Issue 4, Spring 2014

Preparing for the Care of the Aging Child Survivor of the Holocaust

By Dr. Robert Krell

Adult survivors of the Holocaust, age 17 years or older at the time of liberation, experience postwar life differently from those who were under age 16. The older survivors had more Jewish education, memories of family and tradition, lived near and married other survivors and found jobs.  The child survivors not only had less Jewish learning, but were often hidden as Christians. After liberation, they were less likely to live near other survivors and more likely to continue their education. Marriage was usually to a non-survivor or non-Jewish spouse.

These different “streams” of life account for differences in later years that challenge health providers who struggle to care for Holocaust survivors. I will address some of these differences and how they may affect the wellbeing of child survivors who became our patients/clients in later life.You may wonder why I would specifically address the concerns of child survivors. The answer is simple: So you do not forget them, so you do not forget us in your deliberations.

You see, the children who survived have, on numerous occasions, been overlooked. For example, various survivor organizations have existed since the early 1950’s. The first memorial gathering in Vancouver, then called The Warsaw Ghetto Memorial Evening, was held in 1953. And in Los Angeles, the 1939 Club, consisting entirely of Polish-Jewish survivors, was started in 1952 and still has today a membership of 700. No parallel organization knowingly accommodated  child and adolescent survivors.

The Landsmanschaften were founded by survivors who were young adults. It is their determination in remembering, while forging ahead with life, which held our attention well into the 80’s. Even today its leaders remain dominant.

In the 1970’s, the second generation, the children of survivors, discovered themselves. Helen Epstein’s book not only identified the sons and daughters, but the publisher misidentified them in the main title as “Children of the Holocaust.” Therefore, the focus on the survivors through the 50’s, 60’s and 70’s – overlapping with their children, bypassed the actual children of the Holocaust, those youngsters who had lived personally through the inferno.  No organizations existed to accommodate the needs of child and adolescent survivors until the early 80’s.

Who actually qualifies as a child survivor? For what reason does a child survivor deserve special or different consideration? Will the aging child survivors present with problems or concerns at variance with those of the older Holocaust survivors?

In order to approach this topic I will adopt a relatively simplistic definition but one which may help illustrate the points to be made.

For the purpose of our discussion let us consider a child survivor to be one aged 16 and younger in 1945 and an adult survivor 17 and older. It should be obvious that a 17 year old Polish Jew was 11 at the outbreak of war in 1939 and clearly suffered through the war as a child and adolescent. In other words, to classify an adult survivor as 17 or older, does not mean that person did not suffer throughout childhood and/or adolescence. Indeed, what the distinction really does is show that a Polish-Jewish child of 11 had eleven years of prewar experience with family and Judaism, while a Hungarian Jew of 17 in 1945 had sixteen prewar years until the 1944 Nazi occupation.

The intensity of experience with Jewish life and family prior to the outbreak of war diminishes by age.  While children between ages five and ten in 1945 retain some connection to Jewish knowledge and tradition those under five have precious little, if any.

If we use 16 and 17 as a demarcation of sorts, then in order to be a child survivor, the dates of birth should be no earlier than 1928 – 1929 and no later than 1944. Today, the youngest child survivor would be 70, the oldest 85 (as of the year 2014).

Yes, even some children of the Shoah have reached their 70’s and are facing the later stages of life. And, as we face them, it will not go easy. So be prepared.

Let me share with you a brief personal account and skip rapidly to the present. I was hidden for three years in The Hague, Holland with the kindest of hiders – truly righteous. I suffered little, or so I thought.  My parents survived as well, a miracle, for their circumstances were dangerous and terrible. My good fortune was enormous. We were still a family. We came to Canada. I had good friends, worked hard, became a doctor and psychiatrist, then a tenured Professor of Psychiatry at the University of British Columbia. I have a family others envy. Immersed in Holocaust education since 1975, I gathered audio-visual survivor testimonies since 1978, and founded a survivor society in 1985, which opened the Vancouver Holocaust Education Centre in 1994. My Christian parents attended my medical school graduation and my wedding. Although both are now deceased, I continue to have a loving relationship with their daughter, my sister, Nora, and we visit each other as often as possible.

I know the facts of my survival. Little of it is confusing. My story is more or less intact.

In fact, I am proud to announce to you today that I am the healthiest, most together-of-all child survivors. There you have it. Take it from me.

In 1996, I decided to apply for victim status in Holland and seek reparations.  I was asked to see a psychiatrist or psychologist with experience in Holocaust survivor trauma. Regrettably, there aren’t any in Vancouver. A very competent psychologist/therapist with a background in childhood trauma was found, and I went for my two-hour interview. Healthy, well-adjusted child survivor me, walked into his office, offered one sentence, then cried uncontrollably for one hour and stumbled through my story while crying still, for the second.

