Old medical records as historical sources - an accessible film

By Bettina Alavi and Eva Franz

Located at the psychiatric clinic in Heidelberg is the internationally known Collection Prinzhorn, in which works of mentally ill artists are archived and exhibited.¹ Its founder, psychiatrist Hans Prinzhorn (1866-1933), laid the foundations for the study of art and art therapy in psychiatric context. From 1910-1921 he was hired by the Heidelberg Psychiatric University Clinic to develop an existing small art collection made by mentally ill persons. His book, "Bildnerei der Geisteskranken" ("Sculpture of the Mentally Ill"), was received by artists such as Max Ernst. Today's scholarly discussion of Prinzhorn's artists, in addition to dealing with the artistic products, also applies to the biography of the patients. The reconstruction of their life stories is based on historical medical records.²

Historical medical records are sources that were primarily written about the patient: the doctor noted symptoms, diagnosis, and treatment. Sometimes there were also letters from relatives. A further part consisted of official documents such as instructions, invoices, etc. Only in exceptional cases were letters, drawings, or pictures by the patient included. Nevertheless, the course of the patient's life can at times be at least partly traced. In addition, they provide insights into the historical background such as the roles of patients and caregivers, as well as insurance issues and much more.

With the demand for inclusion in education and with the development of disability history, the question arises about the provision of adequately prepared knowledge about mental illnesses and their treatment in history. Accessibility for all is an important basic condition: both to the Collection Prinzhorn, and to the materials made for educational purposes in the museum. The accessible preparation of these materials is the focus of a project in history didactics. Teacher training students at the University of Education in Heidelberg created accessible film sequences,³ which elaborate aspects of the history of psychiatry around 1900 in the context of the Collection Prinzhorn for a diverse group.

A product of the project is the film sequence "Alte Krankenakten als Quellen" ("Old medical records as historical sources").⁴ In the section shown here, the notion of historical source is clarified using an example of a medical record. Accessibility is enhanced through linear narration. This narration consists of language and visualization, which additionally structures the section and explains the content. The language is based on an everyday comprehensible vocabulary and follows the rules of Leichte Sprache (German version of Simple English).⁵ The moderation is calm, the articulation is clear. The source work is equated with detective work; a detective is repeatedly used as stylistic means. This visualization loosens the content humorously but not ironically. The lack of background music is intended and mental breaks are built in.

Making a film accessible is more than just methodological adjustments. It demands a deliberate reduction of the complexity of content through didactic elementarization.⁶ This concept is based on theories originated in special education. Leading questions for the process of elementarization are: What are the basic structures of the subject? What do people experience? And what is important from a social perspective? The elaboration of these "elementary structures", "elementary experiences" and "elementary basic principles of life" serve to elucidate the core of the matter.⁷

In the context of history didactics, the film sequence corresponds to the method of inquiry-based learning, as the detective work provides a method of identifying a historical source and shows ways to use it: Asking questions to a historical source is explicated. This is regarded as an important competence on the path to historical awareness.⁸

Recommended Citation:
Bettina Alavi & Eva Franz (2017): Old medical records as historical sources - an accessible film. In: Public Disability History 2 (2017) 4.

Footnotes:
[1] www.prinzhorn.ukl-hd.de/index.php?id=84, visited 2/22/2017.^↩
[2] Fuchs, Petra (2010): "Sei doch dich selbst". Krankenakten als historische Quellen von Subjektivität im Kontext der Disability History. In: Elsbeth Bösl, Anne Klein, Anne Waldschmidt (Hrsg.): Disability History. Konstruktion von Behinderung in der Geschichte. Eine Einführung. Bielefeld, 105-123^↩
[3] Vision Kino gGmbh (Hrsg.) (2013): Praxisleitfaden Inklusion und Film. Methoden, Tipps und Informationen für eine inklusive Filmbildung. Berlin: www.visionkino.de/publikationen/leitfaeden/praxisleitfaden-inklusion-und-film, visited 2/22/2017. ^↩
[4] The film was made by Anna Güse and Alena Roberts in Alavi’s and Franz’ seminar "Disability History" in winter semester 2016/17.^↩
[5] www.leichtesprache.org, visited 2/22/2017.^↩
[6] Lamers, Wolfgang/Heinen, Norbert (2006): Bildung mit ForMat – Impulse für eine veränderte Unterrichtspraxis mit Schülerinnen und Schülern mit (schwerer) Behinderung. In: D. Laubenstein, W. Lamers, N. Heinen (Hrsg.): Basale Stimulation kritisch – konstruktiv. Düsseldorf, 141-205.^↩
[7] Seitz, Simone (2006): Inklusive Didaktik: Die Frage nach dem Kern der Sache. Zeitschrift für Inklusion www.inklusion-online.net/index.php/inklusion-online/article/view/184, visited 2/22/2017. ^↩
[8] Reeken, Dietmar von (2014): Historisches Lehren und Lernen. In. A. Hartinger, K. Lange (Hrsg.): Sachunterrichtsdidaktik für die Grundschule. Berlin, 98-116. ^↩

