Henry Norman Bethune was a
doctor; adventurer; artist; poet; dandy; rebel; philosopher; social visionary
ahead of his time; humanitarian; political agitator; teacher; guerrilla;
revolutionary; inventor of tools and
gadgets; medical innovator; founder and administrator of
hospitals and public health services.
He is revered as a saint in China . IN 1972 he was declared
"a Canadian of national historical significance" by the
Canadian Federal Government, and "the world's best known
surgeon" by his medical colleagues. His contributions to
military medicine is indisputable. Yet to his contemporaries he was
a brawling, egocentric, alcoholic philandering swashbuckler, took to
bedding the wives of his colleagues. Who was the real Henry Norman
Bethune ?
This is his story.
Norman Bethune was born on March 3, 1890, into a prominent Scottish Canadian family in
Even as a youngster, Bethune stood out for his wide-ranging curiosity, and
was variously described by his peers as independent, restless, reckless, driven
energetic, and stubborn. Since his father's occupation involved frequent moves,
the boy attended a series of different schools. In 1908, at the age of 17, he
completed his high-school in Owen Sound
collegiate, Ontario .
after a spell as a primary-school teacher in the village
of Edgeley , north of Toronto ,
he enrolled in the University
of Toronto in 1909, to
study physiology and biochemistry. Even as a medical student he demonstrated
the compassion and commitment to helping less fortunate people that later
became the dominant feature of his unorthodox but highly creative medical
career. In 1911 he deliberately interrupted his studies for one year to become
a volunteer worker-teacher with Frontier college, a unique canadian adult
education agency, to teach immigrant laborers at remotr lumber and mining camps
throughout northern Ontario
to read and write English.
When Canada
entered the First World War in august 1914, Bethune, in a flourish of
patriotism, joined the Canadian Army Medical Corps. He was the tenth person in
the City of Toronto
to enlist in the army. In February 1915 he was with the No.2 Field Ambulance as
a stretcher bearer in France and witnessed some of the worst slaughter ever
suffered by Canadian troops.In April the same year, during the second battle of
Ypres in Belgium he was badly wounded by shrapnel in the left knee. He spent
six months in hospital, first in France
then in England ,
before being invalided home. After returning to Toronto , he pinched pennies and worked his
way to a medical degree in December 1916. Dr Frederick Banting, one of the
discoverers of insulin, was in his graduating class.
Bethune returned to
While in Edinburgh
Bethune met the strikingly beautiful Scottish woman, Frances Eleanor Campbell Penny, eleven years his junior.
They were complete opposites : she was a subdued introvert; he was a brash
extrovert. In spite of their differences and the resistance of her upper-class
parebts, they married in 1923. The same year Bethune passed the difficult
examination to qualify as a Fellow of the Royal college
of Surgeons in Edinburgh . After the wedding the couple went
on a one year " Grand Tour " through continental Europe ,
where Bethune demonstrated his spendthrift ways. One time they had run out of
money in Vienna ,
so Bethune got a friend to wire him some emergency money. On the way home from
collecting the money, he spent it all on a piece of fine China that he saw in
an art shop, much to the displeasure of his wife. In one year Bethune managed
to spend his wife's entire inheritance. But the trip was not a total loss, ever
the diligent student, Bethune took time off to observe the work of leading
surgeons in Paris , Vienna
and Berlin .
After the honeymoon and with little money,the couple settled in Detroit , Michigan ,
where Bethune took up private practice and a part-time job as an
instructor at the Detroit College of Medicine and Surgery. During the two years
in Detroit Bethune gained first-hand, personal knowledge of poverty, as his
practice put him in daily contact with the poor and their never-ending medical
and financial problems. Later as his surgical fame grew, rich patients came and
paid handsomely, sometimes for what he regarded as trivial services. Gradually
Bethune came to realize the extent to which money was corrupting the medical
system.
The Bethune marriage was tempestuous, and as time went by, Bethune
and his wife drifted apart. A passionate, energetic man, but also
impatient and authoritarian, Frances found his irascibility,
among other things, difficult to live with. At the time Bethune
was also heavily absorbed in his work, and Frances often found herself
alone at home. Tired of their quarreling, particularly over money matters,
in 1925 she went to stay with friends in Nova
Scotia . Then personal tragedy struck. In
1926 Bethune, a smoker, contracted moderately
advanced tuberculosis due to overwork. After treatments in Detroit and at the Gravenhurst Sanatorium, he was sent in
late 1926 to a sanatorium at Saranac Lake , by the Adirondack Mountains in upstate New York . In 1927,
believing he was dying, he insisted Frances divorce
him and return to her native Scotland .
In the 1920's the conventional treatment for TB was total bed
rest, and the prognosis was generally poor. By October 1927 a
year had passed and the TB got worse. By
chance Bethune came upon a book: " The surgery of Pulmonary
Tuberculosis", and learnt about a radical new surgery for
tuberculosis called artificial pneumothorax. This involved
artificially collapsing the diseased lung, thus allowing it to rest and heal
itself. Intoxicated by renewed hope, Bethune burst into the
middle of a staff meeting and demanded that artificial pneumothorax be
performed on himself. The physicians at the Trudeau thought the procedure
was too new and too risky, whereupon Bethune bared his
chest and laughed aloud, "Gentlemen, I welcome the
risk!" Progress was spectacular after the operation. Bethune
was sputum negative two months later,and was able to leave Trudeau in good health
by December 1927 .Before going, he drafted a plan for a university programme to
be conducted at the sanatorium, to prepare patients vocationally and
psychologically for their return to normal life. Ten years later at Saranac Lake his dream became a reality.
Upon recuperation Bethune immediately wrote to his wife and proposed marriage again. At first she refused but eventually they were remarried in 1929. The marriage did not last, and they were divorced again for a final time in 1933. However, though they were unable to live together, they always stayed in contact and remained genuinelly fond of each other ..
