer (Sturmarzt). At the time of the German military’s entry into Austria, he held the rank of an Oberscharführer (equivalent to a staff sergeant in the US Army) in the SS Standarte [regiment] 89. Members of this unit had occupied the Federal Chancellery in 1934 in an attempted putsch [coup] and assassinated Federal Chancellor Engelbert Dollfuss (Neugebauer & Schwarz, 2005, p. 242). In November 1938, during the so-called Reichspogromnacht [Reich pogrom night, popularly called “Kristallnacht” or “night of broken glass”], SS Standarte 89 was critically involved in anti-Jewish assaults and in the destruction of stores, apartments, and synagogues (Hoke & Reiter, 1993, p. 552). Just a short time earlier, as of September 11, 1938, Birkmayer had been promoted to the rank of SS-Untersturmführer (equivalent to a second lieutenant in the US Army).

In 1945, explaining his turn to National Socialism, he stated that he had been active in “national” organizations and moved in “national circles” since his youth. In the Austrian context between the world wars, “national” really meant “Pan-German nationalist” and was often explicitly linked with an anti-Semitic orientation. The illegal National Socialist movement in Austria sought the violent destruction of Austrian sovereignty and the Anschluss [annexation] to Hitler Germany. In the attempted Nazi putsch of July 1934, numerous individuals were killed (e.g., Schafranek, 2006). Against this background, Birkmayer’s joining the NSDAP and SS can by no means be explained as acts of opportunism. Rather, his membership in terrorist organizations responsible for killing 41 people and injuring almost 300 others in attacks between 1934 and 1937 meant risking considerable potential repercussions on his career and personal freedom.

After the Anschluss in March 1938

In the wake of Austria’s annexation by the German Reich in March 1938, Birkmayer, based on his dedication of many years to the Nazi movement, was appointed to the NSDAP Vienna’s “Office of Racial Policy.” Just a few months later, he took over the post of a “Hauptstellenleiter für praktische Bevölkerungspolitik” [director of the department for practical population policy] at this office, which he held until November 18, 1939. The head of the Office of Racial Policy, the genealogist Heinrich Wamser, substantiated Birkmayer’s appointment by stating that he had already known him as an illegal National Socialist who had been active in work groups for racial hygiene at the Wiener Gesellschaft für Rassenpflege [Vienna Society for Racial Hygiene] since 1934. This organization, founded in 1924, constituted one of the most important academic platforms for the promotion of racial-hygienic and racist ideas in Austria before 1938 and was closely linked to the National Socialist movement, serving as an academic front following the latter’s ban in 1933. After the Anschluss, the organization turned out to be a pool for staffing numerous key positions in National Socialist racial politics, as evidenced by Birkmayer’s example (Neugebauer, 1998, pp. 128-129). Little is known about Birkmayer’s actual activity in the Office of Racial Policy since source material on this institution for the years 1938 and 1939 is extremely scant. Wamser cites the establishment of a “marriage counseling center for hereditary health” at the psychiatric university clinic as well as a “number of other population policy measures” that could be credited to Birkmayer’s initiative. In addition, he mentions that Birkmayer had proved his skills as a propagandist in lectures before Nazi party officials in matters of racial hygiene and racial policy.

For Birkmayer, the Anschluss also meant a boost from a professional point of view. While he had been affiliated with the psychiatric-neurological university clinic headed by Professor Pötzl since December 1935, this was probably not a paid position. Only in March or April 1938, in the wake of the dismissal of Jewish colleagues, did he obtain an assistant position in the clinic. Even if Birkmayer would later deplore that his status, discovered in 1939, as “Mischling [crossbreed] of the second degree” had impeded his professional advancement at the university, he initially was able to make a career leap as a result of the expulsion of Jewish colleagues and because of his long-term involvement in the illegal Nazi movement.

The Anschluss had immediate and direct effects on the universities, including the systematic expulsion of Jewish faculty members. After Nazi party supporters at numerous hospitals and clinics in Vienna had personally expelled their Jewish colleagues in the early chaotic hours and days after the power seizure, incipient centrally controlled measures soon followed (Hubenstorf, 1984, p. 89). In 1938, the Viennese Faculty of Medicine was, behind Berlin, the second largest medical faculty in the German-speaking area if not worldwide (Hubenstorf, 1989, p. 236). A total of 178 faculty dismissals are documented from 1938 to 1945; with an initial number of 309 active and 43 retired persons, this is equivalent to a proportion of approximately 51%, the largest loss among all medical faculties in the German-speaking area (Hubenstorf, 1995, p. 16).

The more recently established specialties, in which until 1938 “Jewish” medical scientists had the best chances of gaining a foothold, now tended to be the hardest hit. Spearheading the dismissals were neurology and neuropathology, where 92% of faculty members (including retirees) had to leave the university (Hubenstorf, 1994, p. 41). Even such prominent Austrian neuroscientists as Josef Gerstmann (1887-1969) (Triarhou, 2008b) and Otto Marburg (1874-1948) (Triarhou, 2008a) were among the dismissed and exiled. Those dismissed were often chased from their offices after dismissal, sometimes made to perform pejorative tasks while their “Aryan” clerical staff looked on in ridicule (Kater, 1989, pp. 177-221). Another notable exiled representative of the neurological discipline was Sigmund Freud (1856-1939), who was able to flee to London where he died in 1939. At least 11 Austrian and Czech neuroscientists would later become victims of the Nazi Holocaust machinery (Hubenstorf, 2002). After the dismissal of their Jewish colleagues, all remaining male assistants at the psychiatric-neurological clinic were SS members such as Birkmayer (Hubenstorf, 1989, p. 251).

