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Norman Bethune

Last modified 10 September 2011.

First published 27 August 2008

Full name Henry Norman Bethune. AKA 'Beth', AKA 'Bai Qiuen'.

Country: Canada, Spain, China.

Cause: Introduction of universal health care system to Canada. Provision of medical care in war-torn Spain and China.

Mini biography: Born on 3 March 1890 in Gravenhurst, Ontario, 140 km north of Toronto. His father is a Presbyterian clergyman. The second of three children, he has an older sister and a younger brother. The family moves frequently during Bethune's childhood, leaving Gravenhurst when Bethune is three and moving six more times before he is 14.

Bethune finishes secondary school in 1907. He works as a lumberjack in the northern woods of Ontario, teaches and then, in 1909, enrols to study physiology and biochemical science at the University of Toronto.

In 1911 he suspends his studies to work as a labourer and teacher at Frontier College in northern Ontario. In 1912 he returns to the University of Toronto to study medicine.

1915 - Bethune interrupts his studies once more to serve in the First World War, enlisting as a stretcher bearer in the Canadian Army's No. 2 Field Ambulance Medical Corps.

While stationed Ypres in Belgium he receives a shrapnel wound to a leg and suffers haemorrhagic shock. He is given a medical discharge and shipped to England to recuperate.

1916 - Back in Canada, Bethune completes his medical degree in December. He now returns to service in the First World War, this time joining the British Royal Navy as a lieutenant-surgeon and serving for 14 months on the HMS Pegasus.

1918 - The First World War ends on 11 November. After being demobbed, Bethune takes a six-month internship at the Great Ormond Street Hospital for Sick Children in London before returning to Canada, where he works in private practice at Stratford and Ingersoll, Ontario.

1920 - In February he joins the medical service of the newly created Canadian Air Force, serving as a flight-lieutenant. He obtains leave in October and returns to Britain to train as a surgeon at first the West London Hospital and then the University of Edinburgh.

1922 - On 3 February he is elected a Fellow of the Royal College of Surgeons. He returns to London and works as a resident surgical officer.

1923 - Bethune marries Frances Campbell Penney, the daughter of a prominent Edinburgh court official, on 13 August. After travelling through western Europe for six months, the couple moves to Detroit in the United States, where Bethune sets up his own private practice.

1926 - Bethune is diagnosed with tuberculosis. At the same time the Bethune's marriage fails. The couple divorce in 1927 and Frances returns to Scotland.

Bethune leaves Detroit to receive treatment at the Calydor Sanatorium in Gravenhurst. Form there he moves to the Trudeau Sanatorium at Saranac Lake, across the border in New York State, where he learns about compression therapy, a newly developed treatment for tuberculosis that deliberately collapses the affect lung.

The operation is performed on Bethune by Montreal surgeon Dr Edward Archibald. Bethune makes a full recovery and is discharged in December 1927.

1928 - Bethune moves to Montreal to study thoracic surgery under Dr Archibald at the Royal Victoria Hospital in Montreal.

Archibald later describes Bethune's operating technique as, "Quick, but rough, not careful, far from neat, and just a little dangerous!"

1929 - The 'Great Depression' begins with the collapse of prices on the New York stock exchange in October, ushering in a 10-year economic slump in North America, Europe and other industrialised regions. Banks close, manufacturing output falls and unemployment rises dramatically.

Concerned that many of his patients are becoming reinfected because of unsanitary living conditions and the lack of ongoing heath care, Bethune turns his attention to the socio-economic causes of disease. He opens a free clinic for the unemployed and begins to lobby the government and the medical profession for reforms to the health care system.

"The treatment of pulmonary tuberculosis involves two problems," he writes in 1932. "The first is that of the infected individual, regarding as a whole, acting and reacting in his social and physical environment, and the second, the reaction of that individual's body, and more particularly his lungs, to the presence of the tubercle bacillus. ...

"The first problem then becomes chiefly an economic and social one, and the second, a physiological and immunological one. In the final analysis they are mutually reactive and inseparable. Trudeau well said, 'There is a rich man's tuberculosis and a poor man's tuberculosis. The rich man recovers and the poor man dies.' This succinctly expresses the close embrace of economics and pathology. ...

"We as a people can get rid of tuberculosis, when once we make up our minds it is worth while to spend enough money to do so. ...

