The Scalpel, the Sword: The Story of Doctor Norman Bethune

by Ted Allan, Sydney Gordon, Julie Allan (Introduction)

Originally published in the early 1950s, The Scalpel, the Sword celebrates the turbulent career of Dr. Norman Bethune (1890-1939), a brilliant surgeon, campaigner against private medicine, communist, and graphic artist. Bethune belonged to that international contingent of individuals who recognized the threat of fascism in the world and went out courageously to try to defeat it.

Born in Gravenhurst, Ontario, Bethune introduced innovative techniques in treating battlefield injuries and pioneered the use of blood transfusions to save lives, which made him a legend first in Spain during the civil war and later in China when he served with the armies of Mao Zedong in their fight against the invading Japanese. He is today remembered amongst the pantheon of Chinese revolutionary heroes.

In Canada Bethune's strong left-wing views made him persona non grata, but this highly readable and engaging account has helped to sustain the memory of a great man.

Genres: History, Biography, China, Nonfiction, Canada, Medicine

368 pages, Kindle Edition

First published January 1, 1952

Reviews

[The Conspiracy is Capitalism · Rating 5 out of 5]

“Peace for the world! Remember Dr. Bethune!”

Preamble:
--Well, I have a new favorite biography, topping my list that also features:
-Che’s I Embrace You with All My Revolutionary Fervor: Letters 1947-1967
-Frederick Douglass’ My Bondage and My Freedom
--How curious it is for me to be born in China, where (post revolution) basically everyone has heard of (Canadian) Norman Bethune through public education (making him perhaps the most well-known Canadian in the world), and then immigrating to Canada where I’ve not met anyone (who is not a Chinese immigrant or very political) who has heard of Bethune (even working in healthcare).
--One of the great privileges of being an immigrant is you by default are gifted with an outsider’s perspective. I’m reminded of the ending of my favourite book, Talking to My Daughter About the Economy: or, How Capitalism Works—and How It Fails:

When you were born, your name, Xenia, appealed to me greatly because its etymology comes from the Greek word xenos, meaning ‘stranger’ or ‘foreigner’ and translates as ‘kindness to strangers’. The appeal of this name came in part from my belief that the best way to see your country, your society, is to see it through the eyes of an outsider, a refugee. Try mentally to travel to a faraway place, if not necessarily in order to move your world – though how splendid that would be! – but to see it clearly for what it is. Doing so will grant you the opportunity to retain your freedom. And to remain a free spirit as you grow up and make your way in this world, it is essential that you cultivate a rare but crucial freedom: the liberty that comes from knowing how the economy works and from the capacity to answer the trillion-dollar question: ‘Who does what to whom around your neck of the woods and further afield?’

…Now, this gift contradicts with the process of assimilation, where immigrants are hyper-vigilant of the hierarchies in their new environments as they attempt to fit in. The root of so-called “model minorities” embracing assimilation comes down to class, i.e. identifying more with middle/upper class rather than the global coloured poor.
…I consider this contradiction in reviewing Jordan Peterson (12 Rules for Life: An Antidote to Chaos), the one Canadian “doctor” (clinical psychologist, although actually known for his reactionary opinions) that many Canadians do know today… Peterson calls Mao the worst mass-killer in modern history, so I doubt he would think much of communist Dr. Bethune.

Highlights:

1) Public health vs. Capitalism:
--Capitalism sells the rope to hang itself; public health is a socialist struggle against the consequences of capitalism’s dispossessions turning nature and humans into commodities (land and labour markets), with the worst in foreign lands (colonialism/wars):

[T]he long rise of capitalism, from 1500 right into the Industrial Revolution, caused dramatic social dislocation everywhere it went. The enclosure movement in Europe, the Indigenous genocides, the Atlantic slave trade, the spread of European colonisation, the Indian famines; all of this took a measurable toll on human welfare around the world. The scars remain starkly visible in the public health record. For the vast majority of the history of capitalism, [economic] growth didn’t deliver welfare improvements in the lives of ordinary people; in fact, it did exactly the opposite. Remember, capitalist expansion relied on the creation of artificial scarcity. Capitalists enclosed the commons – lands, forests, pastures and other resources that people depended on for survival [creating the land market] – and ripped up subsistence economies in order to push [dispossessed] people into the labour market [to fill “dark, Satanic mills” (William Blake, 1804)]. The threat of hunger was used as a weapon to enforce competitive productivity [as well as vagrancy laws to fill brutal workhouses]. Artificial scarcity quite often caused the livelihoods and welfare of ordinary people to collapse even as GDP grew.

It wasn’t until nearly 400 years later that life expectancies in Britain finally began to rise […]. It happened slightly later in the rest of Europe, while in the colonised world longevity didn’t begin to improve until the early 1900s [from decolonization, as the colonizers’ competition led to world wars]. So if growth itself does not have an automatic relationship with life expectancy and human welfare, what could possibly explain this trend?

