Hektoen International

A Journal of Medical Humanities


Mary V. Seeman
Toronto, Canada

Małgorzata Grochowina
Warsaw, Poland


Hospital in disrepair. Photography by nijanulu - KNOBZ.NET
Photography by nijanulu – KNOBZ.NET

In 1938, there were 14,000 psychiatric beds in Poland, distributed over thirty-one institutions. One of these institutions was Zofiówka, dedicated to the care of Jewish patients with nervous and mental illness.1 It was opened in 1908 thanks to a donation by Zofia Endelman, for whom the facility was named.2 Its first director was the eminent neurologist, Samuel Goldflam.3 Jakub Frostig was the director between 1932 and 1938. He pioneered insulin therapy for schizophrenia in Poland and was recruited to the US just before war broke out.4 Włodzimierz Kaufman took his place.

As soon as the Germans occupied Poland, they began a systematic extermination of psychiatric patients in the western part of the country.5 The first step was to oust all Polish hospital directors and replace them with Germans. Patients were forbidden to leave the hospital. A list was compiled and divided into three categories: A) Jewish patients, B) chronically ill patients C) patients fit to work. The Jewish patients were shot straightaway. Chronic patients were also murdered, early on by shooting, later by carbon monoxide gas piped into sealed bunkers, later still in specially outfitted gas vans that transported them, as they died, to their burial site in a nearby forest.5 In all, 13,000 patients were killed in Polish psychiatric hospitals during World War Two. An estimated additional 7,000 were probably killed in family care centers, pediatric centers, rest homes, homes for the aged, and other such locations.

The process was somewhat different in the part of Poland that was not officially incorporated into the Reich. In Zofiówka, although there was a German physician overseer, Kaufman and his second in command, Stefan Miller, continued to manage the hospital. Some of their staff fled eastward but were replaced by others from the German-annexed western parts of Poland. On January 15, 1941, a ghetto was created in Otwock and, after June, under the pretext of an alleged typhoid epidemic no one inside was allowed out. Patients could no longer be discharged from the hospital even though Jewish psychiatric patients from all over Poland were periodically transferred to Zofiówka, causing overcrowding and starvation. Out of a total of 406 Zofiówka patients, 210 died of hunger, infection, and cold between June 1 and November 16, 1941.2

Funds from the few paying guests who still came for “rest cures” were used to offset the costs of running the acute hospital. Adam Czerniakow, head of the Judenrat (Jewish Council) of the Warsaw ghetto, describes in his diary going for weekends to Otwock, a sanctuary away from the crowds, the dangers, the terror of the ghetto.6,7 He was one of the few with permission to leave the Warsaw ghetto (the German authorities even provided him with a car) and with funds to pay for the “cure.” Stanislaw Adler recalls in his book, “In the Warsaw Ghetto:”

Every one of us who had been living in the ghetto for a few months deserved, to a lesser or greater degree, to be sent to Zofiówka, but only the wealthy could afford that oasis of tranquility. Before the war, nobody of sound mind would have gone near a mental hospital to find rest but now a stay in Zofiówka became most desirable to many people.

Not even the howling of the mentally ill day and night could disturb their rest, or the fact that the non-violent patients wandered in the gardens and woods and became involved in conversations with the paying guests.8

When the Otwock ghetto was liquidated on August 19, 1942, many of the Zofiówka staff fled. Many, including Kaufman and the Millers, took their own lives. One hundred to 140 patients were shot outright, both children and adults, or else, along with the rest of the Otwock ghetto population, packed into trains for Treblinka to be subsequently gassed to death.2

Ninety percent of the inmates sent to Treblinka died within the first two hours of arriving. The gas chambers continually broke down. As a consequence, some of the incoming Jews had to be shot.9

The local population handed over to the Germans the few Zofiówka patients who managed initially to escape.10

Zofiówka was finally closed in the mid 1990s. It is now abandoned and serves as a favorite site for photographers.11-15 The ruins extend to more than just the buildings. Psychiatric asylums as havens of rest and refuge have ceased to exist. The word “asylum” is now paradoxically synonymous with “madhouse” – a place of bedlam, forced detention, and inadequate treatment.



  1. Puzynski, S., Moskalewicz. J. (2001). Evolution of the mental health care system in Poland. Acta Psychiatrica Scandinavica 104 (Suppl 410:69-73).
  2. Webb, C. (2009). Otwock & the Zofiówka sanatorium: A refuge from hell. Holocaust Education & Archive Research Team http://www.holocaustresearchproject.org/ghettos/otwock.html Accessed Nov. 1, 2013.
  3. Domzał, T.M. (2010). History of Polish neurology and neurosurgery. Samuel Goldflam. Neurologia i Neurochirurgia Polska. [Polish Neurology and Neurosurgery] 44:99-101.
  4. Herczyñska, G. (2007). Jakób Frostig 1896-1959. Postępy Psychiatrii i Neurologii [Advances in Psychiatry and Neurology) 16:275-280.
  5. Nasierowski, T. (2006). The extermination of the mentally ill in Poland during the Second World War. International Journal of Mental Health. 35:50-61.
  6. Czerniakow, A. (1979). The Warsaw Diary of Adam Czerniakow. Hilberg, R., Staron, S., Kermisz, J. (eds.) New York: Stein & Day.
  7. Engelking, B., Leociak, J. (2009). The Warsaw Ghetto; A Guide to the Perished City. Yale University Press, New Haven, p. 248.
  8. Adler, S. (1982). In the Warsaw Ghetto 1940-1943. An Account of a Witness.Yad Vashem, Jerusalem, p.108.
  9. Donat, A. ed. (1979). The Death Camp Treblinka. Holocaust Library, New York.
  10. Engelking, B. (2011). Murdering and denouncing Jews in the Polish countryside, 1942–1945. East European Politics and Societies, 25:433-456.
  11. Markyparky. Zofiówka Psychiatric Hospital. http://www.flickr.com/photos/marekimages/4002789646/ Accessed Nov. 1, 2013.
  12. MrBoblarz. http://mrboblarz.dentart.com/art/Mental-Hospital-Zofiowka-Otwock-312631457 Accessed Nov. 1, 2013.



MARY V. SEEMAN, MD, Professor Emerita in the Department of Psychiatry at the University of Toronto, was born in Lodz, Poland. She has published in the area of women’s mental health and psychosis, receiving numerous awards, including an honorary degree from the University of Toronto and appointment as Officer in the Order of Canada.

MAŁGORZATA GROCHOWINA (nijanulu) is a graphic artist and photographer. She was born in Warsaw, Poland and is a make-up artist for television and commercial production. Her main interests include abandoned buildings and industrial photography. She takes part in KNOBZ.NET project, creating slideshows documenting the life of structures after they have been abandoned.


Summer 2014  |  Sections  |  Hospitals of Note

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