Norman Bethune

Known widely as an innovative thoracic surgeon, a vigorous advocate of democratic medical services, and an international humanitarian, Norman Bethune is revered in China as a hero in the successful struggle for the establishment of its first united republic in 5,000 years. Mao Zedong, who received Bethune after his arrival in China early in 1939, wrote with great appreciation of Bethune’s spirit of absolute selflessness as proven dramatically in his tragic death on the battlefront in northwestern China from blood poisoning on November 12, 1939. His spirit and Mao’s tribute to his life and work became primary sources of inspiration in the new China.

Bethune’s unique contributions in China were the culmination of his family’s long tradition of dedication to altruistic human service and his personal experiences as a medical doctor in the First World War, the Spanish Civil War, and among the sick and destitute in both Canada and the United States. A descendant of French nonconformist Christians who emigrated from France to Scotland in the sixteenth century and to North America in the eighteenth century, he was born on March 3, 1890, into a deeply religious family in Gravenhurst, Ontario, the “Gateway to the Muskoka Lakes” a hundred miles north of Toronto. Curious, independent, and sometimes stubborn in his youth, he prepared for his medical career through study at the University of Toronto.

As a university student he began to demonstrate the compassion and commitment to helping less fortunate people that later became dominant features of his unorthodox but highly creative medical work. He consciously delayed his university studies on two separate occasions. In 1911-12 he worked as a lumberjack and as a teacher at Frontier College, a unique Canadian adult education agency dedicated to meeting the educational needs of men labouring in lumber and mining camps and other remote locations. When Canada entered the First World War in August 1914, he enlisted immediately as a stretcher bearer.

Badly wounded by shrapnel at Ypres, he spent six months in hospitals, first in France and then in England, before being invalided home. On completing his university studies and qualifying for his medical degree, he re-enlisted and served as a surgeon in the British navy. During the last six months of the First World War, he was a medical officer with Canadian airmen in France.

After the war he completed his internship at the Hospital for Sick Children and the Fever Hospital in London, England, financing himself in a variety of enterprising ways including the buying and selling of art. Overcoming many distractions, he completed his internship and, in 1923, wrote and passed the difficult examination to qualify as a Fellow of the Royal College of Surgeons. A few months later, despite the resistance of her parents, he married Frances Campbell Penny, eleven years his junior. Theirs was a tempestuous and ultimately tragic marriage. Bethune and his wife travelled through much of western Europe in 1924. He observed the work of leading surgeons in Paris, Vienna, and Berlin. By the end of that year they were settled, with little money, in a rented apartment in a busy but, unknown to them, somewhat disreputable section of Detroit, Michigan.

Painting of Dr. Norman Bethune, presented by a delegation of 17 Chinese diplomats and officials attending the official opening of the Bethune House in Gravenhurst, Ontario, on August 30, 1976 [Bethune Memorial House].

During the two years he and his wife lived in Detroit, they gained first-hand, personal knowledge of poverty, then affluence, and finally tragedy. Bethune’s initial practice in Detroit put him in close daily contact with the less fortunate and their never-ending medical and financial problems. Increasingly, however, as his skill as a surgeon became known in Detroit, new patients came and paid handsomely, sometimes for what he regarded as trivial services. Gradually he began to appreciate the extent to which money was corrupting the medical system. He was greatly troubled by the unattended suffering among the poor. Then personal tragedy struck.
Tuberculosis had infected his left lung! After treatments in Detroit and at the Gravenhurst Sanatorium, he was sent in late 1926 to a sanatorium at Saranac Lake, New York. After reading an article on a surgical procedure for the treatment of tuberculosis of the lung, Bethune underwent this risky operation. Two months later, following careful examination, he was pronounced fit to leave.

For two years he worked at a tuberculosis hospital in Ray Brook, New York, and in 1929 began to specialize in thoracic surgery at the Royal Victoria Hospital, Montreal, and later at the Sacré Coeur Hospital in Cartierville, north of Montreal. More dedicated than ever to the practice of medicine, he wrote articles for medical journals setting out new surgical techniques and suggesting improvements based on his research.

In the late summer of 1935, Bethune participated in the International Physiological Congress in the Soviet Union. He returned to Canada convinced that democratic societies must be much more aggressive in their development of publicly financed medical care and health systems. Earlier he had set up a free clinic for the unemployed in Montreal. After his return, he organized “The Montreal Group for the Security of the People’s Health.” This group championed the idea that in democratic societies the primary duty of medical doctors must be to secure and to maintain the health of all citizens.

