Q J Med 2000; 93: 487-495
© 2000 Association of Physicians
Occasional paper |
Contributions by German émigrés to British medical science
From the Royal College of Physicians, London, UK
When the Nazis came to power in Germany on 30 January 1933, they produced not only gigantic political change but a revolution in science, arts and intellectual life that was bigger than any other in the history of the world. At that time, Germany led the world, especially in science, in a way no other nation had ever done. The situation changed in a matter of weeks, for one specific and simple reason. Adolf Hitler acquired total political power and he was a fanatical anti-semite. Those two facts account for the devastating damage to German science and scientists.
There was no surprise about Hitler's anti-semitic policy, only about its speed and intensity. Most Jewish scientists realized before Hitler's advent to power that professional life would become difficult or impossible for them. The change in official tone was immediate. The reason why German Jewish scientists left so quickly was that in Germany almost all universities were state institutions; so when the law for ‘cleansing’ the civil service was promulgated (not voted) on 7 April 1933, only 9
weeks after Hitler's appointment, all academics became liable to dismissal and most were quickly dismissed.
For some this completeness and abruptness of anti-semitic measures was an advantage. Jews knew exactly where they stood vis-à-vis the state. Werner Heisenberg, the great physicist who at the age of 32 was already a Nobel prizewinner, said he almost envied his Jewish colleagues, they were in no doubt what they had to do. They had to leave—he did not. Eventually he decided to stay in Germany in spite of great temptation to leave, mainly, it is thought, under the influence of Max Planck and his passion to preserve German science in the face of the danger he foresaw only too clearly. Very few non-Jewish scientists left—Otto Krayer, Marthe Vogt, Erwin Schrödinger, under very different circumstances. It is easy to criticize those who did not leave in spite of the approaching horror, but the personal and professional problems of doing so were immense. It was easier to take action from the safety of Britain (and still more of the USA); the action of British academics who formed the Academic Assistance Council (AAC) which rescued so many German academics was extremely creditable. The AAC was led by William Beveridge, of the London School of Economics, Lord Rutherford, President of the Royal Society, A.V. Hill, biological secretary and MP for Cambridge university, and Leo Szilard, ex-Hungarian physicist, who was one of the first to diagnose the situation in Germany. They were helped by the admirable Tess Simpson who remained as secretary for many years, sustaining the AAC and her ‘children’ in it for decades.
The scientists flocked over to London, some went to France and to USA. In some cases, e.g. Krebs, they were already known as budding scientists. He had written direct to Gowland Hopkins, who wrote back that he had long been interested in his work, and if he could find funds he would welcome Krebs in his laboratory.
I am talking here of the contributions by German emigrés (including Austrians and Hungarians who had been working in Germany, or trying to do so), to British medical science. That statement needs some qualification—first, for the obvious reason that contribution to British medical science included Western science generally, especially American; second the subject is medical science, not clinical medicine. This distinction, today becoming of less significance, was not so then. The British attitude to German medical scientists was very different from that to German doctors in general. In the first instance Britain's attitude was entirely welcoming; in the second, quite the reverse.
German doctors were not generally welcome here, for both economic and nationalist reasons. This was a period well before the National Health Service, when doctors' income came from various sources, mostly private practice and health insurance; in the case of hospital practice service was voluntary. It was easy, therefore, to see the financial threat to British consultants and general practitioners. Less worthy, was an attitude on the part of leaders of the profession that Britain had little to learn from German and Austrian medicine. Witness the comments of the Home Secretary, Samuel Hoare, in the early post-Hitler days; he ‘would gladly have admitted the Austrian medical profession en bloc’, but his humanitarian sentiments had received ‘an unpleasant shock’ when he encountered resistance from the British medical profession, who assured him that ‘British medicine had nothing to gain from new blood and much to lose from foreign dilution’. It may well be true that some of the qualities which had put Germany and Austria in the lead, in surgery and psychiatry for example, were no longer so prominent, but they could not be so cavalierly dismissed. However, there was an undoubted air of smugness in those years on the part of the British Medical Association as well as the Colleges, which was unhelpful to the emigrés. Fortunately the scientists—individually or in organizations—behaved much more openly.
Krebs's pre-eminence can need no urging—the fundamental importance of his research in intermediary metabolism was officially recognized by the award of the Nobel prize in 1953 jointly with Fritz Lipmann, another German refugee (to the USA). By this time, he was professor of biochemistry at Sheffield (whence came another later Nobel prizewinner, Howard Florey, originally of Adelaide—no anti-semitism there!) Next year, 1954, Krebs was appointed to the chair at Oxford where he stayed until his death in 1981. His presence in Britain was a towering advantage for his subject, his universities and his new country.
