The Auschwitz doctor who couldn’t ‘do no harm’

Gisella Perl did not have the luxury of doing no harm. Instead, the Hungarian gynaecologist worked to save lives and minimise the harm she witnessed as a doctor in Auschwitz.

On 15 April 1945, Dr Gisella Perl delivered a crying, screaming baby.

As for all of her other deliveries in the last year, the Hungarian gynaecologist had no tools, no anaesthetics and no assistance. The mother, a young Polish woman named Marusa, was feverish and weak. But there was one major difference: unlike the others, this baby would live.

As Marusa pushed through the last stages of labour, the two women heard a shout of liberation go up. Perl heard trumpets sound, and British soldiers began entering Bergen-Belsen. To Perl, Marusa’s final scream sounded “almost jubilant”.

But as Marusa held the newborn in her arms, her condition began to worsen. Her face and lips grew pale, and blood coursed out between her legs. Perl knew she needed to operate, but she had no instruments. Outside the barracks, she ran into a high-ranking British soldier and begged for antiseptic and water – luxuries she had been working without. “Half an hour later I had the water, the disinfectant, and could wash my hands and perform the operation, not as a helpless prisoner, but as a doctor,” she would recall in her 1948 memoir I Was a Doctor in Auschwitz.

It was a rare moment of triumph near the end of an unimaginably painful journey. Since April 1944 Perl had been imprisoned in the Hungarian Women’s Camp at Auschwitz-Birkenau, where she was tapped by the Nazis for her skills as a doctor and gynaecologist. When Dr Josef Mengele, the camp’s chief physician, learned her specialty, he ordered her to report every pregnant woman to him personally. Perl soon realised that these women were marked for death.

To Perl, nothing was more miraculous than the birth of a child. But she knew what she had to do. To defy the Nazi extermination project and help women survive, she had to invert her skills as a healer and bringer of life.

She would hide any pregnant women she found and, if necessary, interrupt her pregnancy, or quietly deliver and then kill, the newborn child.

It was the only way the women would have even the slightest chance of survival – and someday, she hoped, would have the chance to have a child in freedom.

“No one will ever know what it meant to me to destroy these babies,” she wrote. But “if I had not done it, both mother and child would have been cruelly murdered”.

By virtue of her gender and her medical specialty, Perl found herself in the very heart of the Nazi machinery which sought to “obliterate the biological basis of Jewry”: mothers and potential mothers. She used her position and expertise to intervene on behalf of pregnant women.

“I think when she fully understood what was going on, she didn’t hesitate,” says Eva Hoffman, an author and daughter of Holocaust survivors who wrote the afterword to the 2019 edition of Perl’s memoir. “She could not afford ambivalence.”

Perl’s actions would haunt her for years after the war, but the moral question of whether to end Jewish prisoners’ pregnancies was likely clear to her.

“In a certain sense, she was living in a time and place where you couldn’t talk about pure ethics,” says Sara R Horowitz, a scholar of gender and the Holocaust at the Israel and Golda Koschitzky Centre for Jewish Studies at Canada’s York University. “She couldn’t hide behind the fact of, ‘Oh, I would never do an abortion that wasn’t necessary.’ It wasn’t a luxury she had. The ethics were situational, but I think she believed that anything that opposed the aggressive genocide of Nazi ideology was inherently ethical.”

Judaism played a central role in Perl’s childhood. She was born in the late 19th Century in Sighet, a small town in Hungary (after the war, it would become part of Romania) that was also the birthplace of future Nobel Peace Prize Winner Elie Wiesel.

Pre-war Sighet had a large Jewish community; more than one-third of Sighet’s residents were Jewish, according to a 1910 census, and there were dozens of synagogues and Jewish-owned businesses. The Perls were no exception: the seven children studied the Torah for hours a day, and singing filled the home every Friday evening for Shabbat.

Gisella’s father, Moshe, was a businessman who brought in enough income to employ a live-in maid and a governess. Her mother, Frida, was a homemaker who filled the house with warmth and the scent of her cooking (her signature dishes included cold cherry soup and chestnut cake). Their children were an intellectual bunch: all but one would receive doctorates in medicine and other fields. Gisella spoke many languages, including Hungarian, Romanian, German, French, and Yiddish.

Gisella, the eldest daughter, showed early academic promise when she became the only woman and the only Jew to graduate from her secondary-school class, at age 16. But when she told her father she wanted to study medicine, he refused. He was worried she would stray from her Jewish faith. To reassure him, she made a vow over a prayer book he had given to her: “I swear on this book that wherever life will take me, under whatever circumstances, I shall always remain a good, true Jew.” He relented.

Years later, when she had patients of her own, she would buy him another prayer book, engraved with his name. As she later told the story, he would carry it with him to the gas chambers at Auschwitz.