In 1938, Birkmayer published in the Wiener klinische Wochenschrift [Vienna Clinical Weekly] a lecture on Vererbung der Nervenkrankheiten [Heredity of neurological diseases] that he had held in the framework of the evening classes of the SS physicians’ league “Donauland” (Birkmayer, 1938b). In it, he advocated the extension of indications for forced sterilization beyond those stipulated in the 1933 “Law for the Prevention of Genetically Diseased Offspring” (such as Huntington’s disease and hereditary epilepsy). He wanted to include some additional hereditary neurological diseases but stated that, in other neurological disorders with less clear inheritance patterns, parents could only be advised to not “bear children.” Furthermore, he posited that some infectious neurological disorders (e.g., neurosyphilis, poliomyelitis, and encephalitis lethargica) might only occur in those with a “genetic predisposition,” given that only a small percentage of those infected developed the associated neurological syndrome, but he did not go so far as to state that those patients should be sterilized. Along those lines and interesting in relation to his later work on Parkinsonism treatment, he stated, “it must be assumed that a vulnerability of the striatopallidal system is heritable,” possibly referring to postencephalitic Parkinsonism (Birkmayer, 1938b, p. 1151). However, Birkmayer further elaborated that not enough was known about the heritability of Parkinsonism, multiple sclerosis, or hereditary tremor and that patients with those disorders should merely be advised not to have children. He also advocated sterilization of individuals “who have fallen prey to any kind of addiction, have criminal or perverse tendencies” and, therefore, “might be a burden on the Volksgemeinschaft [people’s community]” (Birkmayer, 1938b, p. 1151). The lecture concluded with a declaration of loyalty to Adolf Hitler and a commitment to National Socialism:

It was our people’s [Volk] privilege to give birth to a genius who instinctively discerned and demanded that only racial purity and hereditary health can prevent our Volk from degeneration. And we, as zealous followers, must purge our Volk from all that is pathological, impure, and corrupting so that after generations, this purification shall enable it to fulfill its destined mission. (Birkmayer, 1938b, p. 1151)

Another article published that same year in the Wiener klinische Wochenschrift contained a similar commitment to Adolf Hitler as a messianic figure who would lead the German people to their historic destiny. Thus, it was the physician’s task to “remove like dust particles” individuals who because of their alien temperamental and biological substance were unable to be enthralled by the Nazi movement’s appeal and “[to] pull up and eradicate these weeds of inferior character” (Birkmayer, 1938a, p. 1249).

In the Wiener klinische Wochenschrift, articles containing openly ideological content such as Birkmayer’s abovementioned “Donauland” papers constituted only a minority; clinical papers written in a dry scientific tone dominated. Besides the openly ideological articles we mentioned, Birkmayer continued in this period with his scientific research. Here, at least one article deserves mentioning because of its potential ethical implications. In it, Birkmayer reported his observations of motor phenomena during Cardiazol-induced convulsions. In addition to the convulsion-inducing Cardiazol, patients received doses of Euphyllin, caffeine, strychnine, Pituisan, adrenaline, ephedrine, bromine, paraldehyde, Luminal, Medianal, scopolamine, or CO2. The goal of these trials was not therapeutic but rather it was the search for a specific “point of action” of Cardiazol in the brain (Birkmayer, 1939a). The investigations had taken place in collaboration with Fritz Redlich (1910-2004) (Birkmayer, 1939b), who had immigrated to the United States in 1938 and would later become renowned as a psychiatrist and dean of the Yale School of Medicine (Anonymous, 2004). In 1939, a paper by Redlich appeared in the American Journal of Psychiatry on experiments whose setting was very similar to those described by Birkmayer, although the time and place were not identified (Redlich, 1939).

The Ärzteblatt für die Deutsche Ostmark [Doctors’ Journal for the German Ostmark (annexed Austria)] was not a medical journal but rather a propaganda tool of the Nationalsozialistischer Deutscher Ärztebund [National Socialist German Physicians’ Association]. Birkmayer, as Gau-Hauptstellenleiter (in the Office of Racial Policy), wrote an article in this journal in 1939 about National Socialist population policy (Birkmayer, 1939d). In it, he explicitly professed his commitment to the “Law for the Prevention of Genetically Diseased Offspring” and to the Nuremberg Laws, through which “purification and maintenance of purity of the Volkskörper [German people’s body] from all pathological influences” was already “fully regulated: With these two laws, it will be possible to protect the Volkskörper from all pathological phenomena, be it racial mixing or hereditary diseases” (Birkmayer, 1939d, p. 246). A lecture published in another journal in 1939 about sports in the workplace emphasized the importance of physical exercise for the people’s military fitness and contained another explicit commitment to National Socialism (Birkmayer, 1939c).

A Case of “Aryanization”

Birkmayer was also, at least indirectly, among the profiteers of the National Socialist policy of looting the Jewish minority, called “Aryanization” in regime parlance. Since January 1941, he inhabited with his family a villa in the upscale eighteenth Viennese district. Until 1938, the villa was owned by Martha Freund, originally from Maribor, who found herself forced to leave the country in the face of National Socialist terror after the Anschluss. After the villa had been initially confiscated by Hitler Youth and Wehrmacht, Birkmayer’s father-in-law, August Besler, acted as prospective buyer, using the party membership of his two sons and of his son-in-law as proof for his political loyalty; he subsequently presented his daughter with the property. After the war, Martha Freund asserted her claims against the new owner, Anna Birkmayer. She achieved restitution of the property, which she eventually relinquished in return for a payment of 120,000 Austrian schilling. Except for a brief interruption immediately after 1945, the Birkmayer family still lived at the same address as of 1953.

Discovery of Jewish Ancestry and Political Marginalization

On March 31, 1939, Birkmayer received a letter from the NSDAP Vienna’s “Gauamt for Kinship Research” that marked the first documented doubts about his “Aryan” origins. On May 5, 1939, the Gauamt finally summoned him to personally conduct an investigation into his mother’s ancestry in Pacov (in the so-called Protectorate of Bohemia and Moravia), but it would be another two years before the Gauamt came to a final assessment with regard to Birkmayer’s “racial” background. Birkmayer’s mother, Franziska Margarethe née Jenisch, born in 1886, had been Jewish at birth and baptized in 1892. This baptism later allowed her to avoid being treated as a full Jew according to the Nuremberg Laws. Instead, her status was that of a Mischling because her mother Franziska Jenisch née Ehrlich (Walter’s grandmother) was originally Jewish before being baptized together with her daughter (Walter’s mother) in 1892, one month before she finally became married to Walter’s grandfather, a Roman Catholic.