Another Oxford figure, at the other end of the scientific/clinical spectrum, was Ludwig Guttmann. He was a neurosurgeon in Breslau who had trained with Otfrid Foerster, the best known neurosurgeon in Europe. He had worked at times with Hugh Cairns, professor of surgery at Oxford, professional descendant of Harvey Cushing and doyen of the subject in Britain. Guttmann was Jewish, but could have stayed in his post in Germany. He was repelled by two things—he would only be able to treat Jewish patients and he had witnessed the burning of the books on 10 May 1934. This action—by students urged on by the Rectors—shocked him greatly. The books were burnt regardless of subject or author, and this action convinced Guttmann that the Nazi intellectual tyranny would last.
As head of the Jewish hospital in Breslau, Guttmann did all he could to protect his patients. Things got particularly bad after Kristallnacht, 9 November 1938, when state-organized violence destroyed synagogues and other Jewish buildings, and killed Jews. Guttmann gave orders to his hospital staff that any man arriving that night should be at once admitted. When Nazi officers came, Guttmann took them round all the patients, often inventing diagnoses. Difficulties got worse for Guttmann despite his courage, but he was helped by his international fame. He was asked by Dr Salazar, dictator of Portugal, to see a man with a spinal tumour, and the request was supported by Ribbentrop, German foreign minister, from whom he got permission to call at Oxford on his return journey. There he got a promise of support from the Society for the Protection of Science and Learning (the new name of the AAC) and was allowed to leave Germany on 14 March 1939 (the day before the invasion of Czechoslovakia).
The family were made welcome in the Master's Lodge at Balliol, and Cairns (a professorial fellow of the College) arranged for him to do research in his department. He did not, however, give him clinical work to do. Cairns did not have a high opinion of Guttmann's mentor Foerster's techniques of controlling bleeding and infection, nor was Guttmann popular with his colleagues. Much of Guttmann's experimental work related to peripheral nerve function and thus to sweating. The result was that he often sweated and he became known as ‘sweaty Guttmann’. For a time, Guttmann was frozen out of the department's activities.
All this changed as the prospect of a second front approached in 1944. George Riddoch, neurologist at the London Hospital and the National Hospital, Queen Square, who was head of the Emergency Medical Service, foresaw the load of spinal injuries that the invading forces in France would have to deal with. Hitherto nearly all paraplegics died—80% within one year from bedsores and bladder infection.
Guttmann was determined to change that, and he was exactly the man to do so. A special paraplegic unit was created for him at Stoke Mandeville, and Guttmann was put in sole charge. He insisted on routine bladder catheterization with full aseptic precautions and on two-hourly body turning. He was in the wards himself throughout the night to make sure his orders were obeyed. They were. The results were dramatic—80% first year mortality was changed to 80% survival. The patients not only survived but recovered a zest for life, later through paraplegic games and other dramatically positive activities. As one patient, an Army chaplain, put it, ‘your first duty is to cheer up your visitors’.
In the course of his work, Guttmann noticed changes in blood pressure, pulse rate and facial colour during catheterization, and that these reactions occurred only when the spinal lesion was above T7. This work he did with David Whitteridge, later professor of physiology at Oxford. They took immense trouble to spare the patients suffering, using old fashioned non-invasive methods wherever possible.
At the age of 76, he was elected a Fellow of the Royal Society. In assessing the life and contribution of Ludwig Guttmann, it seems to me that they came from character, determination, thoroughness and basic understanding rather than intellect or imagination—just those ‘Germanic’ qualities it has been so common to deride.
Rescue of refugee scientists came in unexpected ways and from unexpected sources. One of the most surprising was Ernst Chain, who was rescued by J.B.S. Haldane. Haldane was one of the most colourful, brilliant, original and perverse of scientists. He was a genius at classics and mathematics as well as genetics and biochemistry. Top scholar at Eton at the age of 12, there was nothing he could not master—except the ordering of life. His character was such that he could never accept any situation as it was, only as he might make it. This led to a crippling of his potential—he saw difficulty where none existed, or where a simple remedy would have solved a problem. Ronald Clark wrote a masterly biography1 ‘JBS’, to which Peter Medawar wrote an even more masterly introduction. Listing Haldane's potential, Medawar said ‘he could have been mathematician, classical scholar, philosopher, scientist, journalist or imaginative writer; he could not have been a politician, administrator (heavens no!), jurist or critic. As it was he was one of the cleverest men I ever knew’ (high praise from that source).