Perl enrolled in medical school and studied for years in Berlin, which was at that time a mecca for Jewish physicians. Jews were well-integrated into the German medical scene during the years of the Weimar Republic, comprising more than half the doctors in Berlin. But when the National Socialist Party rose to power in 1933, Jewish doctors – including gynaecologists – were increasingly stripped of their positions and purged from universities, professional societies and government.

Perl managed to return to Hungary, where she became a beloved doctor and worked alongside her husband, a surgeon named Ephraim Krauss. They had two children, a boy and a girl. She would recall evenings spent listening to her son play violin, surrounded by undulating green and gold fields in the shadow of the snow-capped Carpathian Mountains.

But life soon became increasingly difficult for Hungarian Jews as they too were pushed out of their positions and public life.

In March 1944, German forces finally invaded Hungary. Perl and most of her family were rounded up and sent to the crowded Sighet Ghetto.

Unbeknown to her, her daughter Gabriella was hidden away with a non-Jewish family and would manage to survive the war.

Within months more than 400,000 Hungarian Jews would be sent to Auschwitz, among them virtually all the Jews of Sighet. As soon as they stepped out of the windowless cattle cars, armed guards began separating families. Perl vividly recalled her first sight of the sprawling death camp: billowing black clouds of smoke from the crematorium, tinged crimson by “sharp red tongues of flame (that) licked the sky”. As they embraced for the last time, Perl and her husband made a promise to each other: “We will meet someday in Jerusalem.”

Patrolling the ramp of newly unloaded prisoners was Josef Mengele. With sleek dark hair and long gloves, the 33-year-old Mengele was the camp’s “head doctor” and arbiter of the fate of hundreds of thousands. With a twist of his thumb, he sent prisoners to one side, death, or the other side, work (and then death). Mengele would come to serve as a universal symbol of the horrors of the Holocaust – and for months he would be Perl’s personal nightmare.

When war broke out, Mengele was at the start of a promising career in anthropology and medicine. Upon arriving at Auschwitz, he found himself in what was, to him, a Petri dish of possibility: human subjects of every variety, with none of the ethical limitations that usually marked human research. “It was a pretty heady experience for him,” says David G. Marwell, author of the book Mengele: Unmasking the ‘Angel of Death’, and former chief of investigative research for the Justice Department’s investigation into Mengele in the 1980s. “He had the opportunity to do something that no one else had been able to do.”

All of Mengele’s experiments shared the same goal: to establish the genetic basis of human talents and imperfections, from eye colour to dwarfism. This research put him at the forefront of the new regime, providing a scientific basis for the Nazi worldview. But he needed help. As he stood on the ramps, he watched the medical talent of Eastern Europe spill out of the cattle cars. He would cherry-pick those whose skills suited his needs, often consulting camp records to find prisoners’ medical specialties and inquiring into them.

Perl was one of five doctors and four nurses ordered to establish a hospital in the camp. She had been told that doctors should bring their instruments on the journey, as they would be allowed to practice medicine. But when she entered the camp, her medical bag was snatched away by another German doctor. “You are going to be the camp gynaecologist,” he told her. “Don’t worry about instruments… you won’t have any. Your medical kit belongs to me now.” Her long hair was shorn, and her right forearm tattooed with her new identity: Prisoner No. 25,404.

Perl found herself responsible not just for gynaecology, but for trying to heal all of the forms of abuse inflicted on her fellow prisoners. She bandaged bleeding head wounds, pulled out infected teeth, and taped up broken ribs. When SS soldiers whipped imprisoned women, she cleaned the painful lacerations. At best she had paper for bandaging and a small knife she sharpened on a stone. When she could do nothing else to help her patients, she soothed with words, speaking of the past and promising a better future.

Though her position filled her with an “impotent distress”, Perl’s help held real value. When prisoners in the hospital were told to provide blood samples, she and the other doctors – knowing that those with contagious diseases would be killed – replaced them with vials of their own blood. On days she knew the SS would clear out the hospital and send the sick to the gas chambers, Perl strategically sent some back to their barracks so they would be spared. She found ointment to soothe a “horrific rash” that spread through the camp, and once helped a prisoner overcome temporary blindness caused by a vitamin deficiency by procuring the necessary injections.

“Without Dr Perl’s medical knowledge and willingness to risk her life by helping us, it would be impossible to know what would have happened to me and to many other female prisoners,” an Auschwitz survivor who went by the name “Ms B” later testified at The Conference on Jewish Material Claims Against Germany. “She was the doctor of the Jews.”

When Mengele learned of her specialty, he gave her a new task: examine every pregnant woman and report her to him directly. He told her they would be sent to a special camp, where they would receive extra bread rations and even milk. She soon learned the truth. One day, she was returning from an errand near the crematorium when she saw a group of pregnant women being beaten with clubs and attacked by dogs. When they collapsed, German soldiers threw them into the crematorium – alive.

