Healers in the hell of the gulag
ROBERT HORNSBY commends a book that gives voice to those who provided medical care to prisoners in the Soviet Union’s brutal labour camp system
Books about the gulag have overwhelmingly focused on excavating the stories of those imprisoned in the Soviet Union’s vast labour camp system from the 1930s to the 1950s. Or, they have set about uncovering the individuals responsible for the suffering of the incarcerated.
Dan Healey’s new book, however, places at the centre of its attention a constituency that cannot be so easily categorised as either victims or perpetrators: those charged with offering the prisoners medical care. Some were prisoners themselves, fortunate to be assigned work as hospital orderlies, before going on to build medical skills that saved them from far deadlier work elsewhere within the camps. Many were freshly graduated doctors and nurses despatched by the state to work in remote labour camps. Some of these were naïve and eager to serve their country; some were drawn by the higher salaries on offer for work in the gulag; while others were reluctant but unable to refuse such a posting.
Meanwhile, established and respected practitioners were among the hundreds of thousands imprisoned in the gulag – and many of these continued to practise medicine inside the camps under the supervision of far more junior ‘free’ doctors.
The ‘gulag doctors’ whom Healey describes were far more common than you might expect within what was a brutal system. By 1944, there were more than 3,700 doctors across the camp network (albeit such statistics remain hugely difficult to verify).
Healey swiftly and effectively knocks down the claim made by Aleksandr Solzhenitsyn – a former gulag inmate who would go on to become the system’s most prominent chronicler – that there were no “good doctors” in the camps. Healey’s counter-argument – that medicine and those who practised it warrant a place in our understanding of the system – is compelling, and is supported by a hugely impressive array of evidence.
As the author shows, the economic purposes of the gulag – from logging and mining to the construction of vast infrastructure projects – ensured that authorities had an interest in inmates being able to perform physical labour. Drawing on interviews, memoir materials and local history accounts, Gulag Doctors reveals a world in which its subjects faced remarkably complex conditions and dilemmas: striving both to fulfil orders from overbearing security police and camp bosses and to help the sick and dying with the limited resources at their disposal.
This was a deeply stressful environment for doctors, nurses and orderlies. Attempts to get sick prisoners signed off from work could provoke anger and the threat of reprisals from camp bosses with plan targets to meet. But climbing mortality rates also had to be answered for by doctors who were frequently unable to provide their patients with the rest and nutrition that they so badly needed.
Some taught prisoners how to simulate medical problems like gall bladder attacks. Or they filed diagnoses, and ordered treatments intended to protect patients from a deeply inhumane system. Others had to expose growing flows of ‘fakers’ from their overcrowded wards, returning them to forced labour that might well prove fatal.
Gulag Doctors has a great deal to offer for both the academic and general interest reader. Centred upon either a single individual or a small handful of doctors and nurses, each chapter offers fascinating snapshots of a group of people that, until this excellent book, has largely been overlooked.
Robert Hornsby’s books include The Soviet Sixties (Yale, 2023)
Attempts to get sick prisoners signed off from work provoked threats and reprisals from camp bosses with targets to meet