During his stay at
Under the final drawing he wrote :
Sweet death, thou
kindest angel of them all.
In thy soft arms, at last O let me
fall;
Bright stars are out,
long gone the burning sun
My little act is over and
the tiresome play is done.
Bethune experienced
wide swings in mood throughout his life, passing from a deep
depression as expressed in his murals
to a high euphoria . After surviving
tuberculosis, he was convinced he should devote his life to
crusade against tuberculosis and the social conditions that caused
it. He wrote to the pioneer in lung surgery, Dr. Edward William
Archibald, the Surgeon-in-Chief of the Royal
Victoria Hospital
in Montreal (the teaching hospital affiliated
with McGuill University ) for a training post in
thoracic surgery . Archibald suggested that he spend a preliminary period
with Dr David T. Smith, later Head of Bacteriology at Duke University ,
at a tuberculosis hospital in Ray Brook, New York. Doctor Smith said later
that Norman
learned more about bacteriology in 3 months than most graduate students
learned in 3 years. Bethune was with Archibald first as a trainee and then
as a colleague from 1928 to 1932, where he dove into the field of thoracic
surgery "with a zest that only a condemned man saved by a last-minute
reprieve can feel."
Bethune caused much controversy within the medical community
because of his "devil-may-care" lifestyle and his unorthodox
approach to Medicine. He dressed flamboyantly, drank heavily and socialized
with artists. He was too exuberant, too impetuous, too headstrong to fit in
with the other staid medical doctors. In 1964 CBC journalist Marjorie
McEnaney interviewed doctors and nurses who knew him at the Royal Victoria
Hospital ,
who recalled his legendary impatience in the operating room : an operation
taking most doctors two hours would be whipped through by him in fifteen
minutes. Archibald who trained Bethune described his surgical technique as
"quick but rough, not careful, far from neat, and just a little
dangerous." He would shout torrents of abuse at any nurse unable to
keep up with his fast and furious pace, and half way through an
operation would fling an instrument to the floor because it was not
performing well. Once the operation's finished he would storm off to his
study and scribble away at diagrams until he had come up with a better design
for the instrument. He had a marked genius for mechanical innovations and
developed or modified more than a dozen new surgical tools which were
soon being used by thoracic surgeons throughout Canada and other
countries. His most famous instrument was the Bethune Rib Shears, inspired
by a set of leather cutting shears he saw in a shoe repair shop.
This table-mounted scapula retractor (the iron intern) was a forerunner of
the automatic table retractor now widely used in abdominal and thoracic
surgical procedures today.
Bethune clashed with many of his colleagues because of his impatience
and outspoken criticism of ideas he didn't agree with, but in research he had
infinite patience, and was forever testing and perfecting new ideas in the
laboratory. He published 14 papers of lasting
significance, describing his innovations in thoracic surgical techniques
and suggested improvements.
Young
doctors generally liked Bethune. He was an enthusiastic and gifted
teacher, informal, outgoing, dynamic,cheerful, and in the words of Wendell
MacLeod, a medical intern at the Royal Vic from 1930 to 1932, he was a
"breath of fresh air". He used the small group approach and
picked specific patient to demonstrate different disease. He listened
with genuine interest to what the students found on examination
and what they thought. He enjoyed ridiculing conventional practice,
and his energetic pursuit of new approaches was especially refreshing to young
trainees who were tired of dry formal instruction. A case in point was the
successful use of maggots to heal chronic empyema resistant to standard
drainage procedures. Young doctors also appreciated his frank
presentations at meetings of the American Association for Thoracic
Surgery, though his manuscript on "Twenty-Five Errors I Have Made in
Thoracic Surgery" was never published. Bethune had a warm and
considerate bedside manner, and took a personal interest in the welfare of patients. A
dashing figure, Bethune would sat on patients' beds and
frankly discuss with them and their relatives the pros and cons of each
treatment.
He was also popular with many of the nurses who found him
attractive, and he had a reputation of being a womanizer. According to his
biographer Roderick Stewart, both medical and non-medical "polite
society" in Montreal regarded Bethune
as shocking and rude. The nonconformist, provocative side of his
character finally caught up with him, and in the fall of 1932 Archibald
dismissed him. By this time Bethune had already gained certain
surgical fame among the thoracic surgeons of Canada
and the United States .
The
eight years in Montreal ,
Bethune developed his creative talents. He wrote plays, poetry and
short stories. He was then 45 years of age, twice divorced, restless, and
seeking new challenges. He plunged headlong into Montreal 's social whirlpool.As a successful surgeon
Bethune was earning an extravagant salary, which he also spent
extravagantly. His Beaver Hall apartment was filled with all that's
luxurious, sensuous and artistic .He supported young Canadian artists, designed
his own furniture, and befriended actors. He gave his friends free run of his
apartment, and they repaid in kind. At one evening party, Bethune told his
guests he needed a new wallpaper in the bathroom. They
immediately smeared their mouths, hands and feet with lipstick and printed
a figured wallpaper for him. A rebel against the pretentiousness of
his profession, Bethune hung his diplomas, which other doctors displayed with
pride in their offices, in that same bathroom.
An accomplished artist, Bethune found release and relaxation in painting. He
loved children,in June 1936, together with the artist Friedrich Wilhelm
Brandtner, an exponent of a new theory
on art training for children, he founded Children's Art Center -
first of its kind in Canada
- to give free workshops in oil and watercolor painting
to underpriviedged children from five to fifteen years. The classes
were held in Bethune's Montreal
apartment three afternoons a week .Every Saturday Bethune took the
children to the art galleries, and explained to them the art exhibits. The
school created quite a stir in Montreal
art circles, and there were public showings of the children's paintings. Some
of Bethune's pieces, such as Night operating theatre (completed
around 1934), were exhibited in Montreal.In his diary Bethune wrote down
his definition of a true artist - " he makes uneasy the static,
the set and the still. In a world afraid of change, he preaches revolution, the
principle of life. He is an agitator, a disturber of the peace, quick,
impatient, positive, restless and disquieting. He is the creative spirit
working in the soul of man."