Read More

Who belongs in the murder clinic? The trouble with Nebel im August

By Ylva Söderfeldt

Germany is obsessed with narratives – movies, TV-series, novels – about its 20th century history. The most successful exports in later years have dealt with Nazi crimes and GDR oppression, not to mention the many productions directed at national audiences. No doubt, several of these works have been both of an outstanding artistic quality as well as having contributed to public awareness about the past, not least also about the continuities into and effects on the present German society.

One of the current movies on this theme (in the theatre where I watched it, there were at least two other films about Nazi Germany currently on the program) is somewhat unusual in that it addresses the murdering of sick and disabled people during the Second World War. Based on a novel that was in turn based on an actual biography, Nebel im August (Gloom in August) tells the story of Ernst Lossa (Ivo Pietzcker), who was murdered at the age of fourteen in a clinic in Irsee on August 9, 1944.
Lossa was Yenish, a minority that suffered persecution under the Nazis, had lost his mother, and was furthermore considered to have behavioral problems, all factors contributing to his institutionalization. We encounter him in the movie as he is transferred to the clinic in Irsee after having been in a series of other facilities. The initial impression is twofold: Lossa appears relieved at the friendly attitude he encounters from the head clinician Walter Veithausen (Sebastian Koch), but reacts with fear and contempt when he meets his fellow inmates, protesting that he doesn’t belong among "idiots".

A young boy with shaved head Ernst Lossa (Ivo Pietzcker)  is being
viewed by a doctor Dr. Werner Veithausen (Sebastian Koch) standing behind him. Courtesy of StudioCanal.

Between working in the fields and daydreaming of emigration, Lossa however soon comes to witness what quietly goes on in the clinic: inmates are being killed. At first, they disappear in enigmatic transports, then given lethal doses of medicine or deliberately starved on the premises.
The story is told at a slow pace and offers the viewers an almost excessive amount of scenic footage. At the same time, it is packed with information. When the camera doesn’t sweep over a beautiful landscape or interiors reminiscent of Vermeer paintings, it follows the protagonists in dialogues that painfully incorporate as many facts as possible about the ‚euthanasia’ programs. The ideological backdrop, the bureaucratic particulars, the role of scientific research as well as the Catholic church: it’s all in there, represented in the clearest way possible. This makes the viewing tedious, and the experience more like reading a Wikipedia entry than following a story. It is thanks to the generally very good acting and in particular Pietzcker’s brilliant performance, as well as David Bennent in an outstanding supporting role, that the movie still manages to engage and touch the viewer beyond the mere telling of historical facts.

A nurse (Henriette Confurius) hands a drink to a boy in a hospital bed. Courtesy of StudioCanal.

This tendency to be overly pedagogic is a common trait for the genre and for German film in general (in a German detective story, you always know who the killer is, no mystery is tolerated). But it might also be due to the specific topic. The makers cannot anticipate that the viewers bring much previous knowledge into the theatre, and obviously felt it necessary to clearly lay out the facts in order to tell the story.

More troubling is the message that follows Ernst Lossa’s story throughout, and is articulated by one of his caretakers – and possibly, his killer  – "but he is a healthy boy!" The idea that Lossa "does not belong there" never quite leaves us even though his alliance shifts away from the staff and to his fellow inmates as the plot unfolds. This trope is all too familiar in narratives about the Nazi crimes against the sick and disabled: outrage tends to be directed especially at the abuse and murder of those who ‘weren’t even actually sick’ but ‘just’ labelled antisocial and degenerate. That line of reasoning, of course, implies that some people did ‘belong there’ and that certain illnesses and disabilities were, if not rightful, at least understandable grounds for extermination. From a public disability history perspective this particular presupposition  is precisely what needs to be questioned, and it is unfortunate that this production does not take the opportunity to do so.

Two boys with shaved heads(Niklas Post and Ivo Pietzcker) and a man (David Bennent)
sit outdoors by a pile of potatoes looking amused and shocked. Behind them, men are making baskets.
Courtesy of StudioCanal.

Nebel im August
StudioCanal, Germany, 2016
Director: Kai Wessel
Screenplay: Holger Karsten Schmidt
Lead cast: Ivo Pietzcker, Sebastian Koch, Thomas Schubert, Fritzi Haberlandt, Henriette Confurius

Recommended Citation:
Ylva Södrfeldt (2016): Who belongs in the murder clinic? The trouble with Nebel im August. In: Public Disability History 1 (2016) 18.

Read More