Long before the decision of the Gauamt, on December 21, 1939, the office of the Reichsführer-SS (Heinrich Himmler) dismissed Birkmayer from the SS “upon his own request” and thanked him for “services rendered,” thus granting him a face-saving exit. The reasons for the discreet dismissal were not mentioned in the document. SS-Gruppenführer Walter Schmitt (director of the SS Personnel Main Office) signed for Himmler. Birkmayer’s membership in the Nazi party was not immediately affected by this decision. In fact, he remained in the party until February 1943, when he was forced by a decision of the Nazi party court to relinquish this membership as well.

Overall, there is no foundation for the claim that Birkmayer was suddenly ostracized or maybe even persecuted by the Nazi regime in the wake of the “discovery” of his Jewish grandmother. Rather, he managed to mobilize high-ranking intercessors from Viennese National Socialist circles in his favor to avert detrimental consequences to his professional career. The recommendation letters contained in the records impressively demonstrate that Birkmayer had been an active member of the illegal Nazi movement, and that he was able to draw on connections in the highest circles of the Viennese Nazi party even after his forced resignation from the SS. His former SS comrade Dr. Otto Planner-Plann, in his function as Gauärzteführer [regional head of physicians], head of the Medical Chamber, and of the NSDAP Gauamt für Volksgesundheit [Regional Office for People’s Health] one of the most important players in Viennese Nazi medicine, was just one among quite a number of intercessors. Planner-Plann attested that Birkmayer had founded a party cell at the university clinic in 1936 following his joining the (at the time already illegal) NS-Ärztebund [Nazi physicians’ association], “despite the clinic being completely infiltrated by Jews.” He further elaborated that during the period of illegal activism, Birkmayer had recruited so many physicians into the NS-Ärztebund that in March 1938 continued clinic operation was possible despite the dismissal of the Jewish colleagues. Regarding his political views, Planner-Plann had the following to say:

During the entire period, Dr. Walter Birkmayer has been known to all of us as an upright and steadfast National Socialist. His foremost endeavor was devoted to our people’s hereditary health and purity of blood. During the illegal period he repeatedly proved his commitment to these goals, as well as those of the party, even under the most difficult circumstances.

Another endorsement shows that Birkmayer’s SA membership (according to this source from May 1933 until his transfer to the SS in September 1936) entailed an active participation in this paramilitary organization, in the course of which he was first promoted to Scharführer [squad leader] and later to Oberscharführer [senior squad leader]. According to this assessment, he had “always carried out his service in the SA with complete personal dedication to the utmost satisfaction.”

Also the head of the NSD-Dozentenbund [National Socialist University Lecturers’ Association] at the University of Vienna, Doz. Ernst Pichler (1907-1977), knew Birkmayer from the time of illegality “as a man whose National Socialist convictions could never be doubted in the least.” He stated that Birkmayer had “clearly expressed his convictions through tireless commitment to the movement in his work for the SS, as an employee of the Office of Racial Policy, and for the party cell at the Vienna General Hospital.” According to Pichler, Birkmayer had dedicated his entire leisure time to the Nazi movement. The decision of the Kinship Research Office to categorize him as “Mischling of the second degree” had come as a surprise to everyone and the loss of his efforts for the movement was generally regretted.

Birkmayer’s former superior at the Office of Racial Policy, Heinrich Wamser, also pointed out Birkmayer’s commitment of many years to the Nazi movement, which he described in the following words: “To work for the preservation of our blood’s purity seemed to be his noblest goal in life already then.” He concluded:

I have always known and appreciated Dr. Birkmayer as an upright and steadfast National Socialist. […] His achievements and his behavior demand that I perceive as injustice any disadvantage arising to him from his not being of German blood.

Dr. Anton Rolleder, also an SS physician and high functionary at the Nazi party’s Viennese Office for People’s Health, had, by his own account, first met Birkmayer in 1934 at a course for illegal National Socialists on the subject of racial policy. According to him, Birkmayer’s National Socialist worldview had already clearly emerged by then. Since that time, Birkmayer had been continuously active in the party cell at the General Hospital as well as in the SS and had taken considerable risks for the Nazi movement’s sake. Since the Anschluss, Birkmayer had put his scientific and political knowledge constantly in the service of the Nazi Party. As head of the party cell “at the Viennese Psychiatric Clinic, up to then heavily infiltrated by Jews,” he had enforced the “personnel changes that had become necessary in the interests of the party” and had made sure “that today, the Viennese Psychiatric Clinic has become a place of purely National Socialist world view.” Thus, not only Planner-Plann but also Rolleder attested to Birkmayer’s active role in the expulsion of Jewish colleagues from their university posts.

Two leading party functionaries at the General Hospital provided further details on Birkmayer’s political activities before the Anschluss. He was admitted to the conspirative party cell at the hospital immediately after he became a candidate (Aspirant) at the Psychiatric Clinic as of April 1, 1936 and, just a few months later, was part of a core group of five activists who focused on the recruitment of new members, the professional advancement of Nazi comrades, and the medical care of illegal party members. This document too emphasizes that he “provided the completely Jew-infiltrated Psychiatric Clinic with reliable illegal [Nazi] physicians shortly before and especially after the upheaval” and thereby significantly contributed to the implementation of the “de-Jewification policy” at the clinic. Both of them concluded with Birkmayer’s assessment as a “comrade, whose attitude and selfless work for the party is exemplary and can be rarely surpassed.” Birkmayer’s Gauakt [party personnel file] contains additional testimonies by companions from the time of illegal National Socialism, which again confirm Birkmayer’s longstanding active involvement.