Bethune had to wait a year before getting the post to head a new
chest surgery department at the Roman Catholic Sacre
Coeur in Cartierville, north of Montreal, because the Archbishop and
the nuns at the hospital had reservations about his "une vie de
boheme". Now that he was his own master, he gave full rein to
his talents and creativity. Both the hospital and Bethune flourished ; the new
clinic soon became an important surgical TB treatment center in French
Canada, and the years Bethune spent at its helm were among the most productive
in his short surgical career. He performed 300 operations during the first
year, many on advanced bilateral cases of tuberculosis; trained qualified
surgeons, and introduced new techniques, such as person-to-person blood
transfusion, while continuing to invent surgical instruments and publish
scientific articles.In 1932 he was made a member of the American Association
for Thoracic Surgery and three years later he was elected to its council.
From
1935 to 1936, Bethune's life abruptly changed from apolitical exuberance
to political intensity. At an artists' gathering, he met then fell in love
with a painter, Marian Scott. Marian was involved in left-wing politics, and
her husband, Francis Reginald Scott, a poet and law professor at McGuill University , was an important member of
the Co-operative Commonwealth Federation. Through his socialization with
literary and artistic people, Marian Scott in particular, Bethune was
introduced to new political ideas.
Against a backdrop of Economic Depression, Bethune became increasingly
disillusioned with surgical treatment and more concerned with the socioeconomic
aspects of disease. He noticed for every case of TB he cured, ten new cases
flared into the open, because TB fed on poverty. Five years after the Stock
Market crash, poverty was the spreading disease. He wrote in the Journal of
the Canadian Medical Association in July 1932:" Tuberculosis was not just
a disease but rather a problem arising from the socioeconomic system. The rich
recovers and the poor man dies. Lack of time and money kills more cases of
pulmonary tuberculosis than lack of resistance to that disease ." Bethune
was greatly troubled by the unattended suffering among the poor and with the
impulsiveness with which he threw himself into any new cause that drew him, he
opened a free clinic for any man, woman or child sent to him by the Montral
Unemployment Association. Thia was the context in which his acute social
conscience and his growing interest in communism developed, thus politics was a
preoccupation for only the last four years of his life.
In August 1935, Bethune traveled to the Soviet Union
to attend the 15th International Physiological Congress. While he was
there he visited Russian hospitals in Moscow
and Leningrad (St Petersburg ) and observed first
hand the Soviet medical system. He was deeply impressed by it, and by the
preventive methods used to fight tuberculosis there. Bethune began to believe in
the necessity of free medical care for all members of society. On his
return he reported to a distinguished medical-surgical society in Montreal that " Russia presents today the most
exciting spectacle of the evolutionary emergent and heroic spirit of man"
This brief visit also led him to learn more about communism. On his return to Canada in November 1935, he formally joined the
Communist Party (then an illegal organization)in Montreal with goals to change the world for
the better.
In the course of that fall, he organized a study group called the
"Montreal Group for the Security of the People's Health" which
consisted of about a hundred like-minded doctors, nurses, and social workers.
Bethune recognized that good medical care depended on team effort, and
under his direction, the group met regularly to examine the health-care systems
of other countries with a view to induce radical reform of medical and
health care services in Canada .
After about six months of study and discussions, the group came up with a
Four-Point Plan: Municipal Medicine ; Compulsory Health Insurance; Voluntary
Health Insurance, and Free Medical Care for the unemployed. In the summer of
1936, at the time of a provincial election, the Plan was submitted to the government,the
opposition party, and health-care workers. The general public and politicians
reacted negatively, while some doctors exhibited frank hostility. The
speech he gave to the Medico-Chirurgical Society of Montreal , titled " Taking the Private
Profit Out of Medicine " struck the medical profession at the time as
socialized medicine, and led to his expulsion from the
Society. Bethune grew increasingly frustrated by the failure of the
Medical Reform Plan and openly expressed contempt for his own profession. He
felt Canada
closing in on him and saw himself as a " big frog in a small pond ".
In mid-July 1936, the Spanish Civil War broke out.It started as a
right-wing nationalist military uprising led by Francisco Franco, against the
newly elected leftist Popular Front government. The Nationalists were
backed by fascist Germany
and Italy , while Russia was on
the side of Popular Front. The civil war was looked upon as a battle
between fascism and communism , and Spain became a popular cause among
many of the leftist artists and writers in the rest of the
world. Bethune saw this war as an opportunity to fled from his
on-going discontent. He realized by now he could never have a real romantic
relationship with Marian Scott; then of course the thrill of a
risky adventure and an international stage on which to fight
a humanitarian cause was resistible. He resigned from
his position at the Hospital du Sacre- Coeur, made his will leaving everything
to his ex-wife, and joined the Committee to Aid Spanish Democracy(CASD), an
organization of Canadian Communist sympathizers. Twelve hundred Canadian
supporters went to Spain
under the banner of the Mackenzie-Papineau Battalion, of these Bethune was
the most famous.
Bethune set off for Spain
on 24 October 1936, taking medical supplies with him. He was strongly motivated
to fight fascism, and wrote a friend :" It is in Spain that the
real issues of our time are going to be decided. It is there that democracy
will live or die." This was an irrevocable turning point in his life .
