In the village of Huangshikou, in the hills between Beijing and the Mongolian plateau, a Canadian surgeon operated on wounded soldiers of the Eighth Route Army on a door laid across two sawhorses. He had been in the country a little over a year. He would be dead within weeks, of blood poisoning from a cut he took while operating without gloves, and a generation of Chinese schoolchildren would learn his name before they learned any other foreigner's.
Henry Norman Bethune was born in Gravenhurst, Ontario in 1890, the son of a Presbyterian minister. For most of the twentieth century he was better known in China than in the country that produced him, and the gap between those two reputations is one of the stranger facts about our national memory.
He came to medicine the hard way. He served as a stretcher-bearer at Ypres and was wounded there. He finished his training, built a practice, and in 1926 contracted tuberculosis — the disease that was then killing more Canadians than anything else. Told to rest and wait, he instead found a journal article describing artificial pneumothorax, an aggressive treatment involving the deliberate collapse of the infected lung, and demanded it. It worked. He emerged from the sanatorium convinced of two things: that he had been given his life back by a technique most patients were never offered, and that the reason most patients were never offered it was money.
The second conviction took him further than the first. By the early 1930s he was one of the better thoracic surgeons in Montreal, inventing and refining instruments that bore his name, and increasingly impatient with a profession he had decided was arranged for the comfort of doctors. He studied the Soviet health system. He argued publicly that medicine should be socialised, which in the Montreal of 1935 was not a career-advancing position. He joined the Communist Party of Canada the same year.
Spain is where the doctor and the politics met. Bethune went in 1936 and built something that had not existed before: a mobile blood-transfusion service that brought refrigerated blood forward to casualties instead of carrying casualties back to the blood. The Servicio canadiense de transfusión de sangre ran out of Madrid, collected donations from civilians, and treated the wounded where they fell. The principle — that you shorten the distance between injury and transfusion — is now so standard that it is difficult to see as an innovation. It was one.
He reached China in early 1938, travelling with Jean Ewen, a Canadian nurse who had already spent years in the country and spoke the language, and he made his way to Yan'an, the Communist base in the northwest. There he met Mao Zedong. The two men talked through a night about medicine at the front.
That his politics were unpalatable to the Ottawa of his day is a fact about Ottawa.
What Bethune then did in the Jin-Cha-Ji border region was, by any professional standard, extraordinary. He operated in villages and temples and caves, sometimes for days without meaningful sleep. He designed a portable operating theatre that could be carried by two mules and set up in ten minutes, and he insisted it travel with the troops rather than wait behind them. He wrote and illustrated medical textbooks for staff who had, in many cases, no formal training at all, and he ran courses to produce more of them. He was by every account a difficult man — impatient, scathing about incompetence, frequently furious — and the work he did in under two years reorganised battlefield medicine for an army of hundreds of thousands.
He was not alone. Dr Richard Brown, an Anglican medical missionary working in China, travelled with him to Yan'an and operated alongside him before returning to his own mission. Ewen worked across the Chinese Red Cross effort and later wrote her own account of those years. James Endicott, born in China to Canadian missionary parents, spent the war there and came home to become one of the most controversial Canadians of the Cold War for what he said about it. They are not a movement. They are a pattern, and the pattern is that a small number of Canadians were present at the founding of modern China in a way no other Western country can quite claim.
He knew what it had been worth to him. "The last two years have been the most significant, the most meaningful years of my life," he wrote near the end — a sentence from a man who had already invented one thing that saved lives and was in the middle of inventing another.
Bethune died on 12 November 1939. He had cut his finger during an operation, on a patient whose infection then entered the wound, and carried on working.
On 21 December Mao wrote an essay about him. "In Memory of Norman Bethune" is barely a thousand characters long. It praises his skill, and then it argues that what mattered was something else: his "utter devotion to others without any thought of self", in the standard translation, offered by a foreigner with no stake in the outcome. That is a political document as much as a eulogy, and it was doing political work. It is also, on the facts of the man's last two years, not an exaggeration. During the Cultural Revolution the essay became one of three short works that were required reading across the country, which means that for decades essentially every literate person in China encountered Bethune's name, often before they encountered Canada's.
The consequence is still visible. There are Canadians who have discovered, on a first trip to Beijing or Shijiazhuang, that a taxi driver knows exactly where they're from and has a surgeon's name ready. There is a medical school in Changchun that carried his name for years. There is a tomb in the Martyrs' Cemetery at Shijiazhuang.
At home he took far longer to arrive. He had been a Communist, which in Canada in the 1950s settled the matter, and the official position was close to embarrassment. The reversal came with the diplomatic relationship: Canada recognised the People's Republic in 1970, and six years later the house in Gravenhurst where he was born opened as a national historic site. There is a square named for him in Montreal, with a statue that was a gift from China, and the statue has been argued about on and off ever since.
The argument is worth having and does not need settling here. What is harder to argue with is the ledger. A Canadian doctor invented mobile transfusion in one war, carried the idea into another, trained the medics of an army that had almost none, and died doing it at forty-nine. That his politics were unpalatable to the Ottawa of his day is a fact about Ottawa.
Canada and China have spent the last several years in a cold and often unpleasant stretch, and there are real reasons for some of it. But the relationship did not begin with canola shipments or an extradition case, and it will not end with them. It began with a surgeon from Muskoka, a door across two sawhorses, and the forty years it took his own country to notice.