Birkmayer’s superior at the university psychiatric clinic, Professor Pötzl, also joined the line of intercessors. He focused on Birkmayer’s professional, medical, and didactic skills, which he highly praised. However, from October 1940 it became clear that Birkmayer would be denied a noteworthy academic career. While he was able to keep his position at the clinic due to an authorization by the Reich Minister of Education, he was denied the opportunity to obtain a habilitation as a result of his categorization as “Mischling of the second degree.” Nevertheless, his advancement was not completely obstructed; in February 1942, he was promoted from assistant to chief assistant at the clinic while he was performing his military service in the East.

The cited documents depict an intense involvement of many years in the Nazi movement at a time when this was accompanied by considerable personal risks. Even if some of the phrases used sound formulaic and might have been partially motivated by a desire to oblige, overall, they were too specific, detailed, and consistent in content to simply write them off as courtesies. Furthermore, those were not character witnesses arbitrarily selected by Birkmayer, but functionaries and officials of the Viennese Nazi party who were prepared to risk their own reputations as tried and tested Nazi activists in support of a longstanding comrade.

Career in the German military (1940-1945)

On November 27, 1939, Birkmayer volunteered (!) for the Wehrmacht [the German military]. It is unclear whether he wanted to “take the bull by its horns” because of his sudden tenuous status or whether he acted from inner conviction. After enlisting, the army screened his family background to determine if he could become a commissioned officer. In June 1940, he declared that his mother had been Catholic from birth (which turned out to be false), but that the Gausippenamt had yet to determine whether he was “Aryan” or “Mischling of the second degree.” In July 1940, after seven months of basic training and service in a field hospital in Vienna as head of a department, he was transferred to a combat unit taking part in the campaign against France. Until March 15, 1941, he was part of the occupation force in France.

In September 1940, the Wehrmacht submitted a routine request to the Gestapo [Secret State Police] for Birkmayer’s screening “in political and intelligence-related regard” in the context of Birkmayer’s possible joining the army reserve. Following inquiries at the Regional Party Headquarters, the Gestapo announced that Birkmayer’s “full preparedness for action on behalf of the National Socialist state” was “beyond any doubt.” Concomitantly, the Wehrmacht prompted Birkmayer to name three renowned character witnesses, who were subsequently asked for an assessment of his person. One of these three guarantors was SS Obersturmbannführer Dr. Fritz Euler-Rolle, who as SS Oberabschnittsarzt [Chief Regional SS Physician] held the highest medical function in the SS-districts of Vienna, Lower Danube, and Upper Danube. Euler-Rolle attested that Birkmayer had a number of characteristics and skills considered particularly important in the context of those days (amongst others, “leadership qualities, organizational skills, rhetorical talent”) and also briefly described his political activity in the SS, where he had taken over management of the “SS-Studiengemeinschaft” [study group] and, thus, the training and indoctrination of young medical students after the Anschluss. Moreover, as Hauptstellenleiter [director of a department] at the Office for Racial Policy, he had dealt “a lot with issues of National Socialist population policy” according to Euler-Rolle. But he also added that Birkmayer as “Mischling of the second degree” had had to resign from the SS. Further guarantors were the SS physician Dr. Alfred (Prince of) Auersperg (1899-1968), who had temporarily taken over the management of the university psychiatric clinic, as well as the head of the clinic, Professor Pötzl. In November, before the Gestapo’s positive assessment of Birkmayer had been received, the Vienna Regional Military Command took steps toward his demobilization because of his quality as a “Mischling of the second degree.” However, no final decision was taken until April 1941, when Adolf Hitler himself dealt with the Birkmayer case. He decreed that the latter could remain and be promoted as officer in the Wehrmacht despite his ancestry. At the same time, he announced that at war’s end, he would grant him complete equalization with persons of “German blood” if he were to prove himself through military service.

Backed by Hitler’s decision, Birkmayer was able to climb the Wehrmacht ranks and to compensate at least partially for his status loss within the Nazi party structures. At the same time, Hitler had made it clear that it was up to Birkmayer to prove his loyalty to the regime. His position was tenuous even if his connections to important Nazi functionaries remained a valuable resource.

The pending decision regarding his status as a Mischling notwithstanding, he had already been promoted several times up to that point, including on January 23, 1941 to medical officer candidate. The recommendation to promote him to medical officer of the German Wehrmacht in the rank of an assistant physician came just six days after Hitler’s decision, and further promotions followed. As of July 1, 1942, Birkmayer was promoted from assistant physician to senior physician in the reserve (Oberarzt der Reserve) and then to staff surgeon in the reserve (Stabsarzt der Reserve) as of February 1, 1944. Each of these promotions required positive evaluations by his superiors, based on his participation in the war. From March 27, 1941 through May 21, 1942, he was assigned to the Artillery Regiment 83 (as Abteilungsarzt), which participated in the campaign against the Soviet Union. On July 20, 1941, he was wounded near Rogosna by shrapnel in his foot. His professional evaluation was very good; in addition, he was awarded the Iron Cross 2nd Class. Moreover, in August 1942, he received the medal “Winter Battle in the East 1941/42.” At this point, he was already back in Vienna, where he headed the Field Hospital XVI for Brain Injuries in Vienna-Schwechat since July 1, 1942. His appointment to this position of responsibility can be explained by his professional qualifications as well as by the great trust his superiors still had in him, despite his Mischling status and having lost his former SS membership.