Perl stood in shock, unable to move. “Gradually the horror turned into revolt and this revolt shook me out of my lethargy and gave me a new incentive to live,” she recalled. “It was up to me to save the life of the mothers, if there was no other way, than by destroying the life of their unborn children.”

She made a vow: never again would there be a pregnant woman in Auschwitz.

“Tragic but Justifiable”

Perl was not alone in coming to this conclusion. Medical ethics have long held that when a pregnant woman’s life is at risk, a physician must prioritise saving her life over that of her unborn child. Doctors adapted this lesson to the camps, says Sari J Siegel, a historian who examines resistance and coercion in the lives of prisoner-physicians. “We prisoner physicians quietly acted in accordance with this regulation,” wrote Lucie Adelsberger, a doctor who also performed abortions in Auschwitz. “The child had to die so that the life of the mother might be saved.”

In this case, the threat to the woman’s life was genocidal rather than medical. In their quest to create a master race, the Nazis explicitly singled Jewish women out as targets of extermination (simultaneously, “Aryan” women were encouraged to bear as many children as possible). In most ghettos it was forbidden for women to give birth on pain of death, says Beverley Chalmers, author of Birth, Sex and Abuse: Women’s Voices Under Nazi Rule. In the camps, the danger was even more extreme. As Perl put it: “the greatest crime in Auschwitz was to be pregnant.”

Perl’s actions also have rabbinical precedent, says Michael A Grodin, director of the Project on Ethics and the Holocaust at the Elie Wiesel Center for Judaic Studies and editor of the anthology Jewish Medical Resistance in the Holocaust. Grodin has studied Jewish law during the Holocaust, including rabbinic responsa – the written counsel rabbis gave in response to questions about how to live according to Jewish values. Rabbis continued to offer this moral guidance in the ghettos and camps. Some of it survived the war, buried in canisters deep underground.

In cases where the presence of a foetus or infant threatened adult lives, Grodin found that it was always permissible to sacrifice the child to save the family. Similarly, it would be allowed –”perhaps mandatory” – for doctors like Perl to perform an abortion to save a living mother. “Abortion is frowned upon in Jewish law, obviously, but the foetus doesn’t have the status of a person,” he says. “It’s a hard thing to say, but to save the life of the woman takes precedence over the foetus. And so this would be a classic situation where it would be tragic but justifiable.”

Perl made it her mission to help women avoid the fate Mengele had devised for them. When she became aware that a prisoner was pregnant, she would explain the situation to her: if the SS found out, they would end both her life and that of her baby. First she did her best to hide the woman’s pregnancy, taping up her expanding belly where she could. When she couldn’t, she ended the pregnancy.

She did some of these abortions at night at the hospital, where a 17-year-old girl named Lea Fridler, a daughter of one of the camp nurses, held a candle up so she could see. Other times she snuck out of her barrack and went throughout the camp, performing abortions in dark corners and on dirty floors. If a woman was near term, she would reach into her uterus with her fingers and break the membranes of the amniotic sac, accelerating the birth. If a woman was just a few months pregnant, she would dilate the cervix and remove the foetus with her bare hands.

Once, she delivered the baby of a woman named Yolanda, also from Sighet. Perl sent Yolanda to the hospital ward to recover with the diagnosis of pneumonia, which – unlike typhus – wasn’t punishable by death. But she found herself unable to kill the infant. After two days, she was forced to act before the baby’s cries drew deadly attention. “I took the warm little body in my hands, kissed the smooth face, caressed the long hair – then strangled him and buried his body under a mountain of corpses waiting to be cremated.”

By day, Perl assisted Mengele in his research. He commanded her to deliver the first pair of twins born in Auschwitz, which she knew were destined for his infamous twin experiments. He had her extract an eight-week-old foetus from a pregnant woman – intact – and preserve it a glass jar so it could be sent to Berlin. Even as she performed these tasks for Mengele, she lived in fear of his wrath and whims. “He was free to do whatever he pleased with us – beat us, whip us, kick us with heavy boots or simply dispatch us to the crematory,” she wrote.

Perl thus performed her nightly abortions at great risk to her own life. “She didn’t make these choices from some point of security or superiority,” says Horowitz. “At the same time as she was a doctor she was a prisoner in a concentration camp… She too was a target of genocide.”

In her essay “Personal Responsibility Under a Dictatorship”, Hannah Arendt writes of “a germ-proof moralism… of being unwilling to dirty their hands.” In assisting Mengele, Perl didn’t have the luxury of keeping her hands clean. Every baby she delivered, every pregnancy she interrupted, she did with hands literally caked in mud and dirt. Mengele, by contrast, kept his fingers carefully encased in gloves. Once, Perl saw him beat a female prisoner’s face beyond recognition, then enter the hospital and take a bar of soap out of his bag to wash his hands.

