Punitive Medicine

by Alexander Podrabinek, translated by Alexander Lehrman
Karoma (Ann Arbor), 223 pp., $12.95

Soviet Psychoprisons

by Harvey Fireside
Norton, 201 pp., $11.95

Institute of Fools: Notes from the Serbsky

by Victor Nekipelov, edited and translated by Marco Carynnyk and Marta Horban
Farrar, Straus & Giroux, 285 pp., $15.00

The practice of “political psychiatry” has so far been limited mainly to the USSR and, to a lesser extent, Eastern Europe, but it could well spread to any country under authoritarian rule. Essentially it is a secret police tool to intimidate, suppress, or terrorize into recantation through drug treatment the open critics of a regime. In Russia it has roots so deep in the practices of both the KGB and their medical collaborators that even if the Kremlin oligarchy wanted to end the bad publicity it causes abroad, the task of stamping it out would not be easy. Not that there is any clear sign that the current KGB boss Yuri Andropov, a powerful member of the Politburo, is concerned to stop it, rather than just conceal it.

But the domestic opposition to this distinctively twentieth-century perversion of medicine has also been tenacious—in the face of repeated official attempts to destroy it. The books under review are part of a steady flow of documents that record the constant dramas of an inevitably protracted contest and illuminate the subtle grays among the moral blacks and whites. Extra color is added by the rich, often eccentric personalities of some of those among whom the victims of political psychiatry are forced to exist in a variety of mental institutions—genuine lunatics and inspired simulators, brilliant crooks and harmless cranks.

Alexander Podrabinek began investigating political psychiatry in 1973 at the age of twenty. He had already been barred from being a doctor because he was critical of the regime, but he managed to qualify as a medical assistant or feldsher. This put him in an excellent position to gather evidence. Working in the Moscow ambulance service, he saw political dissenters being forced into hospitals. He started to question former victims of such actions, and interviewed current victims and their doctors. He made his own intensive study of official legal and psychiatric literature. He listened to the lectures of leading practitioners of political psychiatry at a Moscow conference.

The book Podrabinek compiled, Punitive Medicine, began to circulate in samizdat in 1977. The next year he was sentenced to five years of exile in Siberia because he had “slandered the Soviet system.” His trial, which became a one day farce, was especially embarrassing to the authorities when a key prosecution witness suddenly confirmed the truth of what he had written. Now he is being held in the coldest inhabited part of the USSR, 5,000 miles from home.

During the years when Podrabinek was secretly working on Punitive Medicine, Sidney Bloch and I were independently researching the same broad topic. Much of our material was the same, and the conclusions we reached were remarkably similar.1 Podrabinek’s book, however, adds much to our own work, particularly in its account of the early history of Soviet political psychiatry, beginning with Lenin’s insistent attribution of mental illness to his foreign minister Chicherin because of the views he held. “We will be fools,” Lenin said, “unless we immediately and forcibly…

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