Medicine, as we are practising it, is a luxury trade. We are selling bread at the price of jewels…. Let us take the profit, the private economic profit, out of medicine and purify our profession of rapacious individualism…. Let us say to the people not ‘How much have you got?’ but ‘How best can we serve you?’
– Henry Norman Bethune
Henry Norman Bethune was born in Gravenhurst, Ontario, Canada, on 3 March 1890. His father was a Presbyterian minister from a long family line of clergymen, educators and medical practitioners, while his mother was an evangelical missionary. The family badge of service and his father’s exhortation to “always go where you’re needed” left an indelible mark on young Bethune, influencing his eventual foray into China. There, he offered his selfless medical services to the war-torn country, an act that made him a national hero in a foreign land.
As a child, Bethune was said to be curious, independent and stubborn. He once wandered away from home at the age of six to explore the city of Toronto, Ontario, for several hours. An early interest in surgery was apparent in his practical interest in dissection and reverence for his surgeon grandfather. In 1912, Bethune entered medical school at the University of Toronto in Ontario, but interrupted his studies in 1914, after the outbreak of World War I, to enlist in the Royal Canadian Army Medical Corps, in which he served as a stretcher-bearer. After he was wounded in Ypres, Belgium, he returned home to finish his medical degree, and then joined the Royal Canadian Navy and Royal Canadian Air Force.
TUBERCULOSIS AND A TUMULTUOUS MARRIAGE
In 1920, Bethune married Frances Penny, a calm, beautiful and introverted woman. The young couple quickly squandered much of her inheritance on a one-year tour of Europe. They moved to Detroit, Michigan, USA, where Bethune started a private practice and took a part-time job as an instructor at Detroit College of Medicine and Surgery. Two years after the move, Bethune contracted tuberculosis in both lungs and sought treatment at the famous Trudeau Sanatorium in Saranac Lake, New York, USA. As his condition worsened, Bethune convinced his skeptical doctors to perform a potentially dangerous operation involving elective pulmonary resection. Its success and his rapid recovery inspired him to give up private practice and join the medical search to conquer the disease that had nearly taken his life. In 1928, he became the first assistant of Dr Edward Archibald, a Canadian pioneer in thoracic surgery at McGill University in Montreal, Québec, Canada.
Unfortunately, Bethune’s improving health was accompanied by his deteriorating relationship with his wife Frances; she divorced him in the autumn of 1927. However, the couple could not part ways completely. They remarried in 1929, only to divorce again four years later.
EARLY HUMANITARIAN
Bethune was a highly trained thoracic surgeon who not only excelled in the care of patients, but also invented or redesigned 12 medical and surgical instruments from 1929–1936. Complementing his inventions, he authored 14 articles describing his innovations in thoracic surgical techniques. Despite these accomplishments, he became disillusioned with surgery and turned his focus to the socioeconomic aspects of disease. He proposed radical reforms to medical care and health services in Canada. As his social conscience grew stronger, he opened a free clinic tailored to treating those in need, just as his father had preached years earlier. Growing increasingly estranged from his medical colleagues who disapproved of his candid and radical advocacy, Bethune gradually began surrounding himself with artists and intellectuals. In 1936, he joined the Communist Party of Canada.
Shortly after the outbreak of the Spanish Civil War in 1936, Bethune stepped down from his hospital position and offered his services to the Spanish Republican government. He set up one of the earliest mobile blood transfusion services to rapidly collect and distribute blood to frontline hospitals and casualty clearing stations. The innovation saved many lives, but Bethune received little personal credit. In order to raise money to expand the blood transfusion service, he had to go on a North American fundraising tour. Unfortunately, at the completion of this tour, Bethune was unable to return to Spain; unemployed, he lapsed into loneliness and dejection. Yet this turned out to be a blessing in disguise for Bethune, as it was then that he felt compelled to travel to China, which was under a full-scale Japanese invasion.
CHINA’S WHITE HERO
In January 1938, Bethune trekked more than 600 miles from Hong Kong to the headquarters of the Chinese Eighth Route Army in northwest China. There, he joined the Chinese Communists led by Mao Zedong, the Chinese revolutionary and political theorist who fought actively against the Kuomintang (Chinese Nationalist Party). While in Yan’an, the capital of the Communist-controlled Shaanxi-Gansu-Ningxia Border Region, Bethune met Dr George Hatem, a New York-born Lebanese-American doctor. One of the few non-Chinese individuals to hold a position of trust in China, Dr Hatem had come to Yan’an two years earlier after practising for several years in Shanghai. He was instrumental in introducing Bethune to the Chinese authorities and assisted him in organising medical services.
In 1939, Bethune was appointed medical adviser for the Jin-Zha-Ji Military District, under the direction of General Nie Rongzhen, a prominent Chinese Communist military leader and one of ten marshals in the People’s Liberation Army of China. Over several months, Bethune constructed makeshift hospitals throughout the region of west Beijing, wrote textbooks on medicine and surgery, and began training young Chinese nationals in medical techniques. He led his mobile medical unit on horseback through the Wutai mountains of Shanxi province and across the Hebei plains. He encountered danger when he occasionally wandered behind Japanese lines, yet never distinguished between casualties, treating wounded Japanese prisoners and Chinese soldiers alike.
DEATH AT 50
Bethune and his medical team worked long hours, which affected his health. On a final tour in the midst of the Second Sino-Japanese War, before a planned return to Canada, Bethune was called to a makeshift operating room to perform a surgical procedure. It was the twist of fate that would ultimately cause his demise. In an era before universal precautions and surgical gloves, Bethune’s scalpel slipped and lacerated his own finger, which became infected. Tragically, the infection proved to be fatal and Bethune died of sepsis on 12 November 1939.
In 1972, the Canadian government declared Bethune “a Canadian of national historical significance”, creating the Bethune Memorial Home in his hometown of Gravenhurst, Ontario, Canada. He is thus described: “Professionally, Bethune gained international recognition as a skilful, dedicated surgeon; socially, he was more unorthodox. He was a complex man who could both antagonise and inspire.” Other Canadian institutions named in his honour are the Norman Bethune College at York University, Ontario, and the Dr Norman Bethune Collegiate Institute, a secondary school in Scarborough, Ontario.
China was unabashedly enthusiastic. During the Cultural Revolution of the 1960s, communist leaders began to use Bethune as a symbol of ‘selflessness, dedication and responsibility’, which were characteristics that the leaders hoped to instil in all of China’s people. An essay written by Mao Zedong himself entitled ‘In Memory of Norman Bethune’ reached every citizen of China with these words: “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 warmheartedness towards all comrades and the people. Every Communist must learn from him… We must all learn the spirit of absolute selflessness from him. With this 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 interests, a man who is of value to the people.”
Bethune is a rare Westerner who has numerous statues dedicated to him throughout China. The Norman Bethune University of Medical Sciences, which was later merged to become the Norman Bethune Health Science Center of Jilin University, has at least three dedicated statues. He is also commemorated at several institutions in Shijiazhuang, Hebei, China – Bethune Military Medical College, Bethune Specialized Medical College and Bethune International Peace Hospital. The Norman Bethune Medal, established in 1991, is the highest medical honour in China. It is bestowed biannually in recognition of an individual’s outstanding contribution, heroic spirit and great humanitarianism in the medical field.
Bethune was buried in the Revolutionary Martyrs’ Cemetery in Shijiazhuang, Hebei, China. He became an instant national hero in China after his death and was given the name Pai-chui-en, meaning ‘white one sent’. In March 1990, on the centenary of his birth, Canada and China simultaneously issued twin commemorative postage stamps in his honour.