On 3 November Bethune arrived in Madrid , and teamed up with Henning Sorensen,
a multilingual Danish-Canadian journalist. After meeting with medical elements
Bethune found there were enough foreign surgeons already in Spain . Not
one to submerge himself anonymously in a hospital surgical team,
Bethune also recognized that the only way to raise
the publicity profile of the Canadian Committee was for him
to spearhead a specific medical service. After an inspection of hospitals
in Madrid
which revealed a severe lack of facilities for blood transfusion, he
decided the best way he could help was by providing a blood-transfusion
service. In late November,he went with Sorensen to London to buy the necessary equipment.
Back in Madrid ,
he set up the Servicio Canadiense de tranfusion de Sangre in mid December.
Theteam was made up of three Canadians, an American woman, and a few
Spanish doctors, to collect blood from donors. They made a public appeal in Madrid and in one
month had 1,000 donors listed who were called upon every 3 weeks if necessary
for a 500 ml donation. The donors received a cup of coffee and a coupon
for extra food. By January 1937, Bethune's unit was supplying 60 hospitals in
the Madrid
region.
A frequent cause of death on the battlefield is medical shock brought on
by loss of blood, but the standard practice at that time was to transfuse
wounded soldiers only after they had been brought from the front lines to
hospitals in the rear, which was often too late. In a TV clip first shown
on 30 Nov 1980, Sorensen recalled how Bethune uttered the words that
revolutionized military medicine :"I have an idea, I think we should
organize an ambulant blood transfusion service."
Bethune elected to lead his team as close to the front line as he could
and transfuse on the spot. His concept was simple but innovative : extrate blood
from volunteer donors in various cities, store it in refrigerators ( with
sodium citrate added to prevent clotting) which would preserve it for two or
eben three weeks, and deliver it to where it's needed, when it's needed, via a
specially outfitted vehivle. The mobile transfusion vehicle he constructed
incorporated a small refrigerator run by kerosene or gasoline, a sterilizing
unit, an incubator, and equipment for drawing and administering blood
transfusion in the field .
This mobile unit also contained dressings for 500 wounds, and enough
supplies and medicine for 100 operations. " In all, our equipment
consists of 1,375 seperate pieces," wrote Bethune in December. The
Instituto Canadiense de transfusion de sangre ( Canadian Blood Transfusion Service)
transfused its first patient on 3 January 1937. Five months later the
transfusion Unit _ composed of a central station which delivered blood to one
hundred sub-stations strung along a front of over 600 miles ( 1000km) ,
supplied every military sector in Spain and administered up to 100 transfusions
per day to wounded soldiers. Where refrigeration was not available, the
precious blood containers were kept in cold mountain streams close to firing
line. This mobile blood-transfusion service had drastically reduced fatalities
among the wounded, in some sectors as much as 75 %.
Bethune's
pioneering battlefront mobile medical unit is viewed by medical historians
as an important innovation to military and medical history. It's considered to
be a precursor to the later development of Mobile Army Surgical Hospital
(MASH) units, the portable surgical hospitals first set up in 1945,
and would prove seminal to the Allies in World War II. It was later
widely used in the Korean War (1950-53).
Not
content with dealing just with medical therapy, Bethune had an idea of setting
up a convalescent club run by an International Nursing Corps of French, German
and English nurses, who could then comfort each of the wounded
multi-national Brigade in his own language.
Bethune had a flair for publicity. He made frequent broadcasts to America and
wrote articles and poetry on the horrors of war. "Spain ,”he wrote
later," is a scar on my heart.”One of his most well-known poems was
published in the 1937 July issue of Canadian Forum magazine:
And the same pallid moon tonight,
Which rides so quietly, clear and high,
The mirror of our pale and troubled gaze
Raised to a cool Canadian sky.
Which rides so quietly, clear and high,
The mirror of our pale and troubled gaze
Raised to a cool Canadian sky.
Above the shattered
Spanish troops
Last night rose low and wild and red,
Reflecting back from her illumined shield
The blood bespattered faces of the dead.
Last night rose low and wild and red,
Reflecting back from her illumined shield
The blood bespattered faces of the dead.
To that pale disc we
raise our clenched fists,
And to those nameless dead our vows renew,
“Comrades, who fought for freedom and the future world,
Who died for us, we will remember you.”
And to those nameless dead our vows renew,
“Comrades, who fought for freedom and the future world,
Who died for us, we will remember you.”
Bethune was reckless in the field. When Franco shifted the battle to
the south, Bethune ignored all warnings and headed straight for Almeria . Malaga had just been
bombed . With his Canadian companion Hazen Sise, Bethune arranged a
marathon rescue relay to help the thousand upon thousands of evacuees from Malaga to reach the relative safety of Almeria . For two
days and two nights without sleep he stayed behind caring for the wounded as
they limped or crawled by the wayside. The memory of the pitiful children
haunted him for weeks, and resulted in his idea of building a chain of
Children's Villages to care for war orphans. The Spanish Aid Committee in Toronto eventually raised
money for the building of the first two Children's Villages. Bethune
later wrote an article recalling the brutality he witnessed called
"The Crime on the Road; Malaga
to Almeira".
Though Bethune worked extremely hard and showed great compassion for his
patients in Spain , he
also continued his womanizing, hard-drinking ways. His brash, opinionated
nature and quick temper frequently got him into trouble with many of
the Spanish Communists, with the result four and a half months later,
following a feud, the previously independent transfusion unit was taken over by
the Spanish Republican Government. By April 1937, Bethune's closest
colleagues, Sorensen, Hazen Sise, and Allan May,were all concerned that
Bethune's escapades of vulgar partying, sex and diversion of funds
was hurting Canada's image. However, the triggering event which led to his
removal was typical Bethune -- involvement with a female he
promoted to administrative rank who had little work merit. By
mid-May, Bethune was in Paris living well on CASD money and on June 2 he was
under escort by a member of the Canadian Communist Party en route across
the Atlantic back to Canada, ostensibly to embark on a cross-country
speaking tour to raise funds for the Spanish cause.