Historians today point out that it began with a startlingly simple intervention […]: [public] sanitation. In the middle of the 1800s, public health researchers had discovered that health outcomes could be improved by introducing simple sanitation measures, such as separating sewage from drinking water. All it required was a bit of public plumbing. But public plumbing requires public works, and public money. You have to appropriate private land for things like public water pumps and public baths. And you have to be able to dig on private property in order to connect tenements and factories to the system. This is where the problems began. For decades, progress towards the goal of public sanitation was opposed, not enabled, by the capitalist class. Libertarian-minded landowners refused to allow officials to use their property, and refused to pay the taxes required to get it done.

The resistance of these elites was broken only once commoners won the right to vote and workers organised into unions. Over the following decades these movements, which in Britain began with the Chartists and the Municipal Socialists, leveraged the state to intervene against the capitalist class. They fought for a new vision: that cities should be managed for the good of everyone, not just for the few. These movements delivered not only public sanitation systems but also, in the years that followed, public healthcare, vaccination coverage, public education, public housing, better wages and safer working conditions. According to research by the historian Simon Szreter, access to these public goods – which were, in a way, a new kind of commons – had a significant positive impact on human health, and spurred soaring life expectancy through the twentieth century. [Source: Less is More: How Degrowth Will Save the World]

2) From Default Liberal to Communist:
--Similar to how many Canadians are not exposed to one of the most famous modern Canadians, working in public health under capitalism means obscuring the socialist history of public health and its blatant communist ideals of classless accessibility/quality/“from each according to their ability, to each according to their needs”.
--So, it should be no surprise to see those in the medical field become radicalized as they face the contradiction of:
a) being tasked to heal the public, while….
b) being siloed from affecting the economy that dictates the environments causing sickness.
…prominent examples along with Bethune include Che (The Motorcycle Diaries: Notes on a Latin American Journey) and Allende (socialist president of Chile until US-backed coup).

When I give food to the poor, they call me a saint.
When I ask why they are poor, they call me a communist.

-Dom Hélder Câmara

--This book details Bethune's radicalization, from a default liberal to a communist:

Money now began to pour in. Whereas his neighbourhood patients came to him only in their extremity, pleading their poverty, his new patients expected to be billed handsomely for the most trivial services. […]

Success was welcome but sometimes, as he sat in his newly furnished office, he looked at his hands and thought: what has changed? They were the same hands. Had they some new magic today that they lacked yesterday? He knew the answer: yesterday they had treated the poor, today they treated the rich.

[…] He found himself now a prisoner in a rigid system, with its "scratch-my-back-and-I'll-scratch-yours" outlook, and its rake-off for the general practitioners who sent him their patients. The specialist was expected to charge all that the traffic would bear, and the "gravy" would pass down the line, with the patient "taxed" to keep the system going.

Money was the beginning and end. He took as much as he could, and returned to his first patients in the slums to find his lost sense of peace, the tarnished ideals of the doctor serving the sick and the poor. […]

He had spent most of his life becoming a surgeon; as a surgeon he could heal the human body, not the whole damn stupid mess called society. "We, as physicians," he continued, "can do but little to change the external environmental forces which predispose to infection and re-infection. Poverty, poor food, unsanitary surroundings, contact with infectious foci, overwork and mental strain are beyond our control. Essential and radical adjustments of these are problems for the economists and sociologists." […]

He declared in all his writings that it was necessary to abandon the idea that T.B. [tuberculosis] was merely a disease of the lungs. It was in reality a disease of the body. The bacillus's attack on the lungs was the end product of the environment's attack on the whole organism. "Any scheme to cure this disease," he often said, "which does not consider man as a whole, as the resultant of environmental strain and stress, is bound to fail." […]

The province with the lowest standard of living had the highest T.B. rate. And throughout the country, in the city slums and bankrupt farm hinterlands, there were many thousands of people slowly succumbing before the disease without even knowing they had it.

Why? The question made him uneasy even as he continued to expound his theory of early lung compression. His search for the answers led him to another disease that was engulfing the world - a disease more deadly than tubercle bacillus and swifter than medieval cholera.

Like any other serious medical practitioner he had always known that T.B. fed on poverty. But now poverty, for some reason, seemed to be spreading everywhere, spewing forth ten new cases of T.B. infection for every single case he and other doctors cured. Now when he asked himself why, the answer beckoned him along many strange, new and disturbing paths. […]

While presidents and ministers talked of "prosperity around the corner," unemployment, bankruptcy and fear gripped every continent. Dislocation and collapse stretched from Spain, where Primo de Rivera ruled through military dictatorship; to Germany, where a strange creature and a strange movement, Hitler and National Socialism, had seized power; to China, where Chiang Kai-shek was busily reducing the population by massacres of opposition elements; to Japan, where a militarist clique dreamed of ruling all Asia.

