Autumn 2013

Three Coins from Freud

A doctor-patient relationship spans nations and generations

Handed Down Issue

  • by Peter Schur

On May 6, 1933, my father, Max Schur, was examining Sigmund Freud. By this time, my father had served as Freud’s physician for four years, overseeing his general care—Freud suffered from a heart condition—but especially monitoring and treating the oral lesions that plagued Freud.

My father had become Freud’s physician after being recommended by Marie Bonaparte, the French author and psychoanalyst who was the great-grandniece of Napoleon. Bonaparte had been in Vienna undergoing psychoanalysis with Freud and had need of an internal medicine physician. Coincidentally, Freud also was in need of a physician; he had fired his personal physician after learning the man had kept from him the truth about the malignancy of his oral lesions. Thus, my father began a doctor–patient relationship that endured for 10 years, a decade that would turn out to be a tumultuous one worldwide.

On that day in May, however, Freud was marking his 77th birthday, and my father was awaiting the birth of his first child: me. My mother, Helen, herself a physician, was overdue, a fact that I’m told led Freud to urge my father to go to her side, saying, “You are going from a man who doesn’t want to leave this world to a child who doesn’t want to come into it.” Three days later, I was born. In honor of my birth, Freud gave me three Austrian gold coins.

Remarkably, I still have those coins. I’ve kept one. The others I’ve distributed to my two daughters, so that they each may have something to remind them of the Schur–Freud connection that, in its small way, helped shape history.

Sundered Lives

The world I came into, Vienna in 1933, was a world in turmoil. The day following my birth, for example, the newspapers reported the burning of Freud’s works, an act justified as one “against the soul-destroying overestimation of the sex life—and on behalf of the nobility of the human soul.”

man and woman looking at baby in the woman's arms
The birth of their son, Peter, brought joy to Max and Helen Schur at a time when much of their world was poised for sorrow

In March of that year, neighboring Germany had placed Hitler in power and Nazism was on the rise. With that menace so near, many members of the Jewish population were fleeing, including Freud’s sons and their families. Austria, weakened by a civil war incited by Nazi coalitions within the country, was allying itself with Italy’s Benito Mussolini. In the unsettled period following the assassination of Austria’s Chancellor Engelbert Dollfus, friends and family urged Freud and my father to leave. My father had gone so far as to apply for positions outside Austria, including one in Cairo. But Freud could not be persuaded, and my father, in deference to his patient, stayed. So did we.

In February 1938, Hitler handed Dollfus’s successor, Kurt von Schuschnigg, an ultimatum: capitulate or be invaded. While Schuschnigg considered Austria’s options, my father went to the U.S. embassy to follow up on a visa application he had made the previous year under the Polish quota. My father had been born in 1897 in Stanislaw, a city that was then part of the Austro-Hungarian Empire but which had, in 1919, become part of Poland: thus, he was considered Polish. My father also urged Freud to leave. Freud refused. Soon it was too late for everyone: The German army invaded Austria on March 12 and annexed the country. TheAnschlusshad taken place.

The next few weeks were tense. My parents continued to go to work at the hospital and I to kindergarten. Many of our neighbors flew Nazi flags. There were parades. I remember my parents being afraid. In particular, I remember an episode when Nazis came to our house. I was on the steps leading upstairs. My father was asked about his possessions, and gave over his automobile; an unloaded, fancy revolver; and some gold coins. I was very upset about losing the car, for I remembered riding in it with my father during many pleasurable trips taken around Vienna.

As frightening as that visit was, my parents were thankful that nothing worse had happened. They knew of the concentration camps and exterminations in Germany. Their efforts to leave the country intensified. Soon, through the political connections of many, including Paris-based Marie Bonaparte, exit visas and permit papers for the Freuds, my family, and others were procured.

sigmund freud looking angrily at the camera
Sigmund Freud

On June 4, we were about to leave for London with the Freuds when my father developed an acute severe phlegmonous appendicitis. The Freuds left, but we stayed while my father underwent an emergency appendectomy performed by an “Aryan” surgeon: At that time few Jewish patients were admitted to hospitals and no Jewish physicians were allowed to practice in the hospitals. The Gestapo monitored my father closely; there were interactions between them and my father and mother at the hospital, at our home, and at Gestapo headquarters. Eventually, on June 10, we were allowed to leave. I remember my father arriving at the train station in a wheelchair, still bandaged, with a drain in his abdomen. The next day we arrived in Paris. We stayed there for three days while my father convalesced, then we traveled to London to join the Freuds.

Sea Change

In London, the routine between my father and Freud resumed. But Freud’s malignant oral lesions recurred, and, in February 1939, a lesion developed that was deemed inoperable. After consultations, radiation therapy was begun.

