Source: Library and Archives Canada/MIKAN 3224432

BETHUNE, HENRY NORMAN, teacher, army officer, author, artist, doctor, surgeon, and inventor; b. 3 or 4 March 1890 in Gravenhurst, Ont., son of Malcolm Nicholson Bethune and Elizabeth Anne Goodwin; m. 13 Aug. 1923 Frances Eleanor Campbell Penney in London, England, and they divorced in October 1927; the couple remarried 11 Nov. 1929 in Montreal, but were divorced again 30 March 1933; they had no children; d. 12 Nov. 1939 in Huangshikou, Hebei province (People’s Republic of China).

Henry Norman Bethune’s grandfather, whose name was also Norman*, was a doctor and in 1849, with four colleagues, he founded Toronto’s third medical school, the Upper Canada School of Medicine. Henry Norman’s father, Malcolm Nicholson Bethune, initially led an adventurous life and travelled around the world. In Honolulu he met an English Presbyterian missionary, Elizabeth Anne Goodwin; he embraced her faith, which was also that of his ancestors, and returned to Toronto. After their marriage in 1887, he became a zealous evangelist, preaching in various parts of Ontario. His elder son, Henry Norman, who would become one of the world’s best-known Canadians, was born in Gravenhurst.

Henry Norman was influenced by his grandfather (whose profession in medicine he chose) and by his father (whose zest for hard work he shared). Even as a youngster, he stood out for his wide-ranging curiosity, his great interest in surgery, and his individualistic spirit. Since his father’s occupation involved frequent moves, the boy attended a series of different schools. In 1907, at the age of 17, he completed his high-school education in Owen Sound. After a spell as a primary-school teacher in the village of Edgeley, north of Toronto, in 1909 he enrolled in University College, University of Toronto, where he studied physiology and biochemistry. Two years later, he was engaged at a lumber camp near Whitefish (Sudbury) as a worker-teacher for the Reading Camp Association (which was to become Frontier College) [see Alfred Fitzpatrick]. In the fall of 1912 Bethune returned to the University of Toronto, entering the faculty of medicine. The calm of his university life was rudely interrupted in the summer of 1914 by the outbreak of World War I.

Accepted into the Canadian Army Medical Corps, Bethune arrived in England in September 1914. In February 1915 he went to France as a stretcher bearer. In April, during the second battle of Ypres, he was wounded in his left leg by a shrapnel shell that exploded nearby. He was taken to a hospital in England and then, in October, repatriated to Canada. Resuming his studies at the University of Toronto, he graduated with an mb in December 1916. In April 1917 he went back to England and the war, first as a surgeon sub-lieutenant in the Royal Naval Canadian Volunteer Reserve, and then in the Royal Navy aboard the seaplane carrier Pegasus. Following his demobilization at the end of hostilities, Bethune planned to specialize in pediatrics. With this in mind, he took up a six-month internship at London’s famous Hospital for Sick Children on Great Ormond Street in 1919. Upon his return to Canada in 1920, he re-enlisted in the army and served for several months as a lieutenant on the medical staff of the Canadian Air Force. He then went back to Great Britain to begin his second internship, at Christmas, in West London Hospital, and, in the next year, to train as a surgeon at the Royal Infirmary in Edinburgh. He was admitted to the Royal College of Surgeons of Edinburgh in February 1922 and, once more at West London Hospital, he became a resident surgical officer.

It was in London in 1920 that Bethune had met a beautiful and cultured Scotswoman, Frances Eleanor Campbell Penney. On 13 Aug. 1923, benefiting from a legacy she had received, they were married; among the things they had in common were a love of luxury and a propensity for excessive spending. After a six-month honeymoon in Europe (during which they squandered much of the inheritance), the Bethunes sailed for North America with the intention of settling there. In the fall of 1924 Bethune opened a medical practice in the rapidly growing city of Detroit. He also obtained a post as a voluntary assistant at Harper Hospital and gave a course in prescription writing at the Detroit College of Medicine and Surgery. Initially his practice had few patients; those he did have were generally poor and paid him in kind. His other jobs, however, brought him into contact with physicians and he was able to make himself known in medical circles. As time went on, his practice grew and attracted more affluent patients. The young couple’s standard of living was improving, so they were able to buy a new car and move to a fashionable part of town. Despite this prosperity, Bethune was about to enter a very dark period of his life.