During this time Bethune continued to develop and refine surgical instruments. He invented or improved a dozen such instruments that soon were being used by thoracic surgeons throughout Canada and in other countries. The experience he gained in the development of new means for the delivery of medical services prepared him for an assignment he agreed to accept in Spain where civil war had broken out in mid-July 1936.

Soon after his arrival in Spain, Bethune organized and put into operation a pioneering mobile blood transfusion service in Madrid. Later he collected blood from donors in various cities and transported it wherever needed, along a front of over 600 miles. “Spain,” Bethune wrote later, “is a scar on my heart.” He knew, however, that the blood transfusion method he had introduced in Spain had drastically reduced fatalities among the wounded, in some sectors as much as 75 percent. When he had accomplished all that he felt he could in Spain, he returned to Canada to undertake a cross-country speaking tour to raise money for the continuance of humanitarian efforts among the Spanish people.

Dr. Norman Bethune, performing a blood transfusion during the Spanish Civil War (1936-1938), is assisted by Henning
Sorensen and other hospital staff. Bethune's innovation created mobile blood banks enabling the wounded to be cared for on fields of action [NAC/C67451]

His lectures stimulated a moral and financial response far beyond all expectations. His tour was barely under way, however, when the Japanese launched a new attack on China. A growing sense of urgency was noted in Bethune’s speeches. He was aware, of course, that Japan had invaded Manchuria in 1931 and that earlier, throughout the nineteenth century, Western nations had contended for privileges and concessions within China. In addition, he knew that China had been grossly exploited during the Opium Wars. It was obvious that China needed help even more urgently than Spain.

Completing arrangements with the China Aid Council in New York, Bethune left Vancouver for China on January 2, 1938. Writing from Hong Kong he 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.” When Mao received him, Bethune enquired concerning the number of mobile medical units then functioning with the Eighth Route Army. Learning that there were none and that many soldiers were dying because of the lack of facilities to treat them, Bethune emphasized the need to organize mobile medical services at once.

Early in May 1938, Bethune left Yenan for the mountain ranges in the isolated border region about two hundred miles to the north. Fighting was extremely fierce and there were only a few qualified doctors to care for the 13 million people in the area. 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. Illustrated manuals were necessary. Modest hospitals were essential. Sick peasants as well as wounded soldiers required immediate attention. Bethune sought to deal with all of these matters. Despite many problems, Bethune established over twenty teaching and nursing hospitals. None of the young doctors supervising these hospitals had received training in a modern hospital. Whenever it was necessary Bethune operated, sometimes at a prodigious rate. He once operated for sixty-nine hours continuously to attend to the urgent needs of 115 individuals.

Word was passed from mouth to mouth among those led by Mao Zedong of the amazing Canadian doctor who shared his clothes, his food, and even his blood with wounded soldiers and civilians. Late in October 1939, while operating on a wounded soldier barehanded because there were no surgical gloves, Bethune accidentally cut his left hand with his scalpel. Immediately he plunged his hand into an 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, given careful attention. But the cut did not heal.

Despite their best efforts 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 could not be long delayed. Blood poisoning had set in; his whole body was infected. In America and Europe there were drugs that might have saved him. But there were none in that remote, war-torn northwest corner of China.

Exhausted by his poisoned system, Bethune wrote - in Chinese - one final letter setting out his last will and testament. In it here quested that some money be provided by the Chinese Aid Council to his divorced wife. His responsibility to her, he wrote, “is undeniable.” He also listed the basic pharmaceuticals his group needed. He concluded: “The last two years have been the most significant, the most meaningful years of my life.... I have found my highest fulfillment here among my beloved comrades.”

Bethune died on November 12, 1939. His affection for, and devotion to his Chinese colleagues were fully reciprocated. Mao Zedong wrote In memory of Norman Bethune. It became one of Mao’s most famous essays. “Comrade Bethune and I met only once.... 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.” Mao’s short essay on Bethune later became required reading in China. Bethune’s picture appeared on posters and postage stamps. Quotations of even a small portion of that essay were enough to identify him.

Dr. Norman Bethune’s unceasing and inventive work as a surgeon, teacher, founder, and administrator of hospitals for Chinese people, whose cause he had made his own, established a lasting bond between his adopted people and this heroic, outstanding Canadian. A message from the Chinese Government thanking Heirloom Publishing for his inclusion in this volume is included here.