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12 Years That Shook the World Podcast

Documents from Pauline Kneissler’s trial, including photographs of her. —Hessisches Landesarchiv

Released: April 21, 2021

All her life, Pauline Kneissler wanted to become a nurse. And in 1939, she is recruited by the Nazis to be a nurse in a secret killing operation. Will she be forced to murder? Or will she choose to become a killer? Featuring historian Dr. Patricia Heberer-Rice.




Erin Harper It’s three years after the defeat of Nazi Germany. 1948. In a courtroom in Germany, psychiatric nurse Pauline Kneissler, is on trial. A witness testifies against her. He says, “... Pauline [Kneissler] greeted me very warmly … And one comes away saying, ‘Oh, that’s a fine nurse… . She’s taking splendid care of my mother.” But, he said, “In doing so she was the murderer of my mother.”

Pauline Kneissler was found guilty of this murder, and hundreds of others in mental health facilities across Germany. She murdered her patients willingly—as a nurse who bought into Nazi ideology at its core. But why?

From the US Holocaust Memorial Museum, this is 12 Years That Shook the World. I’m Erin Harper.

Pauline Kneissler was born and raised in the Russian Empire. She came from a wealthy family with German roots. Her father managed a large estate, and provided Pauline with a private tutor. But after the rise of communism, the newly-formed Soviet Union government threatened violence against the wealthy, and stripped Pauline’s family of their money. With nothing left—they fled. Pauline and her family moved to Germany to try to rebuild a new life.

Dr. Patricia Heberer-Rice They end up in Germany and she has to go to work.

Erin Harper That’s Dr. Patricia Heberer-Rice, Senior Historian of the Jack, Joseph and Morton Mandel Center for Advanced Holocaust Studies at the Museum.

Dr. Patricia Heberer-Rice She becomes a nurse. And all her life, she’s wanted to be a pediatric nurse.

Erin Harper Pauline finds work as a pediatric nurse at a prestigious institution in Germany. But a few years later, with state spending cuts, Pauline loses her position. She transfers to a mental health facility.

Dr. Patricia Heberer-Rice And she becomes a psychiatric nurse. And so she’s not altogether happy with this, but she has to make money. And she obviously has her goals set on being a very good nurse.

Erin Harper By now, in the the late 1920s, the Nazi Party is gaining popularity in Germany. And it appeals to Pauline because it promises hope, and a new beginning in Germany—a country struggling to recover from the first World War. And the Nazis, like Pauline, are anti-Communist. So Pauline joins the Nazi Party, and later becomes a leader in a Nazi women’s organization.

By the time World War II begins, Pauline had been working as a psychiatric nurse at German facilities for more than a decade. But her life is about to take a significant turn—when she gets an invitation from Nazi administrators.

Dr. Patricia Heberer-Rice In December 1939, Pauline is summoned to Berlin. Where administrators informed this handful of basically young female nurses that this new government program that’s going to grant a mercy death to seriously ill and suffering patients.

Erin Harper The Nazis’ systematic murder of European Jews, was not the regime’s only program of mass murder. In 1939, the Nazis secretly begin this program, called “T4”—named after the address of the program’s office in Berlin.

Dr. Patricia Heberer-Rice The T4 program is one of the many radical measures that the Nazis undertook to restore what they understood to be the racial integrity of the German nation. And it targets for killing mentally and physically disabled patients housed in institutions throughout Germany, and in German-annexed territories. People who had some severe intellectual, or developmental disability, a severe physical disability, or incurable mental illness, who were seen to pose both a genetic as well as a financial burden on the society and the state.

Erin Harper For example, a mother of three, who was diagnosed with epilepsy. A 3-year-old girl, with an intellectual disability, and a middle-aged man with bipolar disorder. The Nazis believed these people posed a threat to the Nazis idea of a pure German race.

Dr. Patricia Heberer-Rice Really what’s happening is, beginning in 1940, patients begin to be removed from their home institutions and taken to one of six killing centers throughout Germany and Austria and within hours of their arrival at one of these facilities, they’re gassed in specially-designed gas chambers, and they’re cremated in special crematory ovens.

Erin Harper After being summoned and briefed on the T4 program, Pauline Kneissler accepts the role in this killing operation. She’s sworn to secrecy. Pauline’s initial responsibility in the program is to help transport victims to T4 facilities. About 70 people a day. She also prepares patients—undresses them, and escorts them to the gas chambers.

Dr. Patricia Heberer-Rice We should be clear that at this stage, nurses did not murder patients. They’re really playing a supporting role. A physician usually facilitated the gassing. So at this point, she’s an accessory to murder.

Erin Harper Despite the fact that the Nazis tried to keep this mass murder program a secret, word got out. Some German citizens and clergy protested. So in mid 1941, the Nazis paused the T4 program for about a year. But in this time period—Pauline Kneissler’s next activity was perhaps her turning point.

Dr. Patricia Heberer-Rice Pauline joined in an activity that’s been shrouded in mystery for us. In the winter months of 1942, she’s asked, along with other T4 staff, to volunteer for a secret mission in the east, which they called the “Eastern Mission.”

Erin Harper By this time, in the east, German soldiers had invaded the Soviet Union in World War II. According to post-war hearsay testimony from Pauline’s colleague, Pauline allegedly said the goal of this Eastern Mission was to murder wounded German soldiers on the front—soldiers who were suffering from severe head trauma, or severe psychiatric disorders—manifested from war trauma.