A gulf opened between Bethune and his wife and, as time went by, they drifted further and further apart. A passionate, energetic man, but also impatient, authoritarian, and even domineering, Bethune had a very different personality from that of his wife, who found his irascibility, among other things, difficult to live with. As well, Bethune was heavily absorbed in his work, and Frances Eleanor often found herself at home, alone and isolated. Tired of their quarrelling, particularly over money matters, in 1925 she went to stay with friends in Nova Scotia. She came back the following year but the situation had not changed. They divorced in 1927. Meanwhile, in 1926, Bethune had faced another ordeal: at the age of 36, he contracted tuberculosis and from December he was hospitalized in the Trudeau Sanatorium at Saranac Lake in New York. In those days, tuberculosis was a fatal disease. In torment, Bethune during the course of 1927 completed a mural entitled The T.B.’s progress which consisted of nine drawings and some poems. One of the scenes shows the artist in the arms of the angel of death and predicts that his own death would occur in 1932. Yet Bethune did not give up and he fought the illness, notably by reading the materials on this disease available in the sanitarium library. One day he found an article about the artificial pneumothorax procedure. Convinced that it would be beneficial in his case, he badgered the physicians at the sanitarium into performing the operation. It was a success: Bethune’s health showed visible improvement and he left the institution at the end of 1927. This particular experience would have a profound influence on the rest of his life. He decided then and there to put the knowledge he had acquired to good use by specializing in thoracic surgery in order to save other tuberculosis victims.

With this aim in mind, he contacted an eminent Montreal specialist who was a pioneer in lung surgery, Dr Edward William Archibald*, a professor of surgery at McGill University and surgeon at the Royal Victoria Hospital. Bethune became his first assistant in April 1928. During the years he spent in this hospital, he taught, led research studies, and published some ten medical papers, four of which came out in 1929. He also attracted attention by inventing several surgical instruments (including rib shears and a pneumothorax device). The instruments Bethune invented or improved are proof of his creative mind; some of them made surgical intervention much simpler and more efficient and were highly regarded by other specialists in thoracic surgery.

Bethune’s relations with Archibald and other doctors in the same hospital were, however, increasingly strained because of differences in their characters and conflicting opinions. Sometimes disagreeing with their medical or surgical procedures, he criticized them openly, and on occasion even vehemently, especially about decisions on whether to operate. Bethune was more inclined than his colleagues to perform high-risk operations, which, in Archibald’s view, increased the number of deaths in the operating theatre. At a more mundane level, unlike most of the other doctors who wore traditional grey suits, Bethune preferred a sports jacket or other casual wear. His social behaviour, too, tended to marginalize him. Rather a reveller who loved to be surrounded by women, he was prone to eccentric behaviour which was liable to shock those around him. The nonconformist, provocative side of his character eventually posed serious problems, and in the fall of 1932 Archibald dismissed him. The ups and downs in his private life, too, were by no means over; he and Frances Eleanor remarried in 1929, but two years later they separated once more.

In 1933 Bethune took up a new post as chief of pulmonary surgery at the Hôpital du Sacré-Cœur in Cartierville (Montreal). Now that he was his own master, he gave full rein to his talents and creativity. He operated, trained qualified surgeons, and introduced new techniques, such as person-to-person blood transfusion, while continuing to invent surgical instruments and publish scientific articles. His work gained him an international reputation. In 1932 he was made a member of the American Association for Thoracic Surgery and three years later he was elected to its council. Bethune was talented as a surgeon, but also as a writer and an artist. During the eight years he spent in Montreal, he wrote short stories and poems. In addition, he took up painting, with the encouragement of Marian Scott [Dale*], a painter whom he met at an artists’ gathering and with whom he fell in love. Marian was involved in left-wing politics, and her husband, Francis Reginald Scott*, a poet and law professor at McGill University, was an important member of the Co-operative Commonwealth Federation. Bethune’s literary, artistic, and medical activities brought him into more immediate contact with society and made him aware of disparities and injustice. The people with whom he socialized, Marian Scott in particular, introduced him to new political ideas. This was the context in which his acute social conscience and his growing interest in communism were developing. For him, as he noted in the Journal of the Canadian Medical Association in July 1932, tuberculosis was not just a disease but rather a problem arising from the socio-economic system: “[Edward Livingston] Trudeau well said: ‘there is a rich man’s tuberculosis and a poor man’s tuberculosis.’” Just as he had fought the disease itself, Bethune now took up the struggle on this more fundamental problem.

While staying in Moscow and Leningrad (St Petersburg) at the time of the 15th International Physiological Congress held in August 1935, he took the opportunity to visit Russian hospitals and investigate the Soviet medical system. He was deeply impressed by it and by the preventive methods used to fight tuberculosis in the Union of Soviet Socialist Republics. This brief visit also led him to learn more about communism. On his return to Canada in November, he became a member of the Communist Party of Canada (a fact that only came to light in July 1937). His views on society and on medicine and how it should be practised would never be the same again. In the course of that fall, he organized a study group known as the Montreal Group for the Security of the People’s Health, which brought together doctors, nurses, and social workers. Under Bethune’s direction, they met regularly to examine the health-care systems of other countries with a view to proposing a plan of reform aimed at solving the practical problems facing health care in Quebec and 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 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 showed no interest, and in certain quarters, which included some members of the medical profession, the reaction to it was hostile. Bethune was deeply disappointed by this negative response.