What is going on? I had it good. Everything turned out alright. I have news for you, disturbing news. It was not good. Which means that the best was not good and that every other child who survived had it worse.

Will you forgive me if I say it simply?  A child needs a year or five of the good life. The child filled with a good life can run on it for many years. The foundation is there, no matter the adversity.

The youngest children of the Shoah were filled, not with comfort and security, but mostly with terror, with insecurity, with loss, with shame – their identities taken, their religion deformed. I have sat across from some and marvelled – how did you make it this far with so little of your entitlement? That is how I have come to view the child survivor – an unfilled vessel, struggling for the sustenance so easily gathered in normal circumstances by children in their formative years.


Pathways – 17 and over

The youths, aged 17 and over in 1945 were 20 by the time they reached new shores. They married early, quickly, often to other survivors. In most countries, perhaps excepting Israel where many went to Kibbutzim, they settled in large urban centres close to one another.

Quite a few of the men had a strong Jewish education until war intervened. If born around 1929, 10 years in Poland, 14 years in Hungary. Women were schooled in Hebrew and in the traditions of home. In short, they had memories, of home and family, of routine and responsibility, of language and culture.

Some radically changed their attitude towards religion after the war, but this group felt comfort with each other, knew the traditions even if they no longer practiced them entirely or in the same way, and they felt at home in a synagogue, a shul. They know what to do.

They know so much. I love to sit with them. They teach me. They have languages, stories, wisdom. Their losses are so enormous, their grief so deep, but there is also a well from which to draw a degree of relief. For they have memories. It is these memories which have sustained the survivor into old age on the one hand, and ravaged him on the other. It is the stuff of precious affirming recollections mixed with recurring nightmares. Each remembrance of what was good carried the memory of its loss, so often in a gruesome manner. And, therefore, there is no greater problem for the aging Holocaust survivor than the ravages of loss of memory, on the one hand, and the often unexpected memories that return, on the other.

The survivor struggles with memory: “I will remember everything, even the horror, for imbedded in those memories are the recollections of the faces of my mother and father, brother and sister, our home, the yard, the tree, the path, the marketplace, my friends, and our enemies. And some of those memories have sustained me to this day, and some of them guided me when raising my children the best I could, for my imagination ends where reality begins.”

The Shoah must be the prime example of a horror that replaces, no, negates imagination. For nothing one can imagine comes close to that reality. No wonder then that it re-emerges in hospitals after anesthesia. No wonder nurses and orderlies are identified as guards and doctors, as Nazi sadists. No wonder that paranoia reigns. It would be so abnormal not to be paranoid.

In my father’s last years, in a Jewish home for the aged, my proud, defiant, stock-straight father, was confined to a wheelchair and had difficulty eating, so most nights I fed him. He had been there at least six months surrounded by caring staff, a reasonable degree of attention and special attention from a family friend who worked there. He motioned me to come close. It was an effort for him to speak. “Rob, get me out of here. Those two nurses over there, say nothing, they are Gestapo.” I wanted to calm him, to reassure him, “Dad, it’s Rachel, you have known her for 30 years.” His response, “She can’t fool me. She is waiting for you to leave, then they’ve got me.” And were these simply the rantings of an elderly, demented man?

In real life he had been summoned three times to Amsterdam’s Gestapo headquarters. Somehow, they let him go three times. He declined the fourth invitation and, most particularly, did not report when our deportation papers arrived. Instead we found hiding places.


Postwar Pathways – 16 and Under

Children and adolescents younger than 16 in 1945 became the focus of much needed attention, for they were orphans, generally too young to set out on their own. The youngest were placed with foster families, which resulted in dispersion throughout the communities in which they were received. They did not have the sense of community of survivors as did the older group. Quite a few were able to resume their education, so they entered the work force late. There was also a greater chance for them to marry a non-survivor and, not infrequently, one who was not Jewish.

Hidden children especially were raised as Christians, at least for a time. With little or no recall of family, tradition or Judaism, and imbued with a crash course in Catholicism, it was not easy for such child survivors to reconnect with their Jewishness. Hence their very identity, precisely the identity for which they were persecuted unto death, was not theirs to accept or reject.

For most it was a fragile beginning. Laced with insecurities, at the mercy of strangers, reliant on an acute sense of surroundings and imminent dangers, quick to learn languages and rituals, slow to speak in order not to betray oneself, cautious about anger and other emotions.

I never complained then, in hiding. I don’t complain now. Sickness was not an issue for us. We could not visit doctors. Giving into sickness meant death. It remains a problem, self- recognition of illness warranting care. Staying upright is what counts. Pain is an irritant.  Having a flu is an interference with work and nothing warrants staying home from work, family illness perhaps, but not mine. It is tough for me to listen to certain complaints.  When I was an intern, I had two wisdom teeth taken out under a short acting, general anesthetic early in the morning and, by 10:00 a.m., picked up another intern to drive to the hospital for work. He asked me about the jar that was sitting on my seat, where, of course, I had my two extracted teeth. It irritates me when I hear of friends taking two or three days to recover and I am not very sympathetic to my children over aches and pains, when perhaps I should be.