Bethune arrived back in Montreal
on 6 June1937, after an absence of 8 months, to a hero's welcome. One thousand
met him at Windsor Station in Montreal and that night 8,000 people, a capacity
audience, heard him speak (without notes), on the bravery of the Spanish
people. He was a good speaker and his talks stimulated a moral and
financial response far beyond all expectations across Canada . With
expert help, he produced a propaganda film about the transfusion
service,"Heart of Spain", which was distributed in North
America .
By Oct 1937, tired of the touring, Bethune requested to be
sent back to Spain . But
the CASD had received a Spanish police report that a Swedish female
journalist Bethune was romantically involved with
was suspected to be a fascist spy and Bethune was no longer welcome
in Spain ,
so he was offered instead a medical mission in support of the Chinese
Communists who were fighting Japanese invasion
With the support of the Communist Party of Canada and the New
York-based China Aid Council, Bethune set sail for Hong
Kong on 2 Jan 1938. He was accompanied by Jean Ewen, daughter
of a prominent Canadian communist and a registered nurse. Ewen had worked
in a Shantung Hospital for 2 years and was fluent
in Chinese. They landed in Hong Kong on the 27th Jan. Bethune,an avid
correspondent all his life, wrote from Hong Kong and
explained why he had come:“I refuse to condone, by passivity, or default,
the wars which greedy men make against others. Spain
and China
are part of the same battle. I am going to China because I feel that is where
I can be most useful.”In China Bethune craved his most enduring legend.
The troupe flew from Hong Kong to Wuhan ,
the provisional capital of the Kuomintang (the Chinese Nationalist Party), and
met Chou En Lai, later premier of China . After working briefly
in several cities, Bethune decided to go to Yan'an, the then Chinese
Communist capital in Shaanxi
Province . Travelling
by truck and by train, by mule cart and on foot, Bethune and Ewen made the
epic 800 mile journey through enemy-held territory and eventually
arrived at the headquarters of Mao Zedong's 8th Route Army 5 weeks later. En
route they treated combat casualties and narrowly escaped capture by the
Japanese. On the 22 March they were greeted by Zhu De, the
commander-in-chief of the 8th
Route Army.
On 31 March Bethune met with Mao Zedong, who was president of
the Revolutionary Military Council, in his cave dwelling. Their discussion
lasted the entire night. Mao, recognizing Bethune's potential value,
immediately made him a member of the Communist Party of China, and gave him
free rein to organize a front-line service for the wounded.
After a month or so in Yan'an, on May Day in 1938, Bethune,at his own
request, together with Ewen, travelled northeast to the
frontier isolated mountain ranges of Jin (Shanxi)-Cha (Chahar)-Ji
(Hebei), where fighting was extremely fierce and there were only a few
qualified doctors to care for the 13 million people (sick peasants as well as
wounded soldiers)in the area. On 17 June 1938 Bethune arrived in Jingangku,
a village on the Wutai Shan mountain, which
was the headquarters of Commander-in-Chief Nie Rongzh. Nie promptly
appointed Bethune the Medical Commander to all Chinese
Communist Eighth Route Army medical forces. In total 1,000
battles were engaged during Bethune's tenure.
China was in desperate struggle against incredible odds.With at least
25,000 wounded always in the hospitals, there were only five qualified Chinese
doctors, fifty Chinese untrained " doctors"- peasants who had picked
up the merest rudiments of operating by observation-, and Bethune, the only
foreign doctor. There were few surgical supplies or medicines, and the "
hospitals" were mostly just peasant huts.
Bethune was disappointed to find his ambulant blood transfusion
system couldn't work in China .
There was little electricity for refrigeration and the road conditions
were too poor.With his genius for originating and organising, Bethune
quickly conceived the idea of a mobile medical unit which travel directly to
the fighting front and treat the wounded on the
spot. The operating team consisting of Bethune, two Chinese
doctors, an interpreter he had trained as an anesthetist, a cook, and two
orderlies. The mobile surgical unit consisted of a collapsible operating
table designed by Bethune,a full set of surgical instruments, antiseptics, 25
wooden splints, sterile gauze, and medicine, all built to fit onto
the backs of two mules. In case of sudden enemy advane, the
whole hospital unit could be packed up and on the move within half an hour.
The mobile units were particularly well suited to the guerrilla campaign
being waged against the Japanese. Bethune and his operating theatre was
often within minutes of the shifting frontline of the guerrilla
fighters. On horseback he led his mobile operating unit through the
barren Wu Tai mountains of Shanxi province and
across the Hebei
plains, covering hundreds of miles at a stretch, over tortuous
mountain paths and primitive country.
Bethune worked prodigiously and took very little rest. He was always close
to the fighting and forced to work under extremely harsh conditions, often
engaged in marathon surgical sessions as casulties mounted.In April 1939,
during the battle of Qihui led by General He Long, he and his team performed
115 operations in a 69 hour period - without sleep.His mobile unit helped
save at least 500 lives a day and continued operating under terrible
conditions. While working in the makeshift mobile unit was
strenuous, conditions in the base hospitals were even worse. These were
built wherever there was space, in temples, huts or caves; they had poor
lighting, only benches or planks for beds, often without blankets.The
sanitary condition was horrendous.
Bethune did not distinguish between casualties, and treated wounded
Japanese prisoners as well as Chinese soldiers. After one night of steady
operating, he wrote " Wounds", a poignant critique of
imperialist war. This is an extract from the article :
Any more?
Four Japanese prisoners. Bring them in. In this community of pain, there are no
enemies. Cut away that blood-stained uniform. Stop that haemorrhage. Lay them
beside the others. Why, they're alike as
brothers! Are these soldiers professional man-killers ? No, these are amateurs-in-arms. Workman's hands. These are
workers-in-uniform.
