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Mobile Blood Banks:

The Innovative Dr. Norman Bethune

Canadian surgeon Norman Bethune (1890-1939) remains today a hero venerated by the Chinese people. At home, Canadians view the doctor from Gravenhurst, Ontario with ambiguity because of his socialist politics. In 1936, Bethune went to Spain to fight Franco's Fascists. Two years later, Bethune was in China aiding the Chinese Communist Eighth Route Army against the invading Japanese. But what makes Bethune a notable medical figure was his innovative approach to saving the lives of wounded soldiers at the battlefront. While in Spain and later in China, Bethune introduced the concept of mobile blood bank units. This allowed Bethune and other doctors to perform immediate blood transfusions on wounded soldiers, often saving their lives before they were sent to hospital.

Trained in Toronto, Bethune became a thoracic surgeon so that he might help the many tuberculosis cases in North America. His interest in tuberculosis came from his own personal experience with the disease. In the 1920s, he had been diagnosed with tuberculosis and spent months at the famous Trudeau Sanatorium in the Adirondack Mountains, where he successfully underwent an artificial pneumothorax, a procedure which collapses the diseased lung thus allowing it to rest. This was considered a new, radical treatment at the time. He moved to Montreal because of its high tuberculosis mortality rates and took a position at the Royal Victoria Hospital. While there, Bethune improved upon a number of surgical instruments. His most famous instrument was the Bethune Rib Shears, which still remains in use today. His greatest contribution to medicine, however, was yet to come.

While in Spain and to a much greater extent in China, Bethune witnessed the loss of many soldiers due to bleeding upon transit back to base hospitals. He organized mobile medical units, which followed regiments into action, to provide needed blood transfusions to wounded men. His blood transfusion service consisted of a wagon containing a refrigerator, sterilizer, incubator and other needed equipment such as lamps, flasks, blood transfusion sets, and stored blood. Blood was needed most at the front, on the spot where the wounded lay. The introduction of the mobile blood bank to the battlefield is an important medical contribution.

In 1939, Bethune died of blood poisoning after operating with a cut finger on an infected Chinese soldier. (He refused to wear rubber gloves, arguing that it reduced the sensibilities of his fingers needed in operating.) There were no sulfa drugs (penicillin) for treatment. Immediately upon his death, he became a martyr and a hero among the Chinese people. Throughout his life, Bethune was an innovator and idealist from his revised surgical implements to his socialist views on the need for universal health care in Canada. He is remembered as both a great doctor and humanitarian for his medical service.