Liberation, “Denazification,” and Gradual Rehabilitation

After the Red Army liberated Vienna in April 1945, Birkmayer, according to his own testimony, worked for the Soviet occupation forces. It is unclear whether he remained head of the neurological field hospital. Birkmayer was suspended immediately after liberation from his post at the university. The head of the clinic, Professor Pötzl, supported Birkmayer’s endeavors at rehabilitation, describing his abilities as far above average. A few months later, Pötzl was himself dismissed because of his Nazi involvement. When the Western Allies entered Vienna in September 1945, Birkmayer was arrested by the American Counter Intelligence Corps (CIC) as a former National Socialist and held in custody for 14 days. After his release, Birkmayer was prohibited from leaving Vienna and had to report to the CIC three times a week.

In January 1946, he was officially dismissed from civil service, effective June 6, 1945, as a former “illegal” National Socialist. At the Staatsamt für Volksaufklärung, für Unterricht und Erziehung und für Kultusangelegenheiten (precursor of the Federal Ministry for Education) his active involvement as a “radical National Socialist” in the years from 1932 until 1939, rewarded by admission to an officer’s career and to the leading position at the special field hospital as late as 1942, was taken as evidence for his continued “bond of trust” with the Nazi party. A possible source of this assessment was Dr. Paul Grüneis, the chairman of the shop council at the General Hospital. In a rather balanced appraisal of Birkmayer, which accompanies the file, he spoke of “inconsistent” behavior toward colleagues:

On the one hand, he warned comrades of political dangers, on the other hand, he caused professional trouble for politically neutral individuals and opponents. It must be underscored that both in his work at the clinic as well as at the special field hospital, later on as head of the special field hospital for brain injuries, he was occasionally helpful to colleagues whom he knew to be open adversaries of National Socialism.

Already on July 3, 1945, Birkmayer attempted in a letter to the Vienna Mayor’s Office to explain at length his involvement in National Socialism and to obtain an exemption from mandatory registration as a former member of the Nazi party and its organizations. He maintained that already in 1933, he had feared the spread of National Socialism to Austria and his subsequent dismissal because of his “non-Aryan origins” and, therefore, he had joined the SA despite his opposition to National Socialism. After he was designated “Mischling of the second degree” by the NSDAP’s Kinship Office, he was forced to resign from the SS and later had his party membership revoked by the NSDAP Vienna party court as well. In sharp contrast to the already extensively quoted documents of the years 1940 and 1941, he now declared that he had never been politically active during his membership in Nazi organizations. While earlier on his comrades had emphasized his efforts toward “de-Jewification” of the university psychiatric clinic, he now maintained that he had been “helpful to his Jewish colleagues in every respect.” According to his letter, he had had to accept serious disadvantages, such as the refusal of a promotion to senior assistant despite a recommendation by Professor Pötzl. Also several applications for his habilitation had been rejected. In the Wehrmacht, he had had to wait for two years for a promotion to assistant physician, which normally would have taken only six months. Besides the professional handicaps suffered, Birkmayer additionally pointed out the “constant surveillance of his person” and further unspecified “constant adversities and difficulties in exercising [his] profession.” He also claimed to have helped numerous patients and subordinates during his work as chief physician at the field hospital. From among 3000 patients only very few, upon their own request, had been discharged as “fit for military service.” On his own responsibility, he had kept employees due to be dismissed for political reasons in their positions; in some cases, he had even saved them from jail or deployment to the front by affirming their indispensability. In conversations, he allegedly had frequently expressed his opposition to National Socialism, which had gotten him into trouble with his superiors. Altogether, he considered himself and his family victims of the regime; his father had lost his job and had to work in an inferior position. His father’s brother, the principal dancer at the Vienna State Opera, Toni Birkmeyer, had had to spend one and a half years in prison.

The fate of Anton (Toni) Birkmeyer and his Jewish wife Jolanthe Birkmeyer (née Weinfeld) is well documented. On April 16, 1940, he was arrested by the Gestapo together with his wife, because they had in their apartment “uttered disparaging comments about the Führer and the state and listened to enemy broadcasts.” Toni was sentenced to 18 months of incarceration by the Sondergericht [Special Court] Vienna, which he served in the infamous Stein penitentiary. In the trial, his wife was sentenced to three years. However, as a “full Jew” no longer protected by her incarcerated “Aryan” husband, she was deported to Auschwitz, where she died in 1943. Later on, Toni Birkmeyer attested that his nephew “[had] always taken up a clear Austrian [and therefore, by implication, anti-Nazi] stance” from 1939 onward.

In an addendum to his petition dated July 6, 1945, Birkmayer provided more details to further his potential exoneration. He now claimed, in contrast to his own previous statements and numerous written endorsements, that he had not belonged to any Nazi organization between 1933 and 1938 and that he had only joined the SS physicians’ league in April 1938 to be able to continue his scientific work and to conceal his “non-Aryan” origin. This explanation lacks any credibility since Birkmayer must have undoubtedly known that membership in the SS was accompanied by much more comprehensive scrutiny of ancestry than any other position. Rather, this document is an expression of his attempt to disown his National Socialist activity during the so-called “Verbotszeit” [time of prohibition] between June 1933 and March 1938, which after liberation had considerably more severe legal consequences than a simple membership after the Anschluss; after all, this was considered high treason against the Austrian state. While Birkmayer’s declarations regarding his Nazi involvement until 1939 are nothing but self-serving, his statements regarding the time from around 1941/1942 onward deserve closer consideration. In the document at hand, he stated that he had arrived at a clear anti-Nazi stance after his return from the front. But if he actually did have troubles with his superiors as a result of his political views, they could not have been too severe since he was promoted to Stabsarzt as late as June 1944. This promotion and all those before required positive assessments not only regarding his service but also his political reliability in terms of the Nazi regime. That same year, his continued employment as assistant at the clinic was also approved once again. The only concrete evidence Birkmayer offered at this point for his anti-Nazi attitude concerned subordinates whom he purportedly saved from dismissal, deployment to the front, or even arrest by declaring them indispensable or by intervening with superiors. Furthermore, he also claimed that in early April 1945, he had prevented the deployment of employees and patients at the field hospital under his responsibility to an already hopeless military operation against the Red Army, which the “adjutant of the SS commander in Vienna” had ordered.

