Abstract
My grandfather was a prominent Jewish physician in Nazi Germany who escaped the Holocaust with his family but nevertheless came to a tragic end. As I, an American family physician, learned more about him, I was surprised by how much I identified with him. I was struck by how his success in his career had not been matched in other areas of his life, leaving him little to fall back on when his professional status was taken away. My grandfather’s story has given me insights about him, my family, and myself and has taught me important lessons about the balance between professional and personal life.
On a laptop computer, we watch the old silent home movies of children, including my father, Peter, playing in the garden. We are in that same garden now, and my young son, Peter, watches with me. I find myself telling the current owner of the house, in broken German, that I have just as nice a garden in California. I am surprised to feel tears on my cheeks.

Dr Caesar Hirsch, 1885-1940.
Ninety years ago, the garden belonged to my grandfather, Caesar Hirsch, the founding chief of otolaryngology at Stuttgart’s Marienhospital and a researcher with over 100 scholarly publications, mostly about topical anesthesia. No one imagined that these scenes of domestic tranquility soon would be shattered. He was a Jew, and soon after the Nazis took power, he was tipped off by a former patient that his life was in imminent danger. The next morning, he performed his scheduled surgeries and then fled with his family, unable to take along money or possessions that might arouse suspicion at the border.
As a skilled physician, he confidently promised his family that they would be fine in another country. He was offered a job in Fascist Italy but did not feel safe there. They went instead to Paris, but France did not welcome German refugee physicians. An American relative managed to get him a visa, something still possible in 1933 before the flood of European refugees. So he went to New York, one of the few states that allowed German physicians. He had no American certification to practice in his specialty but managed to find some sort of medical work to support his family in a middle-class lifestyle. I don’t know the details, but he must have found it deeply unsatisfying.
He thought his break finally had come when he got an offer to join a medical practice in Seattle. He studied for and passed the necessary licensing exams with flying colors and drove across the country with his family, but by the time he arrived, the offer was rescinded. He tried instead to open a private practice in Seattle, but the patients didn’t come. His resources and spirit exhausted and broken, he watched as Hitler’s armies swept across Europe while America seemed oblivious. He fell into a deep depression and in 1940, at the age of 54, killed himself.
I never thought much about my grandfather for most of my life. I don’t recall that my grandmother ever mentioned him. On the rare occasions that my father did, it was usually to point out his flaws: he was authoritarian and critical and had a temper—a tragic, failed figure. Perhaps it was too hard to forgive the unkept promise that everyone would be fine, though he left life insurance that provided for his widow and his children’s education. But it was more than that. No one seemed to miss him much.
My rediscovery of my grandfather began by accident. He had a large personal medical library that included books of the trade for a practicing otolaryngologist a century ago along with older medical texts he collected. These were confiscated by the Gestapo along with everything else and ended up in the library of the University of Tübingen, where he had once studied. Dr Hans-Joachim Lang, a journalist and historian who specializes in remembrance of Holocaust victims, stumbled upon the collection of Caesar’s books and was curious who he was. He managed to unravel the mystery and track down the family in America. Eventually, the books were returned to the family, and they now have a new home in the University of California library.
My father gave a speech about my grandfather’s life at the ceremony when the collection was donated to the UC library. He spoke with pride about Caesar’s professional achievements and sympathy for the trials of his last years. It was more than I had ever heard him say about his father. The extensive collection of materials, including many of Caesar’s own writings, spoke to the breadth of his intellect and professional achievement. I began to see him in a new light.
Last summer I took my teenage son on a long-promised trip, delayed by COVID-19, to visit the home of his ancestors. I hoped this would be a meaningful experience for him, but I never expected the impact it would have on me. We visited the Catholic hospital that my grandfather helped to build and walked the halls of the old hospital building he once walked. I was surprised that the head nun and the ear, nose, and throat physicians knew exactly who my grandfather was and received us graciously.
We visited the family home. The house was new, bombed out in the war and reconstructed in a different plan. But the garden was still the same with many of the old trees, and a plaque placed by the city on the sidewalk marked that my grandfather once had lived there. Dr Lang showed us the files he had collected about my grandfather, including a letter of recommendation from the head nun of the Marienhospital back then. It said that he was an outstanding physician and researcher and an excellent colleague who provided care for all, regardless of their station in life—exactly what I would want someone to say about me.
Questions began to fill my mind. How could a man remembered by strangers almost a century later be so forgotten by his family? Was he just the stereotypical distant authoritarian German father figure, or was there something worse? If ever there had been a loving relationship between him and my grandmother, why didn’t she tell us about him? I had heard vague suggestions that he may have killed himself for the life insurance money. If so, yes, this was a failure, but it was also an act of love. Why was it so utterly unappreciated? How much of the family’s attitude toward him was deserved? I cannot tell you why I never asked these questions before. We family physicians are often worst at analyzing our own families. Now those who might have given me answers are gone.
I wonder if things could have been different. Would a better balance between his professional and personal life have helped him withstand the loss of his professional status? Perhaps he could have built a positive new life with his family, even without the leadership role he once had, grateful at least to have escaped the Nazis and come to America as so many others could not. Maybe modern antidepressants could have pulled him through the crisis and helped him reach a less tragic end. Was he like Lot’s wife in the Bible, paralyzed by looking back instead of forward? Or was he just too tired and discouraged to keep going?
The world still has much to learn from the holocaust. It required persistence to convince the University of Tübingen to return Caesar’s stolen books to my family. The University of Freiburg took away his medical degree during the Nazi times for the crime of being a Jewish refugee, and they have refused requests to reinstate it. On a grander scale, we see the resurgence of totalitarian regimes and dictators starting wars of aggression while the world’s democracies waiver.
I also have lessons to learn. Uncovering the truth about my grandfather has not changed the world, but it has changed me. I have discovered ways that I am like him and ways that I do not want to be like him. I give and expect more now in my relationships and am ready to move on when necessary, looking forward instead of back. I have learned to be a little less full of myself and more thankful to live in a free country. As physicians, we know that health and life are fleeting, but we imagine that our position and status are earned rights that are inalienable. We are wrong. Careers can be derailed in many ways, and heaven help us if this is all we have.
And what about those of us lucky enough never to have our life uprooted or our professional identity stripped? Could we be happy with just our personal life if our professional life was lost or taken? Or are we giving ourselves a pass, settling for mediocrity or worse in our personal lives, as we never would professionally? If so, is this not our own slow-motion tragedy?
He was a physician and a scholar, brilliant at times, domineering and distant at others, a proud man of great initiative struck down by forces beyond his control. I will not judge him or believe I am a better man than he was. I never knew him, but I have not forgotten him. And I will try to learn from him.
Footnotes
Conflict of interest: author reports none.
- Received for publication November 10, 2022.
- Revision received March 7, 2023.
- Accepted for publication March 29, 2023.
- © 2023 Annals of Family Medicine, Inc.