Dr. Norman Bethune’s participation in the international anti-fascist cause began when he answered a call for a medical unit to be assembled and sent to Spain. Just months after his political awakening—and commitment to communism—brought on by disgust at the state of for-profit medicine in Canada, Bethune had become obsessed with anti-fascism and the resistance in Spain. He was voraciously reading all that he could in Montreal’s left wing newspapers and magazines about the Nationalist uprising, one of which contained the call for a Canadian medical unit to be sent to Spain. The “Spanish Hospital and Medical Aid Committee” sent out the call in the social-democratic, Cooperative Commonwealth Federation (CCF) run magazine, New Commonwealth. When Bethune telegraphed the editor of the magazine, Graham Spry, to inquire about the unit, Spry confessed that at that the committee was more of a hopeful thought than an organization capable of mustering the funds to send anyone. This did not deter Bethune, who set out to make the committee and the unit a reality. After some discussion and reflection, Bethune resigned his position at Sacre-Coeur hospital in Montreal and prepared to go to Spain. The committee was renamed “The Committee to Aid Spanish Democracy” (CASD) and was one of the foremost examples of a Canadian “popular front” of liberals, socialists, and communists resisting fascism during the 1930s. At this time, the democratic socialist CCF and the Communist Party of Canada, which Bethune had joined in 1935, were often rivals on the Canadian left; however, “inspired by a common goal” they worked together to send Bethune and a properly equipped unit to Spain (Stewart and Stewart 139-141). The work of Norman Bethune in Spain was certainly an example of what he called, in a 1936 trans-Atlantic radio broadcast, “practical international comradeship” resisting “the threat of the New Dark Ages of Fascism” (Station EAQ).
Development of Blood Transfusion
Bethune at first struggled to carve out a place for his talents in Spain. He had arrived independently of other international volunteers, many of whom were sent as a part of the International Brigades. The brigades did not need another surgeon, and the hospitals of Madrid turned him away. Bethune’s interpreter and fellow Canadian, Henning Sorenson, felt “Bethune’s usefulness was limited because he could not speak Spanish” (Stewart and Stewart 160). While purchasing an ambulance in Valencia to donate to the International Brigades, Bethune “burst out, ‘Henning, I’ve got it!’” (163). The combination of exposure to the need for ambulances and Bethune’s experience in the First World War as a stretcher bearer for men dying of blood loss caused him to realize he could assemble a mobile blood transfusion unit. The Canadians set up the Servicio canadiense de transfusion de sangre, known in English as the Canadian Blood Transfusion Service or the Canadian Blood Transfusion Institute. Their headquarters, referred to as “the Institute,” was in a wealthier section of Madrid, which made it considerably less susceptible to bombing by Franco’s forces. While wholesale aerial bombardment and artillery shelling of working class neighbourhoods were underway, the Nationalists avoided damaging the property of their most prominent supporters: the wealthy classes. By the time Bethune left Spain, an impressive amount of blood had been transfused. In June 1937, he claimed in an interview with the Daily Clarion that the unit had gathered and transfused over 90 gallons—about 340 litres—of blood in their year of work (Stewart and Majada 138).
It does not appear, as some have asserted, that Bethune was the first person to conceive of a mobile transfusion unit in Spain. Dr. Frederic Duran i Jordà was operating another mobile blood transfusion clinic in Barcelona two months before Bethune arrived in Spain. However, because of the Nationalist assault on Madrid, the Canadian transfusion institute was in a position to provide many more transfusions on the front lines than Duran i Jordà’s service ever could (176). The Canadian operation was also much more ambitious in its area of coverage. The transfusion unit was conceived by Bethune to be administered by Canadians and funded by Canadian donations. He reasoned “there was a Scottish ambulance unit and also an English hospital unit in Madrid [...] Why should there not be a Canadian blood transfusion unit?” (164). On top of their greater number of transfusions, it also appears that Bethune, unaware of the Barcelona transfusion service at the outset, came to the idea independently. Stewart and Stewart write: “Few outside the Aragon Front, including officials of the Socorro Rojo Internacional in Madrid, knew of Duran i Jordà and his work, so it is almost certain that Bethune too was unaware of it” (164). Regardless, Bethune’s transfusion work was groundbreaking in many ways and saved many lives.