No more. Six o'clock in the morning. God, it's cold in this room. Open the door. Over the
distant, dark-blue mountains, a pale, faint line of light appears in the
east. In an hour the sun will be up. To bed and sleep.
But sleep will not come. What is the cause of this cruelty, this stupidity?
A million workmen come from Japan to kill or mutilate a million Chinese workmen. Why should the Japanese worker attack his brother worker, who is forced merely to defend himself. Will the Japanese worker benefit by the death of the Chinese? No, how can he gain? Then, in God's name, who will gain? Who is responsible for sending these Japanese workmen on this murderous mission? Who will profit from it? How was it possible to persuade the Japanese workmen to attack the Chinese Workman – his brother in poverty; his companion in misery?
Is it possible that a few rich
men, a small class of men, have persuaded a million men to attack, and attempt
to destroy, another million men as poor as they? So that these rich may be
richer still? Terrible thought! How did they persuade these poor men to come to
China? By telling them the truth? No, they would never have cone if they had
known the truth, Did they dare to tell these workmen that the rich only wanted
cheaper raw materials, more markets and more profit? No, they told them that
this brutal war was “The Destiny of the Race,” it was for the “Glory of the
Emperor,”it was for the“Honor of the State,” it was for their “King and
Country.”
False. False as
hell!
The agents of a criminal war of
aggression, such as this, must be looked for like the agents of other crimes,
such as murder, among those who are likely to benefit from those crimes. Will
the 80,000,000 workers of Japan, the poor farmers, the unemployed industrial
workers – will they gain? In the entire history of the wars of aggression, from
the conquest of Mexico by Spain, the capture of India by England, the rape of
Ethiopia by Italy, have the workers of those “victorious” countries ever been
known to benefit? No, these never benefit by such wars. Does the Japanese
workman benefit by the natural resources of even his own country, by the gold,
the silver, the iron, the coal, the oil? Long ago he ceased to possess that
natural wealth. It belongs to the rich, the ruling class. The millions who work
those mines live in poverty. So how is he likely to benefit by the armed robbery
of the gold, silver, iron, coal and oil from China? Will not the rich owners of
the one retain for their own profit the wealth of the other? Have they not
always done so?
It would seem inescapable that
the militarists and the capitalists of Japan are the only class likely to gain
by this mass murder, this authorized madness, this sanctified butchery. That
ruling class, the true state, stands accused.
Are wars of aggression, wars
for the conquest of colonies, then, just big business? Yes, it would seem so,
however much the perpetrators of such national crimes seek to hide their true
purpose under banners of high-sounding abstractions and ideals. They make war to
capture markets by murder; raw materials by rape. They find it cheaper to steal
than to exchange; easier to butcher than to buy. This is the secret of war. This
is the secret of all wars. Profit. Business. Profit. Blood money.
Behind all stands that
terrible, implacable God of Business and Blood, whose name is Profit. Money,
like an insatiable Moloch, demands its interest, its return, and will stop at
nothing, not even the murder of millions, to satisfy its greed. Behind the army
stand the militarists. Behind the militarists stand finance capital and the
capitalist. Brothers in blood; companions in crime.
What do these enemies of the
human race look like? Do they wear on their foreheads a sign so that they may be
told, shunned and condemned as criminals? No. On the contrary. they are the
respectable ones. They are honored. They call themselves, and are called,
gentlemen. What a travesty on the name, Gentlemen! They are the pillars of the
state, of the church, of society. They support private and public charity out of
the excess of their wealth. they
endow institutions. In their
private lives they are kind and considerate. they obey the law, their law, the
law of property. But there is one sign by which these gentle gunmen can be told.
Threaten a reduction on the profit of their money and the beast in them awakes
with a snarl. They become ruthless as savages, brutal as madmen, remorseless as
executioners. Such men as these must perish if the human race is to continue.
There can be no permanent peace in the world while they live. Such an
organization of human society as permits them to exist must be
abolished.
These men make the
wounds.
This passage is all the more relevant today as Japanese
militarism is once again on the rise.
Bethune took it upon himself to work feverishly in an endeavour
to make improvements to China 's
medical system. He worked with Chinese carpenters and
blacksmiths and invented several instruments, including a wooden
packing container that greatly facilitated the transport of drugs and
supplies, which could also double as operating table. Because of
its shape, he gave it the Chinese name lugou qiao (Marco Polo
bridge).
One of the most pressing needs was to train individuals to provide basic
first aid and sanitation services and to carry out simple surgical
procedures.In January 1939 Bethune organized a week of intensive
training in the village of Yangjiazhuang. In August and September, he
supervised a five-week program and trained everyone from orderlies to nurses
to surgeons. This led to the opening, on 15 September, of a permanent
model hospital(also to be used to train doctors and nurses),in Sung-yen
K'on.
Bethune designed and established over twenty teaching and nursing
hospitals. With adequate translation he taught hands-on surgery, and trained a
large number of medical cadres in basic medical techniques. He performed near
miracles by taking illiterate peasant boys and uyoung workers and made doctors
( the Barefoot doctors ) and nurses out of them. Another major achievement was
improvement in sanitary conditions.
Bethune wrote and illustrated elementary medicine and surgery
textbooks and graphic manuals for wartime surgery, as there was none
available.The same year he produced another first- a medical manual devoted
entirely to guerrilla warfare, known in Chinese as "Youjizhan zhong shi
yezhan yiyuan de zuzhi he jishu," and in English as "Organization and
technology of division field hospitals in guerrilla war."