"Lack of time and money kills more cases of pulmonary tuberculosis than lack of resistance to that disease. The poor man dies because he cannot afford to live. Here the economist and the sociologist meet the compressionist on common ground."

Meanwhile, Bethune remarries Frances. The couple split again in 1933.

1933 - Bethune leaves Royal Victoria Hospital to head the Department of Thoracic Surgery at the Sacré Coeur Hospital at Carterville, Montreal.

As well as practising medicine, Bethune researches and develops new medical equipment and techniques. He invents or redesigns a dozen surgical instruments and writes articles describing his medical innovations.

He is also an accomplished amateur artist and in 1935 helps to form and fund the Children's Art School of Montreal.

1935 - In August, Bethune attends an international physiological conference at Leningrad (now St Petersburg) and Moscow in the Soviet Union, taking the opportunity to inspect Soviet hospitals and sanatoriums while he is there.

He is impressed by the Soviet's universal, free health care system and on his return helps to organise the Montreal Group for the Security of the People's Health to try to introduce a similar system to Canada.

"The problem of medical economics is a part of the problem of world economics and is inseparable and indivisible from it," he argues in a speech to the Medico-Chirurgical Society of Montreal.

"Medicine, as we are practising it, is a luxury trade. We are selling bread at the price of jewels. The poor, which comprise 50% of our population, cannot pay, and starve; we cannot sell, and suffer. The people have no health protection and we have no economic security. ...

"Socialised medicine and the abolition or restriction of private practice would appear to be the realistic solution of the problem. Let us take the profit, the private economic profit, out of medicine, and purify our profession of rapacious individualism. Let us make it disgraceful to enrich ourselves at the expense of the miseries of our fellow men. Let us organise ourselves so that we can no longer be exploited as we are now being exploited by our politicians. ...

"Let us say to the people not 'How much have you got?' but 'How best can we serve you?' Our slogan should be, 'We are in business for your health.'"

However, his ideas continue to be ignored by the profession and the government. Later, he is expelled from the Medico-Chirurgical Society.

In November, disillusioned with his inability to make any headway with the introduction of health care reforms, Bethune secretly joins the Communist Party of Canada and begins to look for other ways to realise his goals.

1936 - The Spanish Civil War begins in July when the Spanish military, led by General Francisco Franco, mount a coup against the elected Spanish government, a coalition of socialists and left republicans called the Popular Front.

Bethune is invited by a committee sympathetic to the Popular Front to head the Canadian Medical Unit in Madrid. He accepts and leaves for Madrid on 24 October.

During the 18 months that he spends in Spain, Bethune performs battlefield surgery, does groundbreaking work on the transportation of blood and develops a mobile blood transfusion unit, the Servico Canadiense de Transfusion de Sangre. However, he clashes with republican authorities when they want to take over his unit and is asked to return to Canada.

1937 - Bethune arrives back in Canada in June and immediately begins a fund-raising tour of North America for the Spanish Republican cause.

The war in Spain will continue for another 18 months, ending on 1 April 1939 when the Republicans surrender unconditionally to Franco's Nationalists.

Meanwhile, in China, the Second Sino-Japanese War breaks out on 7 July. The war pits the Japanese against both Chinese Nationalists (the Guomindang) led by Chiang Kai-shek and the Chinese Communist Party, led by Mao Tse-Tung.

The rival Chinese forces initially cooperate in the fight against the Japanese. However, by 1938 the preexisting hostilities between the two begin to resurface.

Bethune decides to focus his attention on assisting the Chinese communists. "I refuse to condone, by passivity, or default, the wars which greedy men make against others," he writes. "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."

1938 - Accompanied by a Canadian nurse and taking a supply of medical equipment, Bethune leaves for China on 8 January. After arriving in China he is escorted to the communist stronghold of Yan'an in Shannxi Province, 700 km southwest of Beijing.

He is asked by Mao to stay in Yan'an and supervise the Eighth Route Army Border Hospital but soon decides he would be more effective working at the front.

On 1 May he leaves Yan'an for the Shanxi-Chahar-Hebei border region, 300 km to the north.

Deciding that the most effective approach would be to train as many medics as possible, Bethune organises a medical corps, sets up training centres and provides lessons in first aid, sanitary practices and simple surgical procedures. He also devises a syllabus and develops illustrated teaching manuals.