Politically he was on the left, being a communist for many years, but his political opposition might be expected to take a more theoretical tone, such as the communist party usually did, rather than indulge in actual rescue. But that is not what he did. He knew about Hitler's tyranny from its earliest days, and he learned about Ernst Chain. Chain was a Jew, born in 1906 in Berlin of parents who had emigrated from Russia. Chain was committed to an academic career, and at school and university had been taught by world famous physicists—Walther Nernst, Max Planck, Otto Hahn (the discoverer of atomic fission), Haber who discovered the fixation of nitrogen and the introducer of poison gas in warfare, Lisa Meitner (co-discoverer of fission) and the great biochemist Otto Warburg.2
Chain became, not surprisingly, interested in enzymes, which in the 1920s were still not known to be proteins, and he published original work. Like so many great scientists, Chain was highly musical, and it was touch-and-go whether he would make music his career. Much of his life's activity was based on instinct and impulse, and they may have been the trigger which made him decide to go to England—he says on 30 January 1933 (the day of Hitler's appointment to power) but two months later according to his passport. At first he stayed with his uncle in north London, who was not keen to receive him, and suggested he might make a new start in his life by delivering newspapers.
Chain did not then, or ever, lose sight of his objective ‘to study and understand the secrets of nature’. He wanted to be a biochemist, so he proceeded directly to the top, writing to Frederick Gowland Hopkins at Cambridge, who was well disposed, as he was to so many scientific refugees, and to Charles Harington at University College, London; within two weeks Harington had appointed Chain to his chemical pathology department. Haldane was in the process of moving from a readership in biochemistry at Cambridge to a chair in genetics at University College. He had read Chain's early reprints and recognized his quality at once. With a charming—and rather uncharacteristic—modesty Haldane said (later) that the help he gave Chain was what ‘posterity may regard as the best and most important action of my life’.
Chain and Harington, respectively flamboyant and reserved, were utterly different characters and soon fell out. Haldane helped again, and got Hopkins to take him into his department at Cambridge where he gave the excitable, depressed, fearful young emigré all the comfort and support he could. Things were better but Chain was still restless (he still had not entirely given up the idea of being a musician). The decisive move came in 1935 when the newly appointed professor of pathology at Oxford, Howard Florey, began his search for rational chemotherapy, for which he needed a biochemist. At first he chose another man from Cambridge, Bill Pirie, but Hopkins couldn't release him, so he suggested Chain. ‘I find his biochemical knowledge is more than merely adequate... I feel that if his race and foreign origin will not be unwelcome in your department, you will import an acceptable and very able colleague.’ Chain jumped at the opportunity, particularly of building up his own department and of acquiring enough advanced equipment, so indispensable to research and so conspicuously lacking in Harington's lab. Even in Florey's department he found cause for worry—seeing a Soxhlet extractor (an expensive piece of apparatus in those days; there were only three or four in the whole of Oxford) he exclaimed, ‘I must have six, a dozen.’
Chain, in all the glory of his success, was never easy to keep sweet and satisfied—even while elucidating the structure of penicillin in his great work with Florey over the next five or six years, he could be a restless and difficult colleague, and this in a situation which other members of Florey's department found stimulating and pleasurable, to put it mildly. He was known by some young colleagues as ‘Mickey Mouse’.
After the war, when he set up his own institute in Rome, his need to be in charge and to have huge resources of scientific apparatus were crucial to his work. It is fascinating to speculate what would have happened to Chain's work and career if he had not come under Florey's influence, a man of just the confidence, force and ideas that brought out the best in Chain (and in many others). Perhaps Chain's character, as well as his immense scientific ability, attracted him to Haldane in his early days in this country when his off-putting characteristics might have frozen his career and he would have migrated to Canada or Australia (which Florey had left 20 years earlier), which he had considered. It is hard to believe that either country would have given a more comfortable reception to the excitable East European Jew who stressed even Oxford's capacity to adapt to eccentricity.
In the end he left Florey, Oxford and England rather unhappily, but by that time he had contributed to one of the greatest biological discoveries ever made. It is now fashionable to diminish the discovery of antibiotics as bacterial resistance has tarnished their image, but nothing can reduce the wonder for doctors who worked in the pre-antibiotic age. The case notes still exist of the first human being3 to receive penicillin, a Kettering policeman dying of multiple staphylococcal abscesses who was pulled back from death and then, when supplies ran out and redistilled penicillin from his urine was inadequate, slipped away and died for a second time.