To Bethune it began to appear as if some mass mania had laid hold of the world. Night seemed to be day and day never seemed to come. "Pull in your belts," cabinet spokesmen of ample girth advised, and stopped counting when the number of unemployed around the globe hit 40,000,000. It was a simple matter of overproduction, they said, but everywhere the people had nothing.

In the world at large he noted a disturbing contradiction. Millions were without clothes, and the United States ploughed under its own cotton fields. Tens of millions were hungry, but Canada burned its wheat. On street corners men begged a nickel for a cup of coffee, but Brazil dumped its coffee into the ocean. In Montreal's working-class districts the children were bowlegged with rickets, but oranges from the South were destroyed by the carload. [This capitalist contradiction/irrationality of destroying "overproduction" for the sake of profit while the masses are in poverty is famously illustrated in The Grapes of Wrath] And from the head of the Canadian Medical Association came a warning that disaster lay ahead for the profession and the people of Canada unless emergency measures were taken to provide medical services for the majority of citizens who couldn't afford to pay, and for the doctors who couldn't afford to treat their patients without payment.

…For the rest of the review, see the comments below, esp. the last part:
"3) Capitalism and War/Colonialism"

[Sowmen Mitter · Rating 5 out of 5]

This book is the story of Norman Bethune, a prominent Canadian thoracic surgeon. During the 1930s he became a convinced communist, which led him to the frontlines of the wars in Spain and China. He arrived in China about six months after th
e start of the major Sino-Japanese War. He made his way to Yenan where, in discussion with Mao Zedong, he advanced his theory that fully 75% of serious casualties would survive if operated on immediately. Mao commissioned Bethune to organize a mobile operating unit, and this brought Bethune to the "center of center of the war" in the interior of northern China.

His extraordinary devotion to duty became a legend throughout the region and eventually throughout China. He died of septicemia contracted when he cut himself while operating under great pressure as the Japanese advanced to within ten minutes of his operating room.

[Paula Dembeck · Rating 5 out of 5]

This is an excellent book about Bethune’s life.

It has so many details including quotes from his journals, so you really get to understand his thinking. He went through many phases in his life, from bohemian to selfless physician, and he always had a quick temper and suffered fools poorly.

It is easy to understand why this is considered the best story of his life, as it has far greater depth than some of the others I have read.

[Dasha · Rating 5 out of 5]

This book is an outpouring of passion between two friends who shared similar aspirations and goals. Allan's book is a eulogy and a mythologizing of Bethune's life. It is thoughtful and Allan's friendship with Bethune shines through. Yes, it is the work that started to establish Bethune as a larger than life hero within Canadian mythos. But I would likely write a similar narrative if I was writing about my close friend and his tragic passing.

[Mohammed Usman · Rating 4 out of 5]

Inspirational.

[Biswadip Chattopadhyay · Rating 5 out of 5]

I have no words.
Just speechless. Dr Norman Bethune was not only one of the best doctors contributing to medical sciences, but also has was a revolutionary, one of the greatest men ever to have lived in earth.
A globalist, communist by heart, he healed thousands and thousands of poor peasants during the independence war of China.
He fought against fascism in Spain during 1936-37 when the western countries were keeping mum and doing nothing to check the fascist aggression due to their pity political advantage.
Dr Norman Bethune is pride of Canada, pride of the whole world.
He invented lots of instrument in thoraco-vascular surgery, including Bethune Rib Shear, even used nowadays. After been inflicted with Tuberculosis, he devoted to root out the disease from the world.
He first developed the practicality of blood transfusion in warzones. He revolutionalised battlefield surgery.
But his greatest contribution to humanity was his last two years when he travelled barefoot amongst the forests and mountains of China to heal 8th route Army Partizan Army and common folks in fight against Imperial Japanese Army. He eventually died after he lost his thumb while operating on bare minimum. Due to non-availability of proper antiseptics, his wound turned into septicemia and he died in the hubei province in China.
He is a hero for every people in China, but he should be a hero for all. West, his own country, has eclipsed him because of his political ideology but he was one of the greatest. He was Pioneer in many fronts.
This book salutes the hero, gives justice to the legend.
100% recommended.

[Tom Axworthy · Rating 3 out of 5]

Written in the early 1950s, the Scapel ,the Sword was the book that made Norman Bethune well known in Canada.( he was already a legend in China).Ted Allen, one of the co-authors, worked with Bethune in the Spanish Civil War and the book reflects this deep friendship.Bethune is a fascinating character( he is likely the model for Dr James Martell one of the main characters in Hugh Maclennan's famous novel the Watch that Ends the Night).He was a brillant surgeon, a medical innovator, a member of the Communist party , a lover of the arts and died a hero's death in 1939 ( Mao himself wrote a tribute)supporting
the Chinese Communist party in its battle against the invading Japanese.This book is historically important as it was the first to portray Bethune but it is an idealized account.It passes over, for example, that Bethune was recalled from Spain by the Communist party itself because he was so difficult , subject to rages with his drinking was out of control.There have been several more balanced books about Bethune since the Scapel, the Sword was published in 1952 but the the impact of this first biography was immense.