In order to provide medical care to as many people as possible, he adapts his innovations from the Spanish Civil War and develops a generalised mobile medical unit. "The time is past in which doctors will wait for the patients to come to them," he writes. "They must go to the wounded."

His work helps to save the lives of thousands.

"It is true I am tired but I don't think I have been so happy for a long time," he writes of the experience.

"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."

1939 - In November Bethune contracts gangrene and septicaemia after a cut to his left hand received while operating on wounded soldiers becomes infected. He dies at Huangshikou Village in Hebei Province, 170 km southwest of Beijing, on 12 November.

Before he dies, Bethune writes a final letter. "The last two years have been the most significant, the most meaningful years of my life," the letter says. "I have found my highest fulfilment here among my beloved comrades."

On 21 December, Mao publishes a eulogy to Bethune. "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," the eulogy says.

"No one who returned from the front failed to express admiration for Bethune whenever his name was mentioned, and none remained unmoved by his spirit. In the Shanxi-Chahar-Hebei border area, no soldier or civilian was unmoved who had been treated by Dr Bethune or had seen how he worked. ...

"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 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."

The eulogy becomes compulsory reading in China and Bethune a national hero.

1949 - By the end of the year Mao's communists control the whole of mainland China. The Japanese have been beaten and the Guomindang forced to flee to the island of Taiwan. Mao formally proclaims the People's Republic of China on 1 October.

1950 - Bethune's body is moved to the Cemetery of Martyrs at Shijiazhuang in Hebei Province, 260 km southwest of Beijing. He is honoured with a tomb, a statue, a pavilion and a museum. Across the road from the cemetery the 800-bed Norman Bethune International Peace Hospital is dedicated to his memory.

1964 - A film about Bethune is produced in China. Several other films about Bethune will be made over the years. A dramatisation of Bethune's life is produced and broadcast by the Canadian Broadcasting Corporation in 1977. Simply titled 'Bethune', the program stars Donald Sutherland.

'Bethune: The Making of a Hero' is released in 1993. The film, which is coproduced by Canada, China and France and shot on location, also stars Donald Sutherland. In 2006 a 20-part television miniseries on Bethune is produced by China Central Television.

1972 - The Government of Canada declares Bethune as "a Canadian of national historical significance."

1973 - The house in Gravenhurst where Bethune was born is acquired by the Canadian Government. On 30 August 1976 it is officially opened as a national historic site. A bronze statue of Bethune is also erected in Gravenhurst. In Montreal, a public square and statue are dedicated to Bethune.

1990 - In March, Canada and China issue two postage stamps commemorating the centenary of Bethune's birthday.

1998 - Bethune is inducted into the Canadian Medical Hall of Fame.

2004 - Bethune is voted the 26th greatest Canadian by viewers of 'The Greatest Canadian' program televised by the Canadian Broadcasting Corporation in November.

Comment: I only stumbled on Bethune's story by accident. Nothing unusual in that. A lot of the personalities featured on this site have been chance finds. It's one of the fringe benefits that makes producing this site worthwhile - the discovery of extraordinary and unsuspected lives.

And Bethune's life is spectacular. It has all the hallmarks of the misunderstood and romantic hero: the single-minded rebel; the artistic temperament; the selfless striving to prevent human suffering; the commitment to universal human values; the rejection at home; the redemption through participation in epoch-defining conflicts; death in the prime of life; the ultimate recognition.

The story of Bethune's life is evocative. He has even been described as a saint. But he was no such thing. He was just a human. And as inspiring as the man and his life may have been, Bethune had many human foibles.

After Bethune's death, Edward Archibald, Bethune's erstwhile mentor, wrote, "He was definitely abnormal, but not 'mental' and not a genius or a leader. ... He was an egocentric. His vision was keen but narrow. He wore blinders. He trod on many toes, quite often without knowing or caring if he did know. He had a superiority complex and he was entirely amoral. And yet, it is not quite fair to say all that, because I do give him credit for sincerity in his social views."

Archibald's view may be jaundiced. It may be accurate. More likely it is completely irrelevant. The broad strokes of Bethune's life speak for themselves. He is a thoroughly worthy addition to the heroes section of this site. More than a misunderstood and romantic hero, he was a remarkable man.