Scientific achievement can be measured in many ways. The most rigorous is by the number of Nobel prizes won. In the case of Germany in 1933–39, the result is damning. Before 1933 Germany had won many more Nobel prizes in science than any other country—33, exactly one third of the science prizes given since their start in 1900. Britain had won 18, the USA only 6. As a result of Hitler's actions, seven winners left Germany and so did no fewer than 20 who went on to win prizes. This was undreamed-of intellectual riches. No country could afford to waste their scientific talent on this scale. Such a loss had never happened to any other country, nor can it ever happen again. Yet the damage was done by Germany to itself.
Four German Jewish biologists were forced out who later won prizes while working in Britain—Perutz, Krebs, Chain and Katz, all of whom I had the privilege of meeting and on one of whom I can claim a minute personal influence, Max Perutz. He was Viennese, and in 1938 as a physics student wanted to come to Cambridge where so much crystallography and other good work was going on. He fell in, more or less accidentally, with J.D. Bernal a genius of X-ray analysis of crystals, who played a leading part in the early foundation of molecular biology and tutored Dorothy Hodgkin, who described him as the brightest man she had ever met.
War came a year after Perutz arrived—he had no wish to return to Austria and was happy here. But a year later, in 1940, came the internment of ‘enemy aliens’, even of those previously diagnosed as harmless or favourable to the Allied cause. It took 5 years to become naturalized. In May, Perutz was suddenly interned and later transferred to Canada, mercifully not on the Andorra Star which was torpedoed with the loss of many lives. Cambridge refugees were particularly hard hit, because there was widespread government fear of a German invasion of the south-east of England.4
After a period of months, the panic subsided and the refugees were released, mostly after being shipped back to Britain. Perutz resumed his crystallographic studies, as he was not considered suitable for any form of national service. Then he received a bizarre request to go to Admiral Mountbatten's Combined Operations Headquarters. On his staff were three unconventional civilians, Solly Zuckermann FRS, professor of anatomy at Birmingham, Desmond Bernal FRS, later a professor at Birkbeck College, London, and Geoffrey Pyke,5 an eccentric man of no set profession but of a highly imaginative and intelligent disposition, especially in scientific matters. Pyke had thought up an idea for constructing aircraft carriers made of ice and wood-pulp which could be refrigerated to form landing stages in mid-Atlantic for ferrying desperately-needed planes to England. In the process the planners needed high-class crystallographic advice in Canada, where the prototype ‘Habbakuk’ was being built; that meant Perutz. But he was still Austrian, and naturalization was stopped during the war. The problem was solved by Mountbatten's chief-of-staff, who simply told the Home Office to naturalize Perutz which they did in 24 h. Nothing of importance came of the Habbakuk project except that Perutz became British. This has proved a good bargain.
When Perutz returned from Canada, he went back to the Cavendish Laboratory. Not being liable to military call-up, he was free to resume his immensely painstaking and seemingly forlorn quest to analyse the entire structure of haemoglobin. Altogether, Perutz worked on the project for 20 years and when you see him demonstrating a model of the haemoglobin molecule it is not surprising that it took so long. Perhaps the only surprise is that he was such a persistent and patient worker, and that the Cavendish Laboratory and the Medical Research Council were such tenacious supporters of his work, which cannot always have seemed so promising. It ended in triumph in 1962 when Perutz shared the Nobel prize in chemistry with J.C. Kendrew, and Crick, Watson and Wilkins shared the physiology prize. The era of molecular biology had begun.
For many years, Perutz presided over the Laboratory of Molecular Biology. I cherish the story, doubtless untrue, that when the LMB got news one October day of yet another Nobel prize, they were celebrating so loudly that Perutz said, ‘We must stop making such a noise in the middle of the day or this place will get a bad name’.
Early indications of molecular biology appeared in the thinking of two physicists who appear in our story, if rather peripherally—Niels Bohr ‘the Great Dane’ beloved and respected by the entire scientific world from the 1920s onwards through his writings on complimentarity, and Erwin Schrödinger, almost equally brilliant though a far less amiable personality. While sitting out the war in Dublin, Schrödinger wrote ‘What is Life?’, a short book which suggested that the gene was a message. Both Bohr and Schrödinger (Nobel prizewinners in 1922 and 1933) were in a sense refugees—Bohr was plucked out of Denmark in 1943 and flown to England6and the USA to help with the design of the Atomic Bomb; Schrödinger, though also not Jewish, came to Britain in 1933 (where he was made a fellow of Magdalen College, Oxford within five days of arriving, a unique honour which, like others afforded him by Lord Cherwell and friends, Schrödinger showed little sign of appreciating). He returned to Austria in 1936 when he had no need to do so, and when a German take-over already seemed probable. He tried in a nauseating letter to ingratiate himself with Hitler, an impossible objective, and escaped back to Britain only just in time to avoid arrest by the Nazis. Finally, after being rescued by Oxford again, de Valera set Schrödinger up in an Institute of Advanced Study in Dublin.