Victum
still of his own foul temper, Bethune at times of frustration would lapse into
his infamous behaviour. Jean Ewen described his near psychopathic rage : "
Dr Bethune was furious, I had never seen such a temper brfoe......He stomped
and kicked everything in sight " Yet his demeanor altered when he was with
the sick. " He was very tender with the wounded, and very concerned
," Sorensen , his Spanish interpreter, recalled," It seemd his whole
personality changed when he went in among the wounded. He was a terribly
complex man." An assistant in China ,
Chu , also remembered how he was with a 5 month
old baby with severe malnutrition, all matchstick limbs and a huge belly. The
baby cried incessantly out of hunger. Bethune excavated a can of milk, a spoon
and a cup with his sack and told Chu to get
some hot water. Together with the mother, Bethune spoonfed the baby a whole cup
of milk. The next morning the mother thanked Bethune profusely, saying the baby
had not slept so well for many nights. The doctor just stood there grinning from
ear to ear .
Another
story told how 10 days of continuous heavy rain caused raging floods in the Hebei
North End village, and Bethune was very upset as he watched houses, trees and crops
being washed away. When the flood threatened the Military Medical
School , he undressed, jumped
into the river and joined the rescue of the precious equipment. Because there
were no boats, flat basket trays were tied to ladders to hold the cargo , a row
of 10 people held hands to seady the ladder while Bethune swam and pushed
the ladder along from the side. They had to make a dozen trips to transfer all
the material to dry ground, all the while Bethune told jokes about the swimming
practices he did in the lakes back in Canada .
The soldiers adored him. Word quickly passed from mouth to mouth inChina of the
amazing Canadian doctor who shared his clothes, his food, and even his blood
with wounded soldiers and civilians. He won the admiration of
the locals by accepting their customs, sleeping in their homes, and
suffered the same hardships as they. His name sparked the courage of
thousands of Chinese soldiers, he was their war cry :" Attack! Bethune is
with us !"
The soldiers adored him. Word quickly passed from mouth to mouth in
Bethune's letters from China ,
however, betrayed the many trials and personal hardship he endured.
Isolated, experiencing a foreign culture, eating sparsely, and clothed in the
threadbare uniform of a common Chinese soldier, he sometimes expressed a
longing for the comfort of home: " I dream of coffee, of rare roast beef,
of apple pie and ice cream. Books- are books still being written ?
Is music still being played ? Do you dance, drink beer, look at pictures ? What
do clean white sheets in a soft bed feel like ? Do women still love to be loved
?"
Since his arrival at the frontier, Bethune had lost a lot
of weight. He was forever surpassing his own records of fortitude, exhausting
even to contemplate. He seemingly survived only by sheer will. Long
hours, poor food and overwork had taken their toll, the once proud,
virile body was thin and bent, the handsome face now deeply lined and
scarred by suffering. In a letter written in August 1939, he states that
his teeth and his eyes are in bad shape and that one ear has gone
deaf. Near the end at the age of 49 he looked 75. The Chinese
affectionately called him " The Old Man".
But given the choice, Bethune would still have preferred to toil under
adversity in China
rather than live in luxury back home. The radical doctor who was scorned and
shunned by the elite of Canadian medical society found solace and a sort of
redemption among the Chinese peasants. In a letter to a friend in August 1938,
Bethune wrote: " It is true I am tired but I don't think I have been so
happy for a long time. I am content. I am doing what I want to do.....I have no
money nor the need of it- everything is given me. No wish. no desire is left
unfulfilled. I am treated like a kingly comrade, with every kindness, every
courtesy imaginable."
In
each letter home Bethune pleaded for more supplies and
money. Supplies were dwindling to a trickle: lacking even ether for urgent
surgery. Bethune worked on, by now bitterly resigned to the fact that the aid
he entreated would not come. In late 1939 Bethune planned
to return to North America for a fund-raising
tour, but delayed his departure when the Mount
Motien (摩天岭)broke
out in his area in Laiyuan
County .
Painstaking down to minute details with the care of his patients, he
was appallingly reckless with his own. On 28 October, even as the
Japanese were seen advancing on the temple where he and his staff were
operating, Bethune refused to evacuate before he had operated on all the
wounded. In the ensuing rush, while operating barehanded (there were no
surgical gloves) on a soldier whose head wound was badly
infected, Bethune accidentally nicked the middle finger of his left
hand. Immediately he plunged his hand into iodine solution to disinfect
the cut but continued operating. It wasn't the first time he had cut himself in
an operation. He was sure this would heal. But the cut did not
heal. Despite their best effort to drain the infection, it spread. His
hand and then his arm became badly swollen. Amputation of his arm was
suggested, but Bethune rejected the idea. He knew his death was imminent. Blood
poisoning had set in; his whole body was infected. His Chinese comrades
tried to carry him to get help on a litter, but there was no help
available. In America
and Europe there were drugs that might have saved him, but out here in
that remote, war-torn corner of China there were none.
Exhausted by his poisoned system,
Bethune wrote one final letter, describing first his condition :" Vomiting on stretcher all the day. High fever,
over 40C. I think I have either septicemia from the gangrenous fever or typhus
fever. Can't get to sleep. Mentally very bright. Phenacitin and Aspirin, Woven's
powder, antipyrin, caffeine, all useless." He then set out his last will and
requested that some money be provided by the Chinese Aid Council to his divorced
wife. His responsibility to her, he maintained, "is undeniable.” He also listed the basic pharmaceuticals his
group needed " Each year will need to buy 250
pounds of Quinine and 300 pounds of iron, specifically for Malaria patients and
a significant number of anemia patients . Do not go to Baoding-Tianjin area to
buy drugs, because the price is twice as expensive as Hong Kong and
Shanghai.". The part addressed to General Nie read : "Dear Commander Nie,
Today I feel really bad. Probably I have to say farewell to you forever ! Please
send a letter to Tim Burke the General Secretary of Canadian Communist Party.
