Although progressive leftists have pretty much pirouetted from their love affair with Communist Russia in favor of close comradeship with various Middle Eastern terrorist groups, it's worth reminding them of some of the more dehumanizing aspects of the Stalinist enterprise. Dan Healey, a professor emeritus of modern Russian history at the University of Oxford, delves deeply into the Russian Gulag system and the physicians and other health care workers who provided medical care to both the prisoners and to the staff that maintained this vast prison system. (The term "Gulag" is an acronym for the "main administration of corrective labour camps.")
Solzhenitsyn's masterwork, The Gulag Archipelago, is always called to mind when considering the topic of Stalin's brutal empire of concentration camps spread out along the vast northern reaches of Siberia. Healey cites Solzhenitsyn's assessment of the medical work in the Gulags:
In a few bitter pages, Solzhenitsyn dismissed evidence of "good doctors" practicing medicine conscientiously such that they could still be doctors in a professional sense. He argued that subordination to the Gulag machinery of camp commandants, internal surveillance, production managers, and medical bureaucrats, meant that doctors, however noble, could only comply meekly to serve "the common purpose" of squeezing the maximum labor out of the "sloggers"—prisoners in hard labour in the system's mines, construction, and timber-felling tracts.
But Healey has a more nuanced view of medicine in the Gulags. He has extensively researched the history of individual physicians and other health care workers whose stories are now revealed after camp archives and worker memoirs became available in Russia. He tackles the paradox that while the Gulags mostly functioned to work the prisoners to death either through malnutrition or endemic tuberculosis, the camps represented an enormous effort to provide medical care to these same individuals. For example, by the time of Stalin's death in 1953 there were nearly 2.5 million prisoners and over 110,000 hospital beds in the Gulag. Healey parts with Solzhenitsyn by describing some of the truly heroic efforts, particularly by many of the prisoner-physicians, to treat their fellow humans.
Another paradox of the camps was their role as both a penal colony and, at the same time, a crucial national effort to "colonize" the barren but mineral-rich Siberia. The Gulags were not only prison camps but were crucial sources of raw minerals, gold, and certain radioactive materials for Stalin's dictatorship.
One of the fascinating aspects about medicine in the Gulags was that the most capable and senior physicians and nurses were typically prisoners, often Jews. The medical staff who had volunteered to work in the Gulags were mostly the newly trained or those who were ideologically committed to the Marxist state and felt duty-bound to provide care in those godforsaken camps. The prisoner-doctors were often the elite of Russian medicine, trained in the most advanced Russian institutes in Moscow and Leningrad, only to be denounced for "Trotskyite thinking," among other crimes, and sent to the vast tundra of the Kolyma Republic.
Healey is meticulous about reminding readers of the potential unreliability of the memoirs, particularly those of the volunteer workers. It was unwise to be too forthcoming even after Stalin died. But he does an admirable job in re-creating the travails of the medical establishment in internal exile. He does so through evocative tales of the lives of physicians and workers in the Gulags. In many of these stories, we encounter the ethical morass of physicians supporting a slavery enterprise while also glimpsing the political minefield of Stalinist Russia.
Take the story of Yan Pullerits. He was a physician hired to work for the OGPU, the then-secret police of the Soviets. He followed his mentor to the Gulag to set up medical care for the hired workers and for the prisoners, all of whom were working to exploit the resources of the region. He became medical director of the Dalstroi, a socialist project that built the roads required to access the gold-mining region of Siberia. That region eventually contributed 50 tons of gold to Stalin's treasury. Despite setting up the vast medical network in Kolyma and being awarded the Order of the Red Banner of Labour for his efforts to treat the scourge of scurvy (a vitamin deficiency condition), Pullerits did not escape the Great Terror. He was arrested after his father-in-law criticized the arrest of another family member, denounced in absentia by some workers in the Gulag without any clear rationale, and executed on the same day he was convicted of antigovernment activity. Even his wife was imprisoned for eight years as "the wife of a traitor to the Motherland."
Conditions in the camps' medical facilities were as brutal as the popular imagination would expect. The death rate of about 15 percent of prisoner workers in the minefields was due to malnutrition and the plague of tuberculosis. Malnutrition was generally the result of dietary deficiency of vitamin C and B complex vitamins. In the 1930s, medical science had identified specific causes of these deficiencies, and supplements were available in Western societies. But the Soviet Union was not a Western society, and instead of fresh fruit to provide a source of vitamin C, a concoction from pine needles was used to attempt to treat the prisoners. In fact, the health care provided sounds more like a gigantic hospice care network than anything resembling mid-20th-century medicine.
Healey recounts some amazing stories of resilience and redemption by the prisoners in the Gulag. Viktor Samsonov was a peasant boy convicted of antigovernment activity as an 18-year-old and sentenced to eight years imprisonment. He started working in the mines but developed night blindness because of dietary vitamin A deficiency. He was hospitalized and then scheduled to return to hard labor but was recognized as uncommonly intelligent by his treating physician. He became an orderly in the hospital, but the bureaucracy prevailed and he returned to work in the timber-felling region. He became ill again and was treated by a specialist, Nikolai Viktorov, who was again impressed by his intelligence and his previous medical activities. Viktorov "rescued" the young man. Samsonov was made an orderly in Viktorov's ward, finished his sentence, but remained in the Gulag for the rest of World War II. He was given increasing authority in the health care system and earned certificates in basic scientific subjects, ultimately leaving the Gulag to achieve his dream. He was admitted to medical school, became a full professor, and went on to be named an "Honored Scientist of the Russian Federation."
These sorts of vignettes populate Healey's reexamination of medicine in the Gulag. One doesn't come away with any sort of admiration for the often-barbaric nature of this system. But one does at least appreciate the resilience and endurance of a small slice of the health care workforce. The real heroes of the book are the prisoners who overcame Stalin's Great Terror to provide some small humane efforts toward the suffering slave workers or, like Samsonov, were able to overcome incredible barriers to have meaningful careers.
This book is a scholarly and detailed examination of a brutish enterprise in Soviet Russia. It is an effective counterpoint to Solzhenitsyn's complete disgust with health care in the Gulag. It ventures into the gray zone of history where individual stories may diverge from the conventional narrative. Nonetheless, it was a terrible time and a terrible thing.
The Gulag Doctors: Life, Death, and Medicine in Stalin's Labour Camps
by Dan Healey
Yale University Press, 368 pp., $38
Stanley Goldfarb is an emeritus professor of medicine at the University of Pennsylvania and father of Washington Free Beacon chairman Michael Goldfarb.