Another German refugee who came to Cambridge because of the Nazis was Herman Lehmann. His arrival in England was the result of two factors—the near impossibility for a Jew to obtain an established research post in Germany after the Nazis came, and luck. Lehmann was an unpaid assistant in Otto Meyerhof's department at the Kaiser Wilhelm Institute (KWI). Meyerhof was Jewish but still able to lead an independent life of sorts, because he worked in the KWI, which was a non-government institution. He was famous, having won the Nobel prize in 1922 (jointly with A.V. Hill). Meyerhof had an arrangement with Gowland Hopkins by which he sent a promising young scientist to Cambridge for a short visit every year. Hopkins had already noticed Lehmann's earliest published work, on creatine phosphate. Although Lehmann was in Cambridge for only a month, it was a turning point in his life—he got to know several of famous—and famously generous—colleagues, in particular Hopkins himself, and Joseph and Dorothy Needham. Hopkins must have foreseen Lehmann's future—when he left he told him to leave his white coat behind the lab door.
Lehmann returned to Meyerhof at Heidelberg, but life became increasingly difficult in Germany, and he decided he must return to Cambridge, where he arrived penniless in April 1936. He was immediately gathered up by the Needhams and formed a connection with Christ's College through C.H. Waddington, the geneticist and C.P. Snow, the novelist, which lasted throughout his life.
Among other things, he worked on nutritional anaemia and the role of iron which stood him in good stead later in the war in the RAMC. He was interned in 1940, but not sent to Canada, and was set free in a matter of weeks through the efforts of friends in high places, of whom there were many in Cambridge.
His interest in nutritional anaemia led to his interest in haemoglobin variants in India and, after the war, in Uganda. He was among the first to understand the relationship between sickling and malaria.
In 1951 Lehmann was appointed to Bart's, and stayed there as lecturer and reader until he returned to Cambridge for good in 1963. His time at Bart's was very highly productive. His laboratory became the haemoglobin centre of the world. Innumerable different varieties were sent to him with all sorts of abnormalities, including the discovery of ‘Hb Bart's’ in association with thalassaemia—a Hb of four chains. He made fundamental discoveries in other fields, and could be described as the father of pharmacogenetics with his work on the inheritance of suxamethonium-sensitivity related to glucose-6-phosphatase deficiency.
His return to Cambridge came at a lucky time—it was a year after the Watson-Crick-Perutz-Kendrew Nobel prize and the burgeoning of molecular biology. His and Perutz's work fitted perfectly—Lehmann quickly understood the structure of haemoglobin and knew his way round the molecule about as well as Perutz himself. It led to the first understanding of a molecule as a living entity; how changes in detailed structure could cause changes in function. His studies on haemoglobin brought together genetics, anthropology and clinical medicine in an exceptionally productive way through his discovery of varying rates of sickle-cell traits in Indian and later African populations. He was vastly energetic and popular in spite of carrying some features of personal suspicion which one cannot avoid ascribing, at least in part, to the trauma of his early life and his forced move to Britain. It may have been a hazardous transplantation, but there were no rejection episodes, and he solved problems that, throughout his life, he seemed the one uniquely fitted to conquer.
Lehmann had a broad view of life, e.g. his essay ‘Why are red cells the shape they are?’, although sometimes urgent preoccupation with science seemed to blot out other interests. An example is when he returned from a trip to China, then a closed country, and Max Perutz asked him for his impressions. ‘Well’, he said, ‘there was a lot more haemoglobin E than I expected!’