If we focus on the issue of memory, perhaps it can be said that child survivors suffer from too little memory, adult survivors from too much. More specifically, the children suffer from fragments of memory, disjointed, confusing, nonsensical. And these grow more intense with time. More vivid and frightening. I think this is so, because hard work and preoccupations with family and personal security have served as a shield until the arrival of a time and age of comparative relaxation. Retirement is a dangerous time. Indeed, for many retirees, it marks the age of nostalgia. When a non-survivor retires, some have the luxury of reflecting at age 60 -70 on a life lived based on primarily pleasant memories of childhood, so pleasant in fact, that few memories are remembered at all. A good childhood leaves few conscious traces of memory. The vessel has been filled with warmth and security, a firm identity. It leaves little to remember other than a threat to physical or emotional security – a broken ankle or a major cut, hospitalization, a fall, the worst – a parental death or divorce.

When an adult survivor reflects, childhood may, in fact, be evocative of pleasant memories until the gruesome terror and experiences shattered all belief in goodness and decency. But there existed a fighting chance to bypass the discontinuity of the Holocaust by linking past to future.

When a child survivor reflects, the abyss beckons. It is straight back into a cellar, a cave, multiple moves and separations, a nightmare melding day into night, sometimes for as long as six years. There is no before. And it was not over in 1945, for it took as many as five to six years more for children to settle into a semblance of permanency and to begin to attempt to recapture an element of security and predictability.


What Can We Expect of the Aging Child Survivor?

What we have seen to date in the field of mental health, with respect to the traumas endured by European Jewry, continues to defy the conventional wisdom of the theories of that time. Today, the focus on trauma has bypassed the survivor of the Holocaust and extends to many other kinds of survivors. While Holocaust psychiatric literature certainly laid the foundations for the understanding of Post-Traumatic Stress Disorder, it has not led to particularly profound improvements with respect to the care and treatment of the Holocaust survivor.

What do we know?  We know that child survivors are fragile beings because of a dreadful beginning and yet, having made it this far, it also demonstrates a toughness, a resilience, a determination that defies conventional understanding of developmental psychology. After all, most psychologic theories would predict a disastrous outcome for children so severely traumatized at so sensitive a time. A friend, Robbie Waisman, 14 years old at liberation in Buchenwald, recalls an assembly at Ėcouis where, in an address by a psychologist or psychiatrist, they were told they could never recover. Few of us can now imagine such words, but the prevailing notion at that time was that anyone who survived while so many perished, must have done something terrible to survive – they must be psychopaths.

Four hundred and twenty-six children and adolescents of the 1,000 or so found at Buchenwald were brought to France to recover, first to Ećouis.

Amongst them were the 16-year old Elie Wiesel, eight year old Lulek, recently Chief Rabbi Israel Meir Lau of the State of Israel, and his older brother Naphthali Lavie, a former Consul General of Israel to New York. There were boys who have become physicians and physicists, businessmen and Rabbis. I know several in Canada and elsewhere who are admired and loved by both their families and the communities in which they reside. Others may not have fared so well, but the universal pessimism proved unwarranted.

And yet – what of later age? What of those who have not yet talked, or offered testimony, or pieced together the fragments of their memory? What of them? They are our special challenge. Can we get to them in time? Will they attend child survivor conferences and form support groups? Will they still join us while there is time, so they can talk to those who truly understand, as we did in New York in 1991 at the first International Gathering of Child Survivors, and again annually every year thereafter?

What we now know is that fragmented memories are dangerous. These shards and splinters of raw and fearsome recollections wound the soul.

You will need to know us very well, although you could never know us completely, because our assumption that you will never truly understand is correct. Fortunately, it is not understanding that the survivor seeks. No survivor truly expects to be understood. Our need is to be heard. How quaint that, after all these years of progress and sophistication in the therapies, it all still comes down to the wounded teller and the healing listener.

Elie Wiesel, in a lecture on the Holocaust Patient, said it so well and it bears repeating. At the conclusion of Wiesel’s lecture in 1981, a doctor stood up and, following a poignant and overpowering talk said, “Professor Wiesel, how shall we treat our survivor patients?”  The answer, “Listen to them, listen to them carefully. For they have more to teach you, than you them.” So I guess we must continue to learn from them, to listen carefully and perhaps they will direct us in the path that will suit their needs at a particular time. If they are properly heard, it is likely you will properly care for them.


Revised version of a 1999 Keynote lecture given at an International Conference on “A Time to Heal: Caring for the Aging Holocaust Survivors.” Baycrest Centre for Geriatric Care, Toronto, Ontario.

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