Published 12 December 2008, doi:10.1136/bmj.a2953
Cite this as: BMJ 2008;337:a2953

Feature

Christmas 2008: Formative Years

Not becoming a communist doctor

¹ Bury St Edmunds IP30 0DA

Being a medical student in Hungary in the 1950s was not straightforward for A P Barabas

Recently, I was miraculously reunited with my "Leckekönyv" (fig1). English has no satisfactory single word for a leckekönyv, but the Magyar-Angol dictionary defines it as a university registration document. Mine was issued in the autumn of 1953, and it records my progress through three years as a medical student in Budapest, Hungary.

View larger version (116K): [in this window] [in a new window] [PowerPoint Slide for Teaching]   Fig 1 Registration document issued by the medical school of Budapest in 1953; it serves as a testament to the state of medical education under communism

 
In 1953 Stalin died, and this triggered a power struggle in the Russian Politburo, closely mirrored by an upheaval among Hungary’s Muscovite leaders. How did the Byzantine machinations of the time affect medical students?

Political events in Hungary, 1945-56 1945—Free election in Hungary; the Communist Party suffers humiliating defeat 1948—Stalin’s "salami tactics" launched to eliminate all opposition to communism March 1953—Stalin dies; struggle between hardliners and reformers in the Kremlin begins June 1953—"Stalin’s best disciple" in Hungary, Rákosi, forced to resign; Imre Nagy appointed as prime minister and initiates reforms January 1955—Rákosi returns to power; Nagy branded a "right revisionist" February 1956—Khrushchev makes a "secret" speech denouncing Stalin’s crimes July 1956—Rákosi resigns (again) and leaves Hungary; Ern Ger appointed 23 October 1956—Student demonstration turns into an uprising 31 October 1956—Russians withdraw, start negotiations with Imre Nagy 4 November 1956—Russians reinvade, crushing the uprising; Imre Nagy arrested and executed November, December 1956—200 000 refugees flee Hungary

The medical curriculum

My leckekönyv records the subjects we had to study during my first semester (fig 2). Physics, chemistry, anatomy, and biology were taught, but we had few textbooks. This was partly because of postwar shortages but also because many of the heads of preclinical departments were replaced by communist cadres, who were too busy attending arty meetings or too ignorant to write textbooks. As the departments lacked good projectors and slides, lecturers used the blackboard. Drawing well requires not only talent but also practice and planning. Our champion artist, one of the assistant professors of anatomy, could draw with both hands simultaneously, while continuing with his lecture. I am indebted to him, for my first publication in the BMJ was on blackboard drawing in medical teaching¹.

View larger version (139K): [in this window] [in a new window] [PowerPoint Slide for Teaching]   Fig 2 Subjects studied during the first semester in the medical school of Budapest in 1953 (English translations added later)

 
We also studied compulsory non-medical subjects: four hours a week of marxism, two hours of Russian, and three hours of military practice. As the only qualification required for becoming a lecturer in marxism or military practice was ardent support for communism, our indoctrinators were ill educated and spoke ungrammatical Hungarian. To make the marxist indoctrinators feel ill at ease, we studied those parts of Das Kapital (Karl Marx’s deadly boring colossal tome) that dealt with difficult concepts, such as a critique of Hegel’s theory of dialectics. We asked searching questions on these philosophical topics and enjoyed the lecturers’ discomfort when they could not answer them. Officers of the Hungarian army instructed us on the workings of rifles and machine guns, not realising that training in these weapons would benefit us during the anti-communist uprising, which was waiting to explode.

In an atmosphere of paranoia and corruption, typical of communism, all examinations had to be verbal, because no head of department was trusted to keep questions secret, no printer would refuse a bribe, and no assessor would mark the examination papers fairly. So we had to go through time consuming viva voces one by one in front of a panel of examiners, always under the supervision of a Communist Party representative, who entered our marks in our leckekönyv.

Extracurricular reading

In 1956, our favourite reading outside medicine was the Hungarian Literary Gazette. But how did this previously unreadable Communist Party organ metamorphose into what we considered a revolutionary journal? In the past, all its intended publications had to be vetted by the communist censors, but towards the end of 1955 its editor, Endre Enczi, encouraged by the contradictory messages received about the future direction of Hungarian politics, took an unprecedented brave step: he "forgot" to send up prepublication copies of articles to party headquarters for approval. He waited tensely the outcome of this disregard for authority; as only two years earlier such an action would have resulted in his arrest and imprisonment for undermining the party’s authority, but no reprisals resulted this time; in the turbulent and confused days of 1956, he got away with it.