Mengele saw himself as a learned man of science, a doctor fighting valiantly for the health of his “race”. But it was Perl who displayed a true devotion to the values of her profession. Though she could not follow the Hippocratic edict to “do no harm”, she did everything within her power to limit the growing harm around her. “A doctor’s life is worth living,” she would conclude in her memoir, “under any circumstances.”

By March 1945, Perl had been moved from Auschwitz to Bergen-Belsen in northern Germany, where she would witness the liberation of the camps. She remained there for several months afterward, working in the hospital to deliver dozens more free babies. Finally, she left to wander Germany on foot for 19 days in search of her family.

To her horror, she learned that her husband had been beaten to death shortly before liberation, while her son had been cremated. For the first time, she no longer wanted to live and attempted suicide by poison.

After recovering, Perl did not immediately return to medicine. Instead she began travelling the world to speak of what she had witnessed and raise money for refugees. The turning point, she later recalled, was a chance encounter with then-First Lady Eleanor Roosevelt, who heard Perl’s story and invited her to lunch. Perl demurred, saying she was kosher. But Roosevelt insisted and organised a kosher lunch, where she urged Perl to return to her practice. “I didn’t want to be a doctor; I just wanted to be a witness,” Perl told the New York Times.

She would be both. In 1948 she published her memoir, the first to attest to the reproductive and sexual horrors inflicted on women prisoners.

She also wrote to the US War Department to offer herself up as a witness at any trial of Mengele, calling him “this most perverse mass murderer of the 20th Century” and testifying that “under his direction, [Auschwitz] became a perfectly organised death camp”. (Such a trial never occurred, as Mengele lived out his days as a fugitive in South America until he died in a swimming accident in 1979.)

That same year, President Harry Truman signed a special bill granting Perl permanent citizenship in the US. Democratic Representative Sol Bloom of New York – at Roosevelt’s urging – had introduced a version of the bill two years earlier.

Perl began working on the labour floor at Mount Sinai Hospital in Manhattan. A 1966 group photo of the obstetrics and gynaecology department shows her smiling wide, with legs crossed, the only female physician in a sea of men. Dr Carmel Cohen, a retired physician who worked with Perl starting in 1958, remembers her as “highly energetic”, defying fatigue even after sleepless nights delivering babies. Though she never spoke publicly of her experience in the Holocaust, he remembers her tattoo was always visible: “She wore it, in my view, as a badge of honour.”

She ultimately opened her own thriving practice on Park Avenue, dedicated to helping women with infertility, many of them also Holocaust survivors she had known in the camps.

Between 1955 and 1972, Perl authored or co-authored nine academic papers that looked into treating diseases common to pregnancy. Her work investigated treatments for vaginal infections in pregnant women, examined unintended effects of the contraceptive pill, and explored ways of treating and diagnosing thrush. Several were co-authored with Dr Alan Guttmacher, the eminent director of the obstetrics and gynaecology department and a reproductive rights leader who pioneered policies to increase access to abortion and the contraceptive pill.

In 1978, Perl made good on her long-ago vow to her husband. During one of her lectures, she had learned that her daughter had survived the war, hidden away with a Protestant family who was unaware of her Jewish identity. Perl emigrated to Herzliya, Israel, to live with her daughter and grandson, Giora Itzhak Yardeni; she was also reunited with her sister Rose, who had travelled to Israel to study in 1938.

Yardeni, who is 70, remembers women on the street falling to their knees before his grandmother and calling her Gisi Doctor, her name in the camps. “They cherished her,” he says.

In Israel, Perl volunteered her medical skills in the gynaecology clinics of Shaare Zedek Medical Center in Jerusalem, continuing to deliver babies until her death in 1988. Every time she entered the delivery room, she stopped first to pray. That prayer was always the same: “God, you owe me a life, a living baby.”

“She was a very strong woman,” says Yardeni. “She was strong enough to say, okay, this is the past and I have to look to the future from here on. But she never forgot what happened.”

In Auschwitz, Perl may have been forced to make wrenching choices about who would live and who would die. But as soon as she was able, she made it her sole aim to bring more life into the world.

Ask people to imagine a scientist, and many of us will picture the same thing – a heterosexual white male. Historically, a number of challenges have made it much more difficult for those who don’t fit that stereotype to enter fields like science, math or engineering.

There are, however, many individuals from diverse backgrounds who have shaped our understanding of life and the Universe, but whose stories have gone untold – until now. With our new BBC Future column, we are celebrating the “missed geniuses” who made the world what it is today.

Portrait of Gisella Perl by Emmanuel Lafont.