New York-tidewater chapters' history of military medicine award: The military odyssey of Norman Bethune

Military Medicine, Apr 1999 by Alexander, C Alex

While visiting the Peoples Republic of China in 1982, I became aware of the work of the Canadian, Norman Bethune, as a military surgeon. Bethune first served as a stretcher-bearer in an ambulance unit and later as a medical officer with the Allies during the First World War. He also participated in the Spanish Civil War as a military physician. He died in China while serving with Mao Tse-tung's 8th Route Army, fighting the Japanese invaders in Yenan. Bethune pioneered the use of whole blood transfusions in combat areas, first in Spain and then in China. In the annals of Chinese military history, he has been given an honored place as a military surgeon and a martyr. He is also credited in China with improving the practice of battlefield medicine, as an organizer, teacher, and innovator. Bethune's fame in China is now spreading to Canada.

Introduction

During the summer of 1982, I visited the Peoples Republic of China with a group of health professionals from the United States. After visiting numerous medical institutions in Beijing, we were headed to Shanghai. In deference to my request to see a military hospital, the group was advised to break its journey in Shih zia zhuang, the capital of Hebei Province. On arrival there, I went on a stroll from my hotel. It took me past two large iron gates into a city park. Soon, I found out that it was also a military mausoleum for martyrs. In the middle of a small square, there was a life-size statue of a man with a stethoscope in hand, mounted on a pedestal with inscriptions in both Chinese and English. It was that of a Canadian surgeon, Norman Bethune, locally known as Pai-Chu-En, translated as "white-- seek-grace." He is the only westerner hailed as a national hero in China. No one in our group knew much about Bethune except that he was a controversial figure, both in Canada and the United States. The military hospital and the medical school in Shih zia zhuang are named after him. This essay is based mostly on my research of published material on Bethune and the notes that I took while traveling in China. Dr. Bethune participated in military actions on two continents, first in France, then in Spain, and finally in China, where he died in 1939. The focus of this essay will be on his contributions as a military surgeon and a humanist.

Early Years as Prologue

Henry Norman Bethune was the first son of a Presbyterian minister, Malcolm Bethune, and his wife, Elizabeth Ann Goodwin. He was born on March 3, 1890, in Gravenhurst, Ontario. His grandfather Norman was a well-known surgeon in Toronto. His parents claimed that when Henry Norman was 8 years old, he hung the nameplate of his surgeon grandfather in his room and insisted that he should be called Norman and not Henry. From his early years, everyone knew that Norman wanted to become a surgeon. He was also considered a daring kid. When he was barely 10 years old, he had to be rescued from drowning after he foolishly attempted to swim across the local harbor. Although he failed in his maiden attempt, he succeeded in doing so the following year.1

Norman had to move with his parents frequently because of his father's commitment to an itinerant ministry to the poor. Despite such dislocations, Norman graduated easily from the Owen Sound Collegiate High School with a good academic record. Norman's parents finally settled in Toronto, to let Norman attend the University of Toronto. Because of the family's limited means, Norman paid for his college education by working at odd jobs. Norman majored in biology and acquired a fascination for the theory of evolution. His mother was most upset one day when Norman brought home a copy of Charles Darwin's The Origin of Species. She tried to divert his reading by placing religious tracts inside the book. Finally, she burned the book when she discovered one morning that young Norman had slid the book under her pillow. She was furious at the thought of having rested her head a whole night on that infamous book.'

Medicine and the Military

Before his enrollment as a medical student at the University of Toronto in 1912, Norman had already completed some course work in physiology and biochemistry.2 That exempted him from repeating the two preclinical subjects in the medical school. The First World War erupted when he was in the final year of medical school. Norman interrupted his medical studies and joined the Canadian Army on September 8, 1914. At the age of 24, he saw combat action in France with the First Canadian Division as a stretcher-bearer in a field ambulance unit. Six months later, at the second battle of Ypres, he sustained a bad leg wound and was hospitalized in England for nearly 3 months before being sent home.3

Norman's thoughts and feelings as a stretcher-bearer can be gleaned from his own writings. In one, he despaired at "the blood-spattered faces of the dead."2 In another, he expressed his dismay at having seen very "little of war's glory" and mostly "of war's waste."' Norman's experiences seemed to have taught him the value of immediate medical intervention on the battlefield and its lifesaving impact on the morale of the soldiers. Norman's ambulance unit was modeled after a similar one the British had used during the Boer War. At full strength, it had 9 officers, 238 enlisted ranks, 15 riding horses, 39 draught horses, and 7 motorized vehicles.4 The unit was divided into stretcher-bearer and tent divisions. The tent division was further divided into three sections, each of which was capable of accommodating 50 casualties before their transportation to a base hospital by either horse-drawn carriage or motorized ambulance. Each section operated immediately behind the battlefront.