Hektoen International

A Journal of Medical Humanities

Who is “Dr. Filth”?

Howard Fischer
Uppsala, Sweden

Child survivors of Auschwitz some of whom may have been tortured by Dr. Joseph Mengele
Child survivors of Auschwitz, wearing adult-size prisoner jackets, stand behind a barbed wire fence. The group includes a few twins. Still from the Soviet Film of the liberation of Auschwitz by the film unit of the First Ukrainian Front-Alexander Voronzow. 1945. Via Wikimedia. Public Domain.

Bob Dylan’s song “Desolation Row” (1965) is full of recognizable names, both real (Ezra Pound, T.S. Eliot, Einstein) and fictional (Cinderella, Romeo and Juliet). There is also a “Dr. Filth,” whose identity is a subject for discussion.1 He is introduced with the lyrics:

Dr. Filth, he keeps his world/inside of a leather cup/But all his sexless patients/They’re trying to blow it up.

Is this a reference to Sigmund Freud?2 Leather, as in “a leather cup,” has uses in fetishes and sadomasochistic practices.3 Freud, of course, insisted that sexuality played a primary role in both normal psychological development and psychopathology. A “cup” may also be a protective athletic supporter used to protect the male genitalia during sports, thus another possible reference to Freud and his focus on human sexuality. Some of his patients were “sexless” in the sense that they repressed or denied the role of sexuality in the origin of their problems.

“Freud” and “Filth” both start with an “F,” have one syllable each, and are both composed of five letters.4 A detailed description of Freud’s home and offices, however, which resembled “a gallery of antique statuettes, bronzes, and terracottas,”5 did not show the presence of a leather cup. And why would Dylan have such feelings about the father of modern psychiatry? Some authors frankly admit that they cannot figure out who Dr. Filth is.6,7 Dylan scholar Steve Ricks, quoted by Fahmi,8 thinks that Dr. Filth may be Marlowe’s “Dr. Faustus” (1604).

Further lyrics include:

Now his nurse/some local loser/She’s in charge of the cyanide hole/And she also keeps the cards that read/”Have mercy on his soul.”/They all play on penny whistles . . .

Tuffley9 states that “the cyanide hole” refers to the Holocaust. Dr. Filth, in his view and others,10 is Dr. Joseph Mengele, the “angel of death” in the Auschwitz-Birkenau concentration camp. He decided which incoming prisoners were to be killed by inhalation of Zyklon-B gas in fake “shower rooms” (“the cyanide hole”), and which would become slave laborers, to be worked to death.

From among the prisoners, Mengele selected Jews, Roma, the deformed, and especially twins, for sadistic, irrational “medical experiments.” Some of these tortured people did, in fact, become “sexless” as a result of sterilization or castration. It has been established that concentration camp personnel used the skin of murdered Jews to make a type of parchment or leather. Is this in some way connected to the “leather cup”?

A detailed painting11 by Theo Cobb depicts verses from “Desolation Row.” In this painting, Dr. Filth wears black boots and a black uniform under a white coat with a swastika on the breast pocket. His “patients” all have shaved heads.

Finally, the “penny whistles” are thought to represent the whistles on the trains,12 bringing more and more victims to the Nazi “Final Solution.”


  1. Howard Fischer. “Dylan and the Doctors”, Montague Street, 2, 2010.
  2. Eric Bou. “Singing the Everyday, Sign(al)ing the World: On Catalogic Poems,” Arizona J of Hispanic Cultural Studies, 19; 2015.
  3. David Tuffley.” Desolation Row, Bob Dylan, Highway 61, Revisited, 1965,” 2009. hobbit.ict.griffith.edu.au/~davidt/desolation_row.htm
  4. Christopher Rollason. “Filth, Dr.” expectingrain.com/dok/who/f/filthdoctor.html
  5. Edmund Engleman. Berggasse 19: Sigmund Freud’s Home and Offices, Vienna, 1938. Chicago: University of Chicago Press, 1981.
  6. Jens-Erik Larsen. “Analyser Dylans Leger,” Tidsskr Nor Lægeforen, 123: 3441, 2003.
  7. Thomas Johnson. “Desolation Row Revisited: Bob Dylan’s Rock Poetry,” Southwest Review, 62 (2), 1997.
  8. Marwa E.E. Fahmi. “‘Are My Songs Literature?’ A Postmodern Appraisal of Bob Dylan’s American Popular Music Culture,” Humanion, 30 (1), 2018.
  9. Tuffley. “Desolation Row.”
  10. Greil Marcus. “The Old, Millenial America: Bob Dylan and the Traditions,” ch.6, In Millenial Literature of the Americas 1492-2002, Thomas Beebee. ed. Oxford: Oxford University Press, 2009. researchgate.net
  11. “Bob Dylan’s ‘Desolation Row’ Artwork on Canvas.” sharoncol.balkowitch.com/desolationrow.htm, ND
  12. NA. “Bob Dylan. ‘Desolation Row’ Lyrics Meaning.” 2009. lyricinterpretations.com

HOWARD FISCHER, MD, was a professor of pediatrics at Wayne State University School of Medicine, Detroit, Michigan.

Highlighted Vignette Volume 14, Issue 1 – Winter 2022

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