Recently, I have reread some of the uncensored articles that gave us so much hope and encouragement and I was amazed how timid and tentative they seemed in retrospect. A great deal of self censorship must have been still taking place. For instance, Tibor Déry’s short story "Behind the Brick Wall" describes how some employees stole from their workplace and how their foreman decided not to report them. There is no political comment or criticism in this piece, just a realistic description of how factory workers speak, behave, and influence one another. Yet—at the time when social realist writers had to express boundless optimism and support for the achievements of the working class—the mere admission that some workers stole from their nationalised factory was a revolutionary statement.

We rejoiced in the refreshing change of tone in the Literary Gazette but remained sceptical about the authors’ motives. We remembered how the same writers had voluntarily penned nauseating eulogies to Stalin and Rákosi. Their sudden conversion seemed to us the result of their instinct for self preservation—acquired during Stalin’s murderous purges—and we believed that they were simply positioning themselves in case more liberal communism would prevail.

Admirable personalities

We reserved our admiration for those few outstanding personalities at the medical school, like the professor of medicine, Imre Haynal (fig 3), who consistently defied both fascism and communism. Haynal spent 1928 and 1929 in Sir Thomas Lewis’s cardiology and research department at University College Hospital, London. On his return, he was appointed professor of medicine in Kolozsvár (now called Cluj and in Romania), and in 1945 he became dean of the medical faculty at the same university. At this time a gang of fascists attempted to eject Jewish students from the medical school, but Haynal stood in their way and refused them entry to the campus. After the war, but before the communist takeover in 1948, he was invited to head the internal medicine department in Budapest.

View larger version (127K): [in this window] [in a new window] [PowerPoint Slide for Teaching]   Fig 3 Professor Imre Haynal: "Cigar in mouth, hand in pocket, brains in the head, and Haynal in our hearts." Reprinted with permission from Domahidy2

 
Haynal always filled the largest auditorium of the medical school, but despite his popularity as a lecturer, a tired medical student once fell asleep in the front row. Haynal whispered something to his assistant, who soon returned with two cups of coffee. Haynal woke the slumbering young man and told him, "My dear young colleague, it seems that we both had a hard night and it will do us good to drink these double espressos."

His lectures were sprinkled with anecdotes. For instance, when Haynal went to say his goodbye to Sir Thomas Lewis before returning to Hungary, Haynal was carrying three newly purchased books. Sir Thomas asked him what English books he was taking back to Hungary, and, when shown, he disapproved of all three authors. H G Wells, he said, was unsuitable, because he had a mistress; Oscar Wilde was beyond the pale as a homosexual, and Chesterton—said Sir Thomas with a shudder—was a Roman Catholic. This anecdote amused us because it was common knowledge that Haynal was a practising Catholic and also had a mistress.

But Haynal was not our hero for his wit and erudition, but because of his undisguised contempt for communism. When a picture of Lenin was hung in the corridor of his department he built an altar to the Virgin Mary facing the image of this communist saint. Officials ran hotfoot to warn Haynal that this would result in retribution, and he told them, "I take down my altar only if you remove Lenin," which they reluctantly agreed to do.

How did Haynal get away with such ridicule of communism? Partly because he was a brilliant physician, consulted by patients from all walks of life, including the Ern Ger, the secretary of the Hungarian Communist Party. He also had an international reputation as an outstanding cardiologist and as someone who stood up against fascism during the second world war. But even with all this in his favour he was kicked out of his professorial chair and compulsorily retired after the Russians brutally suppressed the Hungarian uprising.

The fate of students

One quarter of students in my year escaped from Hungary after the uprising. Of those who stayed behind, scores were arrested, imprisoned, or barred from further study. One medical student, Ilona Tóth, was executed, but after the collapse of communism in 1989, a statue was erected in front of the main building of the medical school, commemorating her martyrdom (fig 4).

View larger version (72K): [in this window] [in a new window] [PowerPoint Slide for Teaching]   Fig 4 Ilona Tóth, medical student, was executed by the communists after the Hungarian uprising

 
I was among those who fled. In November 1956, my mother, brother, and I crawled across the still partially fenced and mined border to Austria. We brought nothing with us at the time, but at a recent ceremony in Budapest, at which I received an honorary membership of the Hungarian Association of Surgeons, somebody in the audience handed me my leckekönyv.

Cite this as: BMJ 2008;337:a2953

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Competing interests: None declared.

Provenance and peer review: Not commissioned; not externally peer reviewed.

References

1. Barabas AP. Blackboard drawing in medical teaching. BMJ 1965;i:782-4.
2. Domahidy M, ed. Ilyen volt Haynal Imre. Bern: EPMSZ, 1989.

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