Freud’s end is well known and has been detailed by many. Early in their association, Freud had exacted a promise from my father that he would not allow Freud to die a tortured death. Freud now reminded my father of that conversation and asked him to fulfill his promise. My father consulted with Freud’s daughter, Anna, and, on September 21, 1939, when Freud was again in agony, administered a one-third grain of morphine. His pain relieved, Freud fell into a peaceful sleep, then lapsed into a coma and died at 3 a.m. on September 23.

With Freud’s death, my father’s obligations to his patient were fulfilled, and we could join the masses of people fleeing Europe. In October, we obtained passage on the SS President Harding, sailing from Southampton, England, and stopping in France for additional passengers on its way to the United States. I slept on a cot in the ship’s former drawing room with others, including my mother and my sister, Eva. My six-year-old self remembers our picking up survivors drifting in lifeboats following an attack by a German U-boat, and watching as British warships circled a burning vessel. I also remember that we were hit by a hurricane. From news reports I now know that one crew member died in that storm of October 17, and that 73 passengers and crew were injured, some severely. But I  remember that right before the brunt of the storm hit, my mother performed an emergency appendectomy on one of the crew, with my father administering anesthesia, and the ship’s doctor, fresh out of medical school, assisting.

When a tidal wave from the hurricane hit, I ended up under a pile of broken cots, unscathed. I stayed in a corridor for a few hours wearing a life preserver as water occasionally swished around, and protecting Eva, as my parents attended to more than 100 fractures. The next night we all slept in one bed in a cabin. The next day a U.S. warship passed medical supplies to the ship via a line.

Bites of the Apple

In New York City, we moved first to the Hotel Anderson, at 80th Street and Columbus Avenue, then to 515 West End Avenue. I attended PS9.

My father resumed his private practice of internal medicine. He applied for hospital privileges and was told by all, except Bellevue Hospital, that they did not accept refugees or Jews. At Bellevue he became an internist in the Division of Syphilology and Dermatology. He renewed his interest in analysis and became a member of the British and New York psychoanalytic associations, eventually cofounding the Psychoanalytic Association of New York (Downstate).

small blonde boy playing outside
Schur as a toddler

In the late 1950s, he gave up internal medicine to practice analysis full time. He quit Bellevue and joined the Department of Psychiatry, Downstate NY Medical Center in Brooklyn, where he eventually became a clinical professor. In the late 1960s, he was president of the American Psychoanalytic Association.

My mother became affiliated with the Department of Orthopedics at Mt. Sinai Hospital in New York, where she eventually ran the polio unit, including the respirators, as well as the posture clinic, in the days before rehabilitation units. When vaccines vanquished polio, my mother switched careers and took a five-year residency in adult, child, and adolescent psychiatry at Downstate. This was followed by training in childhood and adolescent analysis. Before being required to retire by New York State (at age 85), she was an assistant professor of psychiatry. Until shortly before her death, my mother continued to see private patients and to work in a children’s clinic in East Harlem.

In the fall of 1969, my father contracted the flu and possibly developed pneumonia. On October 12 of that year, he died in his sleep. My mother outlived him, and, collab­orator to the end, wrote the preface to his book, Freud: Living and Dying, published in 1972.

Unbroken Links

The Schur–Freud connection lingers on in me. After graduating from elementary school, I attended Fieldston High School and went on to attend Yale College. In 1954, I entered Harvard Medical School, graduating in 1958. Anna Freud provided both Yale and HMS with wonderful, strong letters supporting my applications. During the years my father had cared for Freud, I had met Anna on several occasions. I recall her as  a small, kind, fragile-looking lady.

In 1967, I joined the faculty at HMS, and, in 1978, became a professor of medicine at what is now Brigham and Women’s Hospital. My clinical and research interests have focused on systemic lupus erythematosus. I have, over the years, become interested in the psychopathology of that disease and of illness in general. This, I suppose, is another way in which the Schur–Freud connection endures.

Much has been written about this connection, and I have often been asked, “What about the connection hasn’t been told?” I can add nothing, for my father, as Freud’s physician, was discreet about what could be said. If he felt something could not be said, he mentioned it to no one, neither my mother, myself, nor others.

I understand that. I feel that is the type of respect that all physicians owe their patients.

I am my father’s son.

Peter Schur ’58 is an HMS professor of medicine in the Department of Rheumatology and Immunology at Brigham and Women’s Hospital.

Images: Courtesy of the author (Schur as an infant and toddler). Sigmund Freud Collection, Manuscript Division, Library of Congress (Freud)