Birkmayer’s statement that he had used his margin of discretion as a physician to save hundreds of soldier-patients from repeat service at the front is contradicted by an article he published in 1944, in which he stated that the nature of the injuries sustained by his patients made it impossible for practically any of them to recover to the point where they could be sent back into combat (Birkmayer & Huber, 1944, p. 350).

Unfortunately, since no patient records from Birkmayer’s field hospital are available, it is not possible to scrutinize the attitude he took towards his patients. However, an expert opinion Birkmayer prepared in October 1944 for the Viennese Sondergericht [Special Court] on a certain Johann Körner provides insight into how Birkmayer acted as a medical expert in a highly politicized environment. Körner had been sentenced to four years imprisonment in January 1944 for having participated in a deal with illegally slaughtered meat. As a child, Körner had sustained severe injuries to his face from a shotgun, had lost one eye as a result and suffered from epileptic seizures and other neurological symptoms. Three experts had to answer the question of whether Körner was legally responsible given his neurological impairments. Two of the experts answered in the negative and pleaded for extenuating circumstances. Birkmayer, however, based on the statements of his colleagues and without examining Körner himself, reached an opposite conclusion. And yet, he could have followed his colleagues by confirming the possibility of a connection between the brain injury and the criminal offenses without any risk to himself. From a neurologic standpoint, Birkmayer’s expert opinion might have been justified, although it is not clear how he was able to categorically exclude a correlation the experts before him had at least considered possible. The impression emerges that Birkmayer wished to see the defendant punished regardless. He concluded his expert opinion with the remark that in any case the defendant would have to be permanently confined as mentally ill even if the court should deny his legal culpability. De facto, he thus went much further than the Sondergericht by demanding an outcome that, given the circumstances of the Nazi regime, could have easily meant a death sentence; after all, numerous “criminal mental patients” were deported from psychiatric institutions to concentration camps in the framework of the action “Vernichtung durch Arbeit” [extermination through labor] (Klee, 1983, pp. 359-360). A few months before liberation, after Birkmayer had allegedly long since rejected the regime and systematically thwarted its war efforts by means of his diagnoses, he acted as a harsh expert in the service of the National Socialist system of repression.

Birkmayer’s denazification file contains a number of endorsements that supposedly prove his political distance from National Socialism as well as, in individual cases, his support for colleagues and employees who were threatened with dismissal, arrest, or deployment to the front. Most of these letters offer few concrete, verifiable facts and are consistent with typical letters of exoneration that former National Socialists frequently wrote for each other and were customary in denazification proceedings. None of these letters contain any concrete indication that Birkmayer exceeded the informal margin of discretion that he could claim as an officer in the German Wehrmacht, highly qualified physician, and head of a specialized field hospital. Birkmayer’s main priority was the smooth operation of the field hospital under his responsibility. The loss of each qualified employee would have opened up a gap that, with the increasing lack of medical personnel, could have been filled only with difficulty. Therefore, caution is indicated when qualifying certain acts as signs of resistance, when an equally convincing explanation is that Birkmayer was simply defending the interests of the institution for which he was responsible. Regarding the purported protection of patients from military service, it would be interesting to further delve into this issue, but, as mentioned before, no case histories from the field hospital have survived to allow a thorough and critical source analysis. Regardless, the exact nature of Birkmayer’s alleged actions of resistance raises important questions. Does he claim to have systematically forged medical findings to prevent his patients from serving at the front? This would have been hazardous indeed, and it is difficult to imagine that no one would have noticed in the course of several years that out of a group of 2,000 patients in Birkmayer’s care not a single one had been discharged as cured and fit for the front. The possibility that Birkmayer might have used his professional margin of discretion on behalf of his patients is more plausible. This would positively distinguish him from many of his colleagues whose highest goal was to quickly restore deployability, a goal that was pursued in part by unethical means. However, there is no evidence to support this latter possibility except Birkmayer’s own statements. Furthermore, Birkmayer’s only expert opinion from this period points, as mentioned, in an entirely different direction.

All the same, a document in Birkmayer’s denazification file suggests that he had consulted with a colleague in Rotterdam regarding the possibilities for Jewish colleagues to obtain residence permits in Holland. He was also corresponding in 1938 with Jewish colleagues who had fled to New York.

The most important tenet of denazification was the obligation of former National Socialists to register in a special directory. Birkmayer too was affected by this measure. On July 9, 1945, he completed a form for the registration of former National Socialists but concealed all memberships before 1938—those that would have potentially exposed him to prosecution for high treason. An initial application for leniency regarding his registration obligation was rejected on August 2, 1945. Thus began a protracted contention with various governmental agencies to minimize his involvement and to cushion the legal consequences—these might include fines, occupational bans, revocation of voting rights, and other sanctions—as much as possible. In October 1945, he turned to the Provisional Government with the assertion that he had joined the resistance organization “Freies Österreich” [Free Austria] on January 1, 1944. In this context, he failed to provide an explanation of why he had not mentioned this important element of exoneration earlier. In fact, in an earlier petition, he had explicitly declared that he had not joined the resistance movement to avoid any further exposure as a “Mischling of the second degree” and to avoid being considered a traitor (read: to his former Nazi comrades). Birkmayer’s claim of being a resistance fighter was no more credible than thousands of others made by former National Socialists after liberation in order to shield themselves from the consequences of their previous choices.

From a human point of view, it is quite understandable that Birkmayer, in his role as defendant, clutched at every straw to save his professional existence and career prospects and that he resorted, like many others in his situation, to false testimonies, half-truths, and outright lies. From a historiographical standpoint, this means that his statements, as far as they cannot be supported by other reliable documents, must be considered above all as defensive maneuvers.