In June 1936, together with the artist Friedrich Wilhelm Brandtner, he organized workshops to teach poor children how to paint in oils and watercolours. Marian Scott was invited to be an instructor. The classes were held in Bethune’s Montreal apartment in a studio which was designated the Children’s Art Centre. This school attracted notice, 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.

At this time, the Spanish Civil War, which broke out in July 1936, was of great interest to Bethune, who was increasingly drawn to political action. The military conflict between the rebel forces of General Francisco Franco, who were backed by the Roman Catholic hierarchy, Nazi Germany, and Fascist Italy, and the Republicans, who organized a popular-front coalition of anarchists, socialists, and communists, was intensifying. Anxious to fight fascism, disappointed by the failure of his project for medical reform, convinced, by now, that he could not have a real romantic relationship with Marian Scott, and tempted to embark on a risky adventure, he resigned from his position at the Hôpital du Sacré-Cœur, made his will (leaving everything to his ex-wife), and set off to help the Republican cause. This was an irrevocable turning point in his life. Thanks to the support of the Canadian Committee to Aid Spanish Democracy, he left for Spain on 24 October, taking medical supplies with him. This Toronto-based organization included members of the Socialist and Communist parties; its president, the Reverend Benjamin H. Spence, was a member of the Co-operative Commonwealth Federation, and two of its vice-presidents, Timothy Buck* and Alexander Albert MacLeod*, were Communists. On 3 November Bethune arrived in Madrid, which was then under attack by Franco’s troops. Having observed and considered the situation, he came to the conclusion that the best way he could help the people of Madrid was by providing a blood-transfusion service. He went to London with Henning Sorensen, a multilingual Canadian, to buy the necessary equipment, including a van, a refrigerator, and bottles for blood. Back in Madrid, he set up the Servicio Canadiense de Tranfusion de Sangre in mid December. The team of three Canadians, an American woman, and a few Spanish doctors collected blood from donors and dispatched it to several hospitals in Madrid. Instead of waiting for the wounded to arrive, Bethune often led his team as close to the front line as he could so as to get blood to the injured soldiers as quickly as possible. This mobile blood-transfusion service, which saved many lives, constituted a major innovation in military and medical history, and was one that would prove seminal to the Allies in World War II. In the spring of 1937 the Spanish government assumed control of the transfusion service, as of the other organizations set up during the war. Bethune reacted sharply to this decision and sometimes, when he had had too much to drink, expressed his criticism in scathing terms. His relationship with the Spanish authorities was already tense; in the climate of suspicion generated by the war, his personality – at once authoritarian, quick-tempered, independent-minded, and charismatic – as well as the success of his initiatives, which competed with the work of some Spanish doctors, were disturbing and aroused anxiety. His relations with his superiors became even more strained from then on, and problems also arose with some of his colleagues, who insisted that he be sent back to Canada. Moreover, according to certain archival documents that can now be consulted, Bethune was a victim of the paranoia prevalent in Madrid at the time. He was suspected of spying because he made notes about the location of bridges and crossroads; as well, he was seeing a Swedish journalist, Kajsa von Rothman, a woman of whom the Spanish authorities were suspicious, believing her to be a fascist spy. It was against this background that in May 1937 Bethune was forced to return to Canada, where he went on a lecture tour to raise funds for the Canadian Committee to Aid Spanish Democracy. In June he received a triumphant welcome from crowds in Toronto and Montreal. In July a new phase of the Sino-Japanese wars broke out. Just as he had helped the Spaniards in their struggle against fascism, Bethune, who had very recently made public his commitment to communism, and, still bitter about the course of events in Spain, felt an ever-stronger desire for active service, decided to fight on the Chinese side against the Japanese aggressors. It was to be his final battle.