The story of Hans Krebs epitomizes the story of Jewish scientists in Germany before the war. It was early clear that he was cut out for a career in science—he was brilliant and entirely committed to academic life. There were difficulties, of course. He was Jewish, he wanted to do both clinical and scientific work (an almost unheard-of combination) and there really was no such profession as biochemist. However, he made the crucial move of attaching himself to Otto Warburg, an unlovable man, perhaps, but a great scientist. Krebs got a job in a department of medicine in a hospital near Hamburg in which he could also do some lab work. Warburg supported his grant application, provided Krebs continued to work on one of his projects. In April 1931, he moved to Freiburg where he had ‘only’ 44 patients to look after (no limit on junior doctors’ hours of work then). Using Warburg's tissue-slice technique, he discovered the first steps in the urea cycle. This phenomenon of a cyclical process, continuing constantly and indefinitely was a new phenomenon and naturally created a sensation. Krebs became known internationally. In recommending him for preferment, his Dean, Professor Rehn, said ‘as an assistant in the department of medicine Dr Krebs has shown not only outstanding scientific ability but also unusual human qualities... his recent scientific work, especially the paper on the synthesis of urea in the animal body, has established his international reputation... one of the classics of medical research.’ A few months later, with Hitler now in power, the dean wrote again, this time saying coldly that according to Ministerial Order 7642 he was placed on leave until further notice. Within days Krebs was making efforts to leave. He was encouraged to write to Gowland Hopkins who replied by return of post, ‘I admire your work so much that I am very anxious to help you,’ and there were other offers. Fortunately Cambridge already had Rockefeller money to back him (the Rockefeller Foundation had long been a very sharp spotter of European scientific talent)
Krebs was at once enchanted by Hopkins, his department and by England. The whole atmosphere was completely unlike that at home in Germany. Many years later, in 1961, he described what he felt about this period in a lecture in memory of Hopkins at the Biochemical Society. ‘It was in Hopkins's laboratory that I saw for the first time and at close quarters some of the characteristics of what is sometimes referred to as "the British way of life". The Cambridge laboratory included people of many different dispositions, connections and abilities. I saw them argue without quarrelling, quarrel without suspecting, suspect without abusing, criticise without vilifying or ridiculing, and praise without flattering. Hopkins was the central figure, beloved and respected as a natural leader... his concern ranged far beyond biochemistry, Cambridge University and the Royal Society. What struck me, in particular contrast to the German scene, was the strong social conscience of Hopkins and his school. Between 1933 and 1935, the laboratory sheltered six refugees from central Europe: Friedman, Lemberg, Chain, Weil-Malheirbe, Bach and myself... for the acceptance of a one time stranger into the family of biochemists I shall always be grateful'.7
Krebs could stay in Cambridge for only a year until the grant ran out, but he got a lectureship in Sheffield. There he rose to be professor of biochemistry until 1954, when he moved to the chair in Oxford where so many people came under his spell, including (very peripherally) myself. We had mutual friends (scientific refugees in USA) and when we met Krebs was friendly, but I found him awe-inspiring, as when lecturing, he would seem to stop halfway through and stare at the audience as if saying, ‘do these people understand this enough for me to go on?’
Under his cool and composed exterior, there was a very warm man, witness his remarks about Hopkins. Even more moving was his speech in 1965 when he had been nominated on behalf of all the ex-German refugees in this country to present a cheque to the Presidents of the Royal Society and British Academy expressing their gratitude for how they had been welcomed to Britain. He was by this time a Nobel prizewinner and famous, but the fact that he was chosen to make the presentation shows what his co-refugees (who included many famous names) thought of him.
‘No sum of money can adequately and appropriately express our gratefulness to the British people. What this country of our adoption gave us was not just a new home and livelihood... we also found a new and better way of life coming from an atmosphere of political oppression and persecution... we found a spirit of friendliness, humanity, tolerance and fairness. It is this way of life with which some of us, I for one, fell in love. We were given here a new home—not merely a shelter but a true home. Home is where one strikes roots, where one has the opportunity of doing the things which... one feels one ought to do in order to fulfil one's life and thereby gain true happiness.'
Krebs's Nobel prize had come in 1953, jointly with Fritz Lipmann, another German refugee, who had gone to the United States. Their names are recorded in the list of prizewinners followed by ‘USA’ and ‘Britain’. That should have read ‘Germany’ in each case. This journal is no place for nationalism in science, but if one had been German would one not be ashamed of a government which had committed such a wanton act?
Krebs obviously found science easy—I suppose geniuses do. When his ornithine cycle paper was so quickly admired, his attitude was ‘well if that is what they want they can have plenty more of it’.
Two tiny incidents concerning Krebs's departure from Germany in 1933: he was seen off at Freiburg by a doctor friend, also Jewish. ‘Don't wait too long,’ called Krebs as the train moved off. When Krebs arrived in London he was met and taken in hand by Hermann Blaschko, with whom he was friends for the rest of his life. As an example of the lasting good done by the barbaric German policy to the Jews, Krebs's son, John, has lived here all his life and is a Fellow of the Royal Society.