Subsequently, Birkmayer repeatedly argued that, de jure, his SS and Nazi party memberships had never existed as he had not met the precondition of “Aryan origin” and had been excluded by retroactive annulment. He also mentioned that his wife had lost her job as a high school teacher and that his father, a post office clerk, had been sent into early retirement. This line of argument was not accepted by the Austrian authorities and Birkmayer’s appeal was rejected at several instances since he had been excluded (resp. forced to resign) not for political but for “racial” reasons. According to the legal situation prevailing at the time, exclusion did not constitute sufficient reason for an exemption from the obligation to register one’s Nazi memberships; for this, voluntary resignation for political reasons before 1944 had to be demonstrated.

In the meantime, in July 1946, the Nazi Registration Office had pressed charges against Birkmayer for “incomplete and incorrect statements” regarding his Nazi past. Only in January 1948, the state police forwarded the file to the public prosecutor’s office upon the substantiation of their suspicion of wrongdoing pursuant to, among others, Section 11 of the Verbotsgesetz [Prohibition Act] and Section 7 of the Wahlgesetz [Election Law]. The investigations covered registration fraud, high treason on grounds of illegal activity on behalf of the Nazi movement between 1934 and 1938, as well as “aggravated illegality” (on the grounds of a political function from a certain rank onward). Section 7 of the Election Law threatened former National Socialists with punishment who, based on false declarations, fraudulently participated in elections. Section 11 of the Prohibition Act included the highest potential punishment, 10 to 20 years of incarceration. However, subsequent proceedings against Birkmayer before the Volksgericht [People’s Court] were closed in June 1948. The prosecution withdrew indictment since it did not consider Birkmayer’s rank as SS Untersturmführer as proven (although it is mentioned, among other documents, in Himmler’s notice of dismissal); lower ranks were punishable only under certain conditions. Another Volksgericht trial against Walter Birkmayer pursuant to the War Crimes Act was closed in May 1949.

Thus, in the first years after liberation, Walter Birkmayer was facing the ruins not only of his scientific career but also of his professional existence, and his personal freedom was threatened by serious criminal allegations. In 1947, he had to expect to be permanently barred from working in the medical profession. He tried to bypass the occupational ban imposed on him by working as a general practitioner at his residential address. In October 1947 and again in March 1948, the Viennese municipal authorities reported him to the police for illegally practicing medicine. However, in June 1948, the tables slowly began to turn. The Federal President authorized an exemption for Birkmayer regarding possible criminal proceedings and sanctions pursuant to the Prohibition Act.

Then, in 1949, Birkmayer also achieved removal from the list of National Socialists because the appeals commission at the Ministry of the Interior followed his earlier line of argumentation that he had resigned from the Nazi party before January 1, 1944 (and had not been expelled). This did not put into question Birkmayer’s earlier Nazi involvement. Ironically, the good will shown by the Nazi authorities by granting him a face-saving “voluntary” resignation instead of an exclusion, later enabled Birkmayer to make the most of the legal situation by claiming he had left the party of his own volition. Moreover, two former SS comrades had declared in his support that he had only been a temporary candidate and never become an actual member of the SS. Such mutual statements of support among former National Socialists were frequent and increasingly successful since the social and political climate had already turned against dealing with the past and in favor of integrating former Nazis into Austrian society.

After years on the scientific sidelines, an increase in Birkmayer’s publishing activity can be discerned starting in 1949. Among his publications at this point there is a joint article with Anton Rolleder, like Birkmayer born in 1910, former SS physician, and functionary in the administration of the Viennese Nazi party, who had vouched for Birkmayer’s Nazi loyalty earlier in 1940 (Birkmayer & Rolleder, 1949). In 1950, Birkmayer accepted nomination as candidate for the Vereinigung Unabhängiger Ärzte [Association of Independent Physicians] in the elections to the Austrian Medical Chamber but later withdrew his candidacy (Hubenstorf, n.d.). The association was closely related to the Verband der Unabhängigen [Federation of Independents] established in 1949, a pool of former National Socialists and predecessor of the right-wing FPÖ [Freedom Party of Austria] (Hubenstorf, n.d.). In the postwar years, he must have realized that this was not a promising path in Social Democratic-dominated Vienna. Like numerous other former National Socialists in academic professions (among them, the infamous “euthanasia” physician Dr. Heinrich Gross [1915-2005]), he joined the Bund Sozialistischer Akademiker [BSA, Association of Socialist Academics], an organization affiliated with the SPÖ [Socialist Party of Austria], which like the other large political parties actively vied for the loyalty of former Nazis (Neugebauer & Schwarz, 2005, p. 240).

His attempts to obtain a habilitation in the field of neurology failed as long as Austria was under the banner of denazification and attempting to make a clear cut with the past. Only in 1954, at the age of 43, he finally managed to earn his neurology habilitation. The reviewers, Hans Hoff and E. Lauda, classified 35 of his scientific papers on hand as “very good,” 10 as “bad,” and 21 as case studies or training lectures. As mentioned earlier, Birkmayer omitted the ideologically tainted papers from 1938 and 1939 in his application.

A lecture published in 1951 on traumatic epilepsy contains a hint of Birkmayer’s view of Europe’s liberation from National Socialism. In contrast to his carefully formulated petitions in the context of his denazification proceedings, according to which he had “suffered” for having been forced to conceal his “true” (anti-Nazi) views, a completely different view emerges almost accidentally in this later text:

[At first] I wish to mention an experience, to which all of you will probably attest. In the wake of the collapse of 1945, with the endangerment of every existence, with the dissolution of existing bonds forming the social fabric, with the difficulties of subsistence, a considerable increase in convulsions has occurred. (Birkmayer, 1951, p. 608)

He does not refer to the liberation from a tyrannical regime but to a “collapse” (Birkmayer, 1951). What might the victims of long-lasting persecution and extermination by the Nazi regime have said about the professed “endangerment of every existence” and the “dissolution of existing bonds” after the liberation of Europe by the Allied Armies? The perspective that emerges in this text from 1951 is typical of former party followers and perpetrators and not of the victims of the Nazi regime.

