At first he just felt cold when almost ice-cold water rushed up to his neck. The cold soon turned into pain. Inch by inch his body froze, the blood receded from his extremities, and his nerves sent excruciating messages to his brain. With his head above water, he couldn’t even count on the blessed numbness that comes with drowning. Finally he asked to be shot. Instead, he and other “patients” like him have been subjected to a range of bizarre thermal therapies, from ambient blanket wraps to alcohol consumption, skin contact and hot baths. If he survived, he would have to undergo the procedure again, because he was the research object of SS chief Heinrich Himmler, the architect of the Holocaust, and a series of incredibly brutal medical experiments.
Himmler’s hypothermia researchers kept prisoners in ice baths, rescued some and killed many. His researchers also helped disprove the theory that passive heating – in warm ambient air – saved the frozen from shock. It didn’t. The only sure way to prevent shock and death was to actively warm bodies in hot water. Thanks to Himmler and the Nazis, we now know that this is true. But what do we do with this knowledge? What are the ethics of using data obtained by heartbreakingly horrific means?
These are the questions that Sam Kean raises in “The Icepick Surgeon: Murder, Fraud, Sabotage, Piracy, and Other Dastardly Deeds Perpetrated in the Name of Science” and which are easier to answer abstractly than personally: If it would be your child freeze to death, would you ignore the rewarming techniques data because it was collected that way?
“The Icepick Surgeon” begins in the prehistoric times and in the distance, with piracy on the high seas and the dark history of the slave trade. We shudder at the gruesome work of grave robbers and surgeons in bloodstained aprons and laugh at the comical fights between paleontologists who want to destroy each other’s careers. Like so many of Mr. Kean’s works, including “The Disappearing Spoon” (2010) and “Caesar’s Last Breath” (2017), “The Icepick Surgeon” has its phraseology pearls. Explorer William Dampier “never met an animal he did not eat” and his stomach adventures sometimes led him to endure 30 bowel movements in a single session until he “heaved his ass dry”. But this book is more than a collection of amusing vignettes. With each chapter, it becomes harder to judge and grin without seeing the systemic ways in which early sins crept into the heart of science and medicine today.
As we read about the Nazi experiments on hypothermia, Mr. Kean reminded us of America’s own focus on end without examining the means. The Nuremberg Code – a set of ethical principles, including patient consent, emerged from war crimes trials in Germany in the late 1940s – made ethics an “indelible part of medicine,” but also led American doctors to associate themselves with their superiors boasted moral status. “We’re not as bad as the Nazis; that’s why we have to be fine, ”they thought. Then Mr. Kean turns to the experiments conducted on black patients in Tuskegee, Alabama, in 1932, in which doctors wanted to investigate the long-term effects of syphilis. Participants were lied to as to whether they had the disease and those infected were denied necessary treatment. Over a period of 40 years, the study showed the course and extent of the disease, but only at the cost of around 128 human lives, as well as the health of the infected spouse and children born with congenital syphilis.