Medical improvisation and the Holocaust: a microhistory of women in medicine in the twentieth century

This article argues that women Holocaust survivors’ experiences of working in medicine and medical research during World War II and the Holocaust provided them with an unconventional but consequential form of training, not least in what has more recently been conceptualised as ‘medical improv’. While medical improvisation—understood here as the ability to adapt, act reflexively, and draw on tacit and embodied knowledge under conditions of uncertainty and constraint—has gained increasing recognition in medical education and practice over the past two decades, its historical antecedents have received little sustained attention. Existing scholarship on medicine and the Holocaust has focused primarily on Nazi medical crimes and their ethical legacies, on the victims of medical experimentation and on persecuted medical professionals during the war. Building on this work, the present study analyses previously unexplored links between women survivors’ experiences practising medicine under extreme conditions and their subsequent careers in medicine and medical science in the postwar period. Drawing on microhistorical analysis of oral histories, ego documents, biographies and archival sources, it traces how skills associated with improvisation—such as adaptability, ethical responsiveness, emotional intelligence and comfort with uncertainty—were developed through necessity rather than formal instruction. By placing these experiences in dialogue with contemporary discussions of medical improvisation, performativity and care, the article treats embodied practice as historical evidence for forms of medical knowing that conventional accounts of formal expertise have often failed to recognise. In doing so, it broadens how medicine can be historicised and makes visible women Holocaust survivors’ otherwise overlooked contributions to medical knowledge, healing and care.