Blaschko was himself a refugee even before Krebs. He showed the crucial personal importance of chance encounters with great scientists that so often changed the stories of the refugees. Blaschko had also worked with Otto Meyerhof, starting in 1925. When he was to go to London on holiday next year Meyerhof said ‘call on A.V. Hill while you are there and give him my greetings’. Blaschko did, and like Bernard Katz and many others, fell under his spell immediately (Hill's energy and imagination were responsible, almost single-handed, for restocking British science from Hitler's carnage). This began Blaschko's visits to the country which became permanent in 1933. He was then in hospital with pulmonary tuberculosis and out of a job. Very soon a letter came from A.V. Hill offering him a place. There was no paid job, but that hardly mattered; Blaschko was out of Germany and could devote his first year to helping the other refugees, finding homes and jobs, working with Tess Simpson and Walter Adams of the AAC. As so often in the story of scientific refugees, these personal contacts show in how they helped each other. They were a remarkably generous and warm-hearted lot.
Blaschko went to Cambridge, where I first met him in 1940 as a pharmacology demonstrator. We all thought he was an established member of the Faculty, only later did we discover that he survived on tutoring fees for undergraduates at St John's. His scientific take-off happened in 1944, when J.A. Gunn, who had also thought he was established in Cambridge, appointed him lecturer, later reader in pharmacology at Oxford. It was in Oxford that he developed his great work on monoamines and chromaffin granules which led to discoveries of fundamental pharmacological and clinical importance. Blaschko was at his most productive in relatively late life, 45–50 onwards.
I had the great pleasure of knowing Blaschko in the last few years of his life—he was extremely easy to get to know, as is shown by his description of his first encounter with Wilhelm Feldberg. They had never met when at a hotel in Rome in 1932, they got into a lift together on the ground floor and emerged as friends on the third floor.
That story is as typical of Wilhelm Feldberg as of Hugh Blaschko, two of the friendliest people it would be possible to meet. Feldberg also taught us at Cambridge. He had started work with Henry Dale (later PRS) at the National Institute for Medical Research, Hampstead before Hitler came when they were studying neurotransmission, especially acetylcholine. Feldberg had devised the eserinized leach preparation which was exquisitely sensitive to acetylcholine.
When in 1933 Feldberg had been instantly sacked from the Institute of Physiology in Berlin, he had gone, without much confidence, to see the representative of the Rockefeller Foundation in Germany. He did not seem very hopeful either as he went through the papers of other scientists in distress, when he came across a paper. ‘Here, I have it—a letter from Henry Dale saying ‘if Feldberg comes to you in trouble tell him I have a place for him here".’ Feldberg went at once to London, later to Cambridge, Australia, Cambridge again and finally the National Institute. Feldberg said he would have been quite happy to stay in Australia where he was working with C.H. Kellaway, but there was no vacancy. Feldberg, lovely man that he was, does not fit with one's concept of the typical Aussie (nor does Bernard Katz, who not only worked there but joined the RAAF and married an Australian).
Feldberg's great work was done before the war on chemical neurotransmission but he continued as a fountainhead of neuropharmacology in the famous F4 lab at Mill Hill. Feldberg exemplified, as well as any of the refugee scientists, friendliness, confidence and optimism—often in circumstances that would have destroyed many of us. He had lost his first wife Katherine, he had married again but his second wife soon died, he had lost his only son, he had been expelled from his job and his country, he had (at the time when he said this to me) been moved out of his lab—yet he said, ‘I have been incredibly lucky.’ So he had. If the timing had been different, he might have been physically liquidated; instead he had led a life of perpetual interest and productiveness which led to benefit to mankind, he had been elected to the Royal Society, he was universally beloved. It seemed to his friends that when he died at 93, he had been carried off prematurely.
It is difficult to stop writing about scientists who came here from Germany, there were so many, they were so fruitful in their work and personally, and did so much good to this country. I have confined myself to biologists who came and stayed here. There were others who were rescued by Britain but moved later, e.g. Otto Loewi, friend and co-Nobel prizewinner of Henry Dale, and Otto Kreyer. Kreyer, a non-Jew, when in Berlin in 1933 had refused the offer of a full chair in pharmacology in Düsseldorf when he was quite young, was forbidden to enter his university, came to England to his old friend, Feldberg, and later was appointed to a full professorship at Harvard—to which some American scientists objected that here was a foreigner taking the place of an American!
