Our Malady: Lessons in Liberty from a Hospital Diary

by Timothy Snyder

If we think that the Nazi Holocaust is the depth of malevolence, what then is the height of good? If we decry Hitler’s language and actions, what follows for what we ourselves say and do? The Nazis treated health care as a way to divide the humans from the subhumans and nonhumans. If we see others as bearers of ailments and ourselves as healthy victims, we are little better than they. If we truly oppose the Nazi evil, we will try to think our way to its opposite, to the good. A part of that effort is to understand that all humans are subject to malady, and have an equal claim to care. Another shelf of books in my office is dedicated to studies of concentration camps. Usually those who run concentration camps treat healthier people better and sicker people worse. When concern for human dignity and human life is absent, all that matters is the labor that can be extracted. Stalin’s Gulag was run according to this logic of reverse health care. Because Soviet administrators regarded prisoners as economic units, health care was distributed according to calculations about productivity. Medical attention meant figuring out who could be exploited for longer and who should be discarded sooner. Stronger prisoners might be cared for so long as they were productive, but weaker ones were allowed to die, often released from the camp to perish beyond its gates—so as not to be counted, so as not to figure in the record. If we think that the Gulag is the depth of horror, what then is the su...