Dr. Patricia Heberer-Rice Pauline tells her colleague she especially, quote, “regretted giving injections at a reserved military hospital in Russia from which the soldiers died painlessly,” end quote. And this is hearsay testimony. We don’t know if it’s true, but if it is, this is where Pauline crosses the line, going from being an accessory to murder, to killing with her own hands.

Erin Harper After participating in the Eastern Mission, Pauline Kneissler returns to nursing in Germany. By this time, the T4 program is operating again. And medical professionals at a mental health facility called Kaufbeuren have started murdering patients.

Kaufbeuren sits in the hills of the German countryside. Inside, rows of small beds are spaced just a few feet apart. Young patients lie in their beds, and older patients play board games at a table. Outside, a patient roams the grass with a cat in her arms. And nurses watch over.

The facility also has an annex building—about a half mile away. And there, gray buses are arriving, full of new patients. The staff puts them into little rooms in the facility. One by one—the patients disappear. And soon another bus arrives with more patients.

By this time in the T4 program, nurses have started murdering patients by lethal overdoses of medication—like luminol or morphine. And in 1944, Pauline Kneissler is sent to work in the women’s ward.

Dr. Patricia Heberer-Rice When Pauline Kneissler begins to work in the women’s ward at Kaufbeuren, the mortality rate soars. She murdered patients by administering lethal overdoses of medication. We don’t know how many persons she actually murdered, but it must have been in the hundreds. And she’s typically killing people on the night shift. And it looks very normal to kill people in the evening before they go to sleep for the evening. These are psychiatric patients. Some of them are very restless. And so it looks very ordinary and common to give these individuals medication for them to get some rest.

Erin Harper Then, Pauline begins work in the annex building at Kaufbeuren. And there—is a young boy named Ernst. He’s 14, and was sent to Kaufbeuren a few years prior, after a state psychiatrist labeled him a psychopath. And one night in August of 1944, Pauline Kneissler visits Ernst during her shift. She administers Ernst an injection—a lethal dose of morphine. Ernst falls into a deep sleep. Shortly after, Ernst is found dead.

Pauline took Ernst’s life, but his story would serve as evidence of the murder of German patients at the hands of medical professionals. After the defeat of Nazi Germany, Ernst’s fate was taken up by American prosecutors in the Nuremberg Doctors Trial. In this trial, 23 leading German physicians and administrators were tried for their participation in this program, and other crimes. Many were found guilty. And Pauline Kneissler faced her own trial in the newly-reconstructed criminal courts after the war.

Dr. Patricia Heberer-Rice She’s, of course, complicit in all these thousands of murders. And she freely admits this. Pauline Kneissler is sentenced ultimately to four years in prison, of which she serves three and a half years. And following her release, she immediately gets a nursing position in West Germany at a relatively well-known mental health facility. And she’s pensioned in 1963 with a state pension. Living that full life while she took the lives of so many.

Erin Harper You might imagine that Pauline Kneissler and these other medical professionals were forced to murder patients. But that’s not the case. Early on in the T4 program, many doctors and nurses were given a choice. In her post-war interrogation by US army war crimes investigators, Pauline Kneissler said, “It was completely voluntary.”

Dr. Patricia Heberer-Rice Most of them concurred in the post-war, that they had encountered really no overt pressure to commit to this program. Pauline Kneissler, though, is one of the only T4 nurses in the post-war who was really clear on this point. She says, “we nurses were sworn to secrecy, we were informed of this program and we’re simply given a few minutes to reflect on whether we like to participate or not.” She says, “we didn’t feel very good about it. But we had no moral reservations.” And all of these young women said yes.

So many of the individuals who are recruited are people who’ve just shown their reliability to the party and to its ideology—she’s politically reliable, and she’s politically convinced—and that’s why Pauline shows up in Berlin in 1939 and she’s recruited for this program.

Erin Harper It’s impossible to know why, exactly, Pauline Kneissler bought into Nazi ideology—and why she chose to kill for its cause. Was it her drive to be a nurse—at any cost? Was she running from the political turmoil that stripped her of her wealth? Or was she looking for something to believe in?

Pauline Kneissler was not alone in her choice. Several hundred other German medical professionals participated in the T4 killing in some fashion. And after the war, many also served minimal prison sentences, and returned to their role as medical professionals.

In total, they claimed the lives of about a quarter million people—both children and adults. In Germany, patients’ medical files are sealed after their death. So today, we still don’t know the identity of many T4 victims. There is growing will in Germany to name the victims of this program, but there are still significant legal challenges.

From the US Holocaust Memorial Museum, this is 12 Years That Shook the World. I’m Erin Harper. Joining us today was Dr. Patricia Heberer-Rice, Senior Historian of the Jack, Joseph and Morton Mandel Center for Advanced Holocaust Studies at the Museum.

Our story is informed by the work of Dr. Michael von Cranach. Our show is produced by myself. Our stories are researched by Meredith Gui. This podcast is funded in part by support from the Crown Family Philanthropies and from Laura Ginns and Family. Listeners, we want to hear from you. Tell us what you think of this episode. Send an email to, or talk to us on social media. We are @HolocaustMuseum. If you love our show, please follow us on your favorite podcast app. Thanks for listening.