From the early 1950s onward, when the “anti-Fascist phase” (per historian Wolfgang Neugebauer) of dealing with National Socialism gave way to an increasing social reintegration of former National Socialists amidst the Cold War, Birkmayer remained largely unchallenged regarding his past. Jarring notes such as a 1964 article in the Communist daily “Die Volksstimme,” in which Birkmayer was attacked as an ideological trailblazer of the National Socialist patient murders, remained the exception. In a letter to the article’s author, former resistance fighter Dr. Eduard Rabofsky, Birkmayer explained that through the “maturing of [his] personality,” he had reached the conclusion that his earlier approval of forced sterilization had been mistaken and that sterilization was acceptable only on a voluntary basis in cases of clearly diagnosed hereditary diseases. While from today’s point of view this formulaic distancing from National Socialist forced sterilizations as well as the endorsement of voluntary eugenic sterilizations shows a lack of critical reflection on the Nazi past, they place Birkmayer right in the mainstream of the social climate then prevailing in Austria.

Conclusions

Former German president Richard von Weizsäcker stated: “The secret of reconciliation is remembering” (von Weizsäcker, 1985). The dominance of subjective personal recollections of friends and colleagues regarding the Nazi past of various medical professionals has been superseded by professional historical review (Karenberg, 2006), and the decades of silence regarding the Nazi past of German and Austrian neuroscience have ended (Peiffer, 2006). Despite an illustrious postwar neuroscientific career and groundbreaking research into Parkinson’s disease treatments with three major breakthroughs, the available documentary evidence suggests that Walther Birkmayer was a convinced Nazi, who was an illegal party member prior to the Anschluss, and contrary to his obituary writers’ statements he remained in the party after his face-saving resignation from the SS. Also contrary to his obituary, he was not sent to the Russian front as punishment but volunteered for the military and was promoted within its ranks due to intercessions from high-ranking Nazis including Hitler himself. He advocated expansion of Nazi forced sterilization beyond the already existent scope at the time, to many other hereditary neurological diseases, reflecting his support for Nazi racial hygiene that trumped concern for the fate of individual patients. Regarding Parkinsonism, he arbitrarily recommended that patients be advised not to have children, despite the lack of heredity knowledge at the time. In light of this advice, it is somewhat ironic that Birkmayer’s mother developed Parkinson’s disease later in life (Carlsson, Riederer, & Stern, 1997). Years after the war, Birkmayer still advocated sterilization of patients with hereditary diseases, although he distanced himself from the implementation of forced sterilizations in Nazi Germany.

Birkmayer’s exoneration strategies after April 1945 are not significantly different from those of thousands of other (former) Austrian National Socialists, who had been disappointed in the expectations and hopes they had placed in Adolf Hitler and the Nazi movement and who, in 1945, had to deal not only with the “collapse” of the German Reich but also of their own life plans. By remaining fixated on their own deprivations and experiences of loss during the war years, they styled themselves into “victims.” This worldview left no space for the perception of the actual victims of the National Socialist politics of conquest and extermination. Alexander and Margarete Mitscherlich observed a similar attitude in Germany and explained it as a consequence of the traumatic end of the psychological identification with Hitler and the National Socialist “Volksgemeinschaft” [people’s community] (Mitscherlich & Mitscherlich, 1967). Renunciation of National Socialism rarely came as a result of deeper insight; more typically it resulted from external pressure. For Birkmayer, it was his categorization as “Mischling of the second degree,” but for many others, it was the course of the war. Far too many turned away at the last moment and only in response to the total military collapse of the German Reich and the death of their idol, Adolf Hitler.

However, even though Birkmayer’s development is in many respects typical of his generation, he still experienced it several years earlier than others. The unexpected exclusion from the Nazi movement must have set in motion a rethinking process; after all, it rendered his continued identification with National Socialism almost impossible. Yet, there is no evidence of Birkmayer’s radical abandonment of Nazism.

How did Birkmayer’s “true” political attitude evolve? At the age of 20 or 21, he voluntarily joined the National Socialist movement and remained loyal to it until external circumstances forced him to change course. After 1945, he accomplished feats of political adaptation to save, as best he could, his personal and professional existence from the denazification measures of the Allies and the Austrian authorities. The German Reich’s military defeat clarified to him and millions of others the failure of Nazism, and he adapted to the new circumstances. At least in the written record, nothing indicates a critical examination of National Socialism and his own involvement. Beneath the surface of his commitment to “the re-erected Austrian Republic” forced upon him by the new circumstances, there probably remained, at least until the war’s end, a conscious narcissistic wound sustained through a tragic genealogical “accident,” leading to a vague self-fashioning as a “victim.”

In the course of our research for this article, we contacted a number of Birkmayer’s former colleagues, who have shared with us their points of view. In the process, a number of alleged acts of resistance by Birkmayer emerged. It was claimed, for example, that Birkmayer had helped Professor Hans Hoff in 1938, shortly before he was dismissed and forced into exile. We have decided not to relate these claims in detail. Even if they were told in good faith, they were not derived from immediate witnesses but had probably been circulated to a large extent by Birkmayer himself. Perhaps even more importantly, Birkmayer himself had not mentioned them even in 1945, at a time when he literally had to cling to every straw to downplay his involvement in National Socialism and gather evidence for his alleged anti-Fascist stance. Therefore, our emphasis was on contemporary documents. These documents present in some aspects a clear and detailed picture, while in other aspects, they remain mute. Neither do they result in any compelling ethical judgment. By analyzing the documents in some detail, we hope to have provided readers with foundations for an assessment of their own. Birkmayer’s friends and obituary writers claim that he eventually deeply regretted his Nazi involvement, but only the “neurologic court of opinion” (Shevell, 2012) can decide how best to remember the codiscoverer of L-dopa treatment for Parkinsonism.