[Lyn · Rating 5 out of 5]

Most Canadians, of the boomer generation anyway, have at least heard of Norman Bethune and have some vague knowledge of his having served in China, and that's about as much as I knew. His life was so amazing, it's hard to believe one man experienced and accomplished so much. A surgeon, a bon vivant, a TB survivor, a survivor of being shot in WWI, an innovator, a doctor who went to serve in the Spanish Civil War and the Second Sino-Japanese War where his legendary status took root. His care and concern for the poor, and his support of socialized medicine was without apologies. Not to suggest he was a saint, but he was a truly exceptional human being. This book, which includes some of Bethune's own writings, captures his many incarnations with wonderful prose, and concise writing. I wish this would be reprinted with an up-to-date forward.

[Carol · Rating 4 out of 5]

Wow, what a fascinating fellow! Somewhat foolhardy, though, as he completely ignored his own health, including signs of utter exhaustion - not realizing that he should keep well in order to better help others.
This book should be compulsory reading in schools, because not only does it describe a Canadian hero, but also because it touches on aspects of the Spanish Civil War and the Sino-Japanese war in the 1930's.
Considering it is a biography, this book is hard to put down. It includes much suspense, and much pure fascination. Very occasionally it dragged or was perhaps a bit repetitive, but skim 3 or 4 paragraphs and you will be right back on track.
Much of the book is made up of excerpts from his diaries, making them all the more interesting.

[Roger Humbke]

Have yet to read "The Scalpel, the Sword" but while in China from 2000 to 2014 I did read "Dr. Norman Bethune" a Longman Secondary English Graded Reader by Ken Beatty

In all my time in China as a teacher, once people knew I was Canadian, they would come up to me smiling and saying Bethune - Bethune and wanting to shake my hand or hug me. Didn't know a word of English, but they sure knew who Bethune was and they loved him. They really want me to know that Bethune was their hero. He did more to create goodwill from Canada to China than any politician or other individual I know.

[☃️ Quirk · Rating 5 out of 5]

Incredible book, one of my favorite biographies! Found it in a little free library and loved it.
1. Medical techniques cycle- some are tried and don’t work because of their context but then work 50 years later with more understanding.
2. Mao’s China was really an underdog in fighting Japan and uniting the country.
3. Experiences and learning compound: you can never be afraid to quit and try something that your values dictate because it might totally reinvigorate your value in the world.

[Brian Griffith · Rating 5 out of 5]

It's a very powerful account of one of the greatest heroes Canada ever produced. His legacy is enormous: major contributions in treatment for tuberculosis, blood transfusion brought to wounded soldiers on battlefields, internationalized resistance to fascist empire-builders, and medical service extended to the poor.

[Sean Egan · Rating 5 out of 5]

An incredible story, passionate and tragic and grand. At its heart is a thoroughly revolutionary and deeply humane conception of medicine, solidarity and duty.

[al · Rating 3 out of 5]

3.5 if we're being specific. The only reason it took me so long to get through this was because I was doing it for a commission, but I genuinely enjoyed it!

[Matthew Antosh · Rating 2 out of 5]

This book accomplishes two seemingly contradictory feats: it is both extremely overwritten, and at the same time it is a very lazily written book. Whole chapters are often direct excepts from Bethunes diaries or pamphlets or speeches. During the chapter on Bethunes experiences during the Spanish Civil War, Allan and Gordon take us out of the action and give a lengthy dissertation in the medical history of Hematology.

This is pure communist hagiography - if you wanted to have a deeper look into the life of Bethune as a man, this is not the right book. This is the Bethune of Mao Zedong Thought, an indefatigable superman dedicated to an universal ideal, to which even his flaws are perfect representations of his "New Man" status. I remember this really inspiring me as a teen ("there are other Canadian Communists! and look how great they where!") but now it's annoying, and it took me for ever to read though.

[Cindy · Rating 4 out of 5]

Moving and well-written in terms of prose quality, but rather hagiographic piece whose effectiveness as a work of nonfiction was rather compromised by the injection of thoughts into minds. Makes little pretense of objectivity - perhaps reflective of the time when this was written? But vivid description of transformations and internal conflicts of the protagonist and of battlefield medicine made it certainly worth the time.

[Alan Barratt · Rating 5 out of 5]

The Story of Dr Norman Bethune (Detailed Story) Excellent Book