Address is No.10, Wellington Street , Toronto , Canada . Please also make a copy for
Committee on International Aid to China and Democratic Alliance of
Canada, send them a Japanese and a Chinese
machetes, and a report of my work here, tell them there is a film to be
completed .....tell them, I am very happy here, I only hope is to be able to contribute
more. The two boxes of surgical
instruments are for the Military Health Minister, ling can take the doctors and
the public health schools .The two camp
beds are for you and hanif, the two pairs of shoes from England are for you, the
riding boots and breeches are for Jizhong, the district commander . To my
servants and cook, a blanket each, the Japanese ( patient) the pair of Shao-ping
shoes . Please give my Kodak Retina II camera to comrade Sha Fei. I cannot write any more ! Norman Bethune,
04:20pm, November 11th, 1939".
The day - 13 November1939, 5.20am, in a tiny peasant hut in the village of Huang Shikou (Yellowstone County ) in
Hebei Province , Dr. Norman Bethune died. He
was buried in an American flag, as no Red Ensign or Union Jack was at hand.
His team carried his body for 4 days along icy mountain paths to a place
of relative safety, as all around battles raged in the countryside. Two
memorial ceremonies were held in succession in his honour : on 1 December 1939
a memorial meeting was held in Yan'an, the troops of the 8th Red Army stood row
upon row, filling the valley between the honeycombed hills while Martial Chu
Teh, the commander-in-chief, spoke to them of the man who died for them. Later
on 5 January 1940, in the frontier region where he had worked, 10,000 people
shuffled by the frail gaunt corpse. Bethune's death was a major loss to the 8th Route Army. A
tomb was built for him in the valley where he died. Nine years later
General Neieh revisited his grave to wipe off the desecration done by the
Japanese. In 1952 his remains were taken to the Mausoleum of Martyrs,and
re-buried in the Revolutionary Martyrs' Cemetery in Shih-chia-chuang , Hebei
Province. A statue, a pavilion and a museum mark the site. Every year on the
anniversary of his death, a ceremony is held there.
Just next to Bethune's grave is the grave of an Indian
doctor, Dr.Dwarkanath Shantaram Kotnis, who died in China on 9
December 1942. He was one of five Indian physicians dispatched to China to
provide medical assistance during the Second Sino-Japanese War in 1938.
Another foreigner honoured in this Mausoleum is Reverend Eric Liddell
of Scotland , the
hero of the Academy Award–winning film, Chariots of Fire. Liddell died while
incarcerated in a Japanese prisoner of war camp in Shandong Province .
Bethune's affection for, and devotion to his Chinese comrades were
fully reciprocated.After Bethune's death, Mao Tse Tung told his countrymen:
" We mourn much more than the passing of a man". On 21December
Mao Zedong published an essay entitled "In memory of Norman
Bethune,"( 紀念白求恩), which documented the final months of the doctor's life
in China.It became one of Mao's most famous essays. In it Mao urged all Chinese
people to emulate Bethune's spirit of internationalism, his sense of
responsibility, his selfless spirit and his devotion to others."
Comrade Bethune and I met only once. Afterwards he wrote me many letters. But I
was busy, and I wrote him only one letter and do not even know if he ever
received it. I am deeply grieved over his death. Now we are all commemorating
him, which shows how profoundly his spirit inspires everyone. We must all learn
the spirit of absolute selflessness from him. With his spirit everyone can be
very useful to the people. A man's ability may be great or small, but if he has
this spirit, he is already noble-minded and pure, a man of moral integrity and
above vulgar interest, a man who is of value to the people. Comrade Bethune's
spirit, his utter devotion to others without any thought of self, was shown in
his great sense of responsibility in his work and his great warm-heartedness towards
all comrades and the people."
Among Chinese only the name Mao Tse-Tung was more familiar than
Pai-Ch'iu-En (White One Sent) because Mao's essay was included in textbooks in China 's
elementary schools. which had become required reading for everyone during China 's
Cultural Revolution (1966 76). Quotations of even a small portion of that
essay were enough to identify him. .His name also appears in Chairman Mao's
Little Red Book as "the ideal communist." and his picture
appeared on posters and postage stamps. Bethune's name becomes
almost synonymous with Canada
in China and
is of great significance in 2010 as the two countries mark the 40th
anniversary of diplomatic relations.
After being elevated to hero status by Mao, Bethune has been revered by
the Chinese people ever since.Bethune is one of the few Westerners to whom
China has dedicated statues and memorials, of which numerous have
been erected around China.Several colleges and universities of medical
sciences and hospitals are named after him in China,e.g.the Bethune Military
Medical College , Bethune Specialized Medical College,and the
800-bed Norman Bethune International Peace Hospital (which includes a Bethune
museum on the hospital grounds), all three are in Shijiazhuang,Hsi Ching
(Yenan Province). Norman Bethune University of Medical Sciences, founded in Changchun , Jilin ,
was later merged into Jilin
University as Norman
Bethune College of Medicine.
Except for his work in
Even before Bethune left for China , he might already
have mentally prepared himself for not being able to come back. He
wrote a farewell letter to " Elizebeth", a former lover " My
road ahead is a strange and dangerous one. You cannot come with me. I don't
want to attempt in my time left any serious emotional engagement......Remember
me as I will you -- with quietness and respect." Bethune also
wrote another friend he was in need of an altar on which to immolate
himself and rise again like the fabled phoenix from the
ashes. Henning Sorensen commented years later " When I look
upon the life of Norman Bethune, it seems to me to be one long preparation for
the final period - his life and work in China
" In China ,
away from whisky and women, Bethune had found his mission in life.
During the 19 months in
Bethune will always remain a figure of controversy. Ted Allan, a Jewish Canadian writer who was with Bethune in the Spainish war, hit the mark when he said " There were times I had loved him because he had been truly magnificent. There were times I hated him because he hadn't measured up to my ideal hero ". Maybe the problem is not Bethune but our unrealistic expectation of a fallible human. At any rate, Bethune should be happy that nobody, not anyone in the whole wide world, could ever accuse him of being "mediocre" !