With the support of the New York-based China Aid Council and other organizations, Bethune and his Canadian-American Mobile Medical Unit sailed from Vancouver on 8 Jan. 1938. The unit’s two other members were Jean Ewen, a Canadian nurse, and Charles Edward Parsons, an American doctor. They landed in Hong Kong on the 27th and then flew to Wuhan, the provisional capital of the Kuomintang (the Chinese Nationalist Party). There Bethune met Zhou Enlai, one of the leaders of the Communist Party of China who would become the premier of the People’s Republic of China. He then set off with Ewen for Yan’an in northern China with the intention of helping Mao Zedong’s 8th Route Army, as it was known in the terminology of the Nationalist armies, who formed a united front against the Japanese. Dr Parsons was unwilling to make this trip and returned to the United States. Bethune and Ewen reached Xi’an on 22 March and were greeted by Zhu De, the commander-in-chief of the 8th Route Army. They also met Richard Brown, a Canadian Anglican missionary and an experienced surgeon, who agreed to join their team for several months while he was on leave. They arrived in Yan’an, the political nerve centre of the Communist Party of China, at the end of the month. On 31 March Bethune met with the party’s leader, Mao Zedong, who was president of the revolutionary military council, and spent a few hours in conversation with him; the interview made a great impression on Bethune. After a month or so in Yan’an, he and Brown travelled northeast to the frontier region of Jin (Shanxi)-Cha (Chahar)-Ji (Hebei), which was under Commander-in-Chief Nie Rongzhen.

On 17 June 1938 Bethune and Brown arrived in Jingangku, a village on the Wutai Shan mountain, where General Nie’s headquarters were located. Nie promptly appointed Bethune medical adviser for the frontier region. Appalled by the lack of surgical instruments and medicines and the inadequate medical training of the staff, he set to work feverishly in an endeavour to change the situation. He examined the wounded and performed a continuing round of operations. He invented several instruments, including a wooden carrying case that greatly facilitated the transport of drugs and supplies, and also made it possible to set up an operating table for the mobile units more easily. Because of its shape, he gave it the Chinese name lugou qiao (Marco Polo bridge). In August and September, he supervised a five-week program that involved training, improvements in equipment, establishment of procedures, and other activities. This work led to the opening, on 15 September, of a permanent hospital slated also to be used to train doctors and nurses. After the hospital was destroyed by the Japanese at the end of October, Bethune focused on establishing mobile medical units and frequently took his team to the front line; as his motto put it: “Go to the wounded! Don’t wait for the wounded to come to you!” These mobile units were particularly well suited to the guerrilla campaign being waged against the Japanese. He also managed to bring together a group of volunteer donors to ensure adequate blood supplies. He laid particular stress on the education of doctors and nurses. In January 1939 he organized a week of intensive training in the village of Yangjiazhuang. The author of several medical textbooks, he wrote one that year 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.” That summer he was making plans to create a medical school. Since there was insufficient money, he planned to go back to Canada on a fund-raising tour.

Bethune worked prodigiously and took very little rest. In April 1939, during the battle of Qihui led by General He Long against the Japanese, he and his team performed 115 operations in just 69 hours. Since his arrival in the frontier region, he had lost a lot of weight. In a letter written in August 1939, he states that his teeth and his eyes are in bad shape and that he can only hear with one ear. Although sometimes the victims of his quick temper, the Chinese with whom Bethune worked considered him not only a great doctor but also a role model embodying the spirit of self-sacrifice and dedication to work. His ideas, his energy, and his courage won him leniency; furthermore, his exhausting pace of life as well as the attitude of the Chinese towards him seem to have helped him overcome the worst of his character traits, notably his penchant for alcohol. His patients were devoted to him. According to one of his assistants, the soldiers, when they were about to go into battle, would cry out: “We fight at the front. If we are wounded, we have [Bethune] to treat us. Attack.” On 28 October, when close to the fighting on Mount Motien, he cut the middle finger of his left hand during an operation. On 1 November, while operating on a soldier whose head wound was badly infected, he contracted septicaemia. He died on the 12th at Huangshikou. Bethune’s death was a major loss to the 8th Route Army. Two solemn ceremonies honouring his memory were held in succession, in the frontier region where he had worked and then in Yan’an. On 21 December Mao Zedong published his famous text “In memory of Norman Bethune,” calling on the Chinese people to assimilate Bethune’s spirit: “utter devotion to others without any thought of self.” After the People’s Republic of China was founded in 1949, Bethune became a widely respected hero there.

In his native Canada, Henry Norman Bethune was ignored for many years. Since the establishment of diplomatic relations between Canada and China in 1970, and with the exchanges ensuing between the two countries, Bethune has been increasingly appreciated and in 1972 the federal government recognized him as a person of national historic significance. The house in Gravenhurst where he was born was turned into a museum. Since then several publications, lectures, and films have been devoted to him. His contributions to surgery and medicine, including his scientific papers and the surgical instruments he invented, the mobile blood-transfusion units he set up and used in Spain and China, his struggles against fascism, and the radical reforms in health care that he suggested for Quebec and the rest of Canada, are the subject of a number of works and are becoming increasingly known across the country. Bethune also serves as an invaluable link between the cultures of Canada and China. Although Bethune was a victim of his complex personality and suffered the consequences in both his personal and professional life, it was no doubt that very personality that helped him to carry out the extraordinary actions that, in the end, have brought him fame.

Shenwen Li