There were three remarkable escape stories. Egon Kodicek of the Strangeways laboratory, who escaped from Prague in 1939 the day before the closing date for British visa applications. His wife ‘divorced’ him (she was non-Jewish) in Prague so that she, at least, could leave. On hearing of his escape, she ‘de-divorced’ him at Genoa on her way to England. Kodicek got past the Nazi frontier guard by describing himself as an ‘Endokrinolog’, which he reckoned the guard wouldn't understand whereas ‘Medicine’ or ‘Artzt’ he would, and would have kept him.
The most terrible dismissal story I know is of Edith Bülbring, pharmacologist, later Fellow of Somerville College and of the Royal Society. When she was a young houseman in the children's hospital in Berlin 1933, she admitted a boy of 11 with diphtheria. The membrane was closing, and he had to have a tracheostomy. She sent to the ENT department for a surgeon. There were none—they were all Jewish and had been dismissed. She had never done the operation, but a nurse had often assisted and together they managed it. Soon afterwards she was called to the hospital director's office to be confronted with the fact that she was Jewish. She was bursting with relief and delight at her success and couldn't take this ‘news’ seriously. ‘Miss Bülbring this is no laughing matter, leave the hospital immediately.’ Fortunately she made an easy escape to England, where Professor J.H. Burn rescued her.
Finally, the story of the formidable Martha Vogt shows a noble aspect of the squalid business. She was a well-known pharmacologist working with H.B. Verney in Cambridge when Hitler came. She was not Jewish, and hated the Nazis. When her fellowship ended she went to the German embassy and threw her passport at them. She started to be naturalized but there hadn't been time to complete the process when the war started and 8 months later a crusty magistrate sentenced her to internment (although she had of course been graded as a friendly alien). The policeman escorting her supposedly to jail, told her that she could appeal. Feldberg, Verney and others got to hear of the situation, they went to Henry Dale, and he went to the Home Secretary, Sir John Anderson. ‘Well, we are rather busy you know (Hitler was 20 miles from England) but I'll see if there is anything I can do.’ By the time her colleagues had got back to Cambridge, Martha Vogt had already been told by the police that she would not be interned. A final—so characteristic—touch: Martha then bawled out her friends for wasting the energies of the British government at a time like this!
Bernard Katz, one of the four Nobel prizewinners in physiology/medicine who came to Britain is perhaps a little further removed from medical science than some of the others. He is a biophysicist who won the Nobel prize in 1970 for his work on physical aspects of the nerve impulse. He was attracted to A.V. Hill at University College, London in an unusual way. Hill had published a lecture on the values of science to which Johannes Stark, a pro-Nazi German physicist (himself a Nobel prizewinner in 1919) had publicly objected. Hill had replied that he had received financial support for the AAC (of which he was vice president) which might have come either from his eloquence or Stark's objections. If the latter he was very grateful to Stark. This light-hearted manner was irresistible to Katz who as soon as he qualified presented himself to Hill, was warmly welcomed, spent most of the rest of his life, succeeded Hill as professor and also became biological secretary of the Royal Society, as Hill had been.
This has been a glimpse into a large story.8 The enforced emigration of scientists (and intellectuals, musicians and artists) in the few years of the 1930s and early 1940s is one of the most remarkable episodes in the history of man—in wickedness and nobility, stupidity and good sense. There has never been anything comparable, nor—as far as I can see—will there ever be. Whether that is so or not, the story carries a powerful, even deadly message, on the danger of intolerance.
David Pyke is publishing a book jointly with Jean Medawar which is scheduled to appear in September 2000. It will be entitled ‘Hitler's Gift’, to symbolize the immense benefit Hitler conferred on British and Western science by expelling so much scientific talent.
Notes
Address correspondence to Dr D. Pyke, Royal College of Physicians, 11 St Andrews Place, Regents Park, London NW14LE 
1 Published 1968 by Hodder & Stoughton.
2 Haber, Meitner and Warburg were Jewish and later driven out by Hitler—except for Warburg who was inexplicably left untouched.
3 One elderly lady dying of inoperable cancer received penicillin to test not its efficiency but its toxicity (with her full consent).
4 Perutz has written a highly entertaining account of his experiences in the New Yorker of 12 August 1985, in which he describes how he helped to set up a university on the banks of the St Lawrence among the numerous academics who had been interned there.
6 Flying to Britain from Sweden in the bomb bay of an RAF Mosquito, Bohr lost consciousness because he had not heard the pilot's instruction to turn on his oxygen. It seems odd to me that a Nobel prizewinner did not think of that himself!
7 Krebs H, Martin A. Reminiscences and Reflections. Oxford, Clarendon Press, 1981.
8 Pyke DA. The Great Insanity. Journal of the Royal College of Physicians 1995; 29:199.
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