After the start of the Canadian institute’s work, Bethune soon learned of the work being done in Barcelona, and was required by the central military command to consult with Duran i Jordà before proceeding with his ambitious plan to extend his blood transfusion service to all of Spain. Bethune recognized the superiority of Duran i Jordà’s container system for the blood, and agreed, for practical and political reasons, that Barcelona should be the centre of the Republican blood transfusion network. In one of his many commitments of Canadian funds without prior consultation, Bethune volunteered CASD to fund this expansion to cover Republican-held Spain, which certainly did not endear him to those who had the authority to recall him at any time (180). CASD sent a representative to check on the unit, as they were worried about scattered reports of disorganization and about the greater expenses they were about to incur due to Bethune’s promise of funds. Finally consolidating all medical care under a central command, the military health service, Sanidad Militar, assumed control over the institute and transfusion unit and promised Bethune he would remain in command (181). Initially, Bethune was also under the impression that he would be chief of the unified blood service. However, as Stewart and Stewart write,
Although Cerrada [, the commander of Sanidad Militar,] had not admitted it, Bethune sensed the Spaniards were reluctant to give a foreigner control over the proposed expansion of the service. He may also have realized that Duran i Jordà would not accept serving under a man whose qualifications in hematology were inferior to his own. (183)
Duran i Jordà was a hematologist, while Bethune was a thoracic surgeon with some understanding of hematology, likely as a result of his study under Dr. Edward Archibald at the Victoria General Hospital in Montreal. Archibald had been an army doctor during the First World War, and had used both arm-to-arm transfusion of blood, and extraction and preservation with sodium citrate before transfusion. Bethune must have learned about the arm-to-arm technique, because he later introduced it at another hospital. Stewart and Stewart also suggest, “Because of his connection with Archibald, it seems likely that he would also have known about the preservation of blood using sodium citrate” (76). Both techniques were used by Bethune prior to his contact with Duran i Jordà, who had refined the process of preserving and transporting blood in a way Bethune had not. The reluctance to name a foreigner— particularly one who did not speak Spanish—as the head of the unit would also cause Bethune problems within the Institute he had created himself, and would ultimately be a central reason for his departure from Spain.
The Crime on the Road
Though lesser known than the bombing of Guernica by the Nazi Condor Legion, the naval and aerial bombardment of refugees on the road from Malaga to Almeria, coordinated with the movements of 10,000 Italian Blackshirt infantry, was one of the worst atrocities of the Spanish Civil War. Approximately 100,000 fleeing refugees were deliberately targeted by Nationalist and fascist forces as they fled Malaga, which had just fallen to Nationalist troops. The refugees were evacuating to the town of Almeria, more than 200 kilometers away. Roderick Stewart and Jesus Majada describe the scene in their book Bethune in Spain: “Fighter planes banked low to strafe the solid masses of fugitives, while from the sea a cruiser and a destroyer fired salvos at them” (69). This barrage continued day and night, unopposed by Republican forces for nearly 72 hours.
The transfusion unit was the only international unit to aid in the evacuation of the civilians on the road. The blood transfusion’s Renault truck was used to ferry refugees, focusing particularly on the families with young children, for three days. The unit members took turns sleeping by the side of the road. While the Renault was in the shop for repairs, Bethune and Thomas Worsley, an Englishman and driver with the unit, witnessed what Bethune would later call “the final barbarism” (qtd. in Stewart and Stewart 191): the bombing of the city square of Almeria, which was packed full of refugees. In the hours following the evacuation, Bethune would compose one of his most powerful pieces of writing, The Crime on the Road: Malaga-Almeria, in which his abilities as a propagandist and his profound care for wounded people, particularly children, are on display. Bethune wrote that the fascist bombers “made no effort to hit the government battleship in the harbour or bomb the barracks” (83). He continues, “They deliberately dropped ten great bombs in the very centre of the town where sleeping huddled together on the pavement so closely that a car could pass only with difficulty the exhausted refugees” (83). Bethune counted fifty dead and another fifty wounded, while only two soldiers were killed. This text by Bethune, accompanied by pictures of the atrocities taken by fellow institute member Hazen Sise, “was later turned into an effective propaganda pamphlet circulated in France and North America” (Stewart and Stewart 192).
The evacuation had another effect: Bethune turned much of his attention to caring for Spanish orphans. He had always cared for children; he never had any of his own but he ran art classes out of his Montreal apartment for all-comers, often children. While he tried to expand the blood transfusion service, fought with military bureaucracy, and dealt with internal strife in the unit, Bethune also tried to persuade CASD to undertake a far greater expense than that presented by the institute: the construction of “children’s villages,” at a cost of $50,000 annually, so that Spanish orphans could be cared for and safely remain in Spain (210). Despite some CASD representatives believing it a good idea, the villages never were funded or built. During the evacuation, Bethune had tried to keep a tally of the number of children less than ten years of age he encountered on the road from Malaga to Almeria; he gave up when it entered the thousands. The Malaga-Almeria evacuation provides an excellent example of the nature of Bethune’s contributions in Spain: they often departed from strictly medical matters and just as often changed on a whim. Ultimately Bethune was most useful as a propagandist, as public dissemination of propaganda by and about the unit and its members raised the profile of the Spanish Civil War in the Canadian popular imagination.
While in Spain, Bethune appeared on international broadcasts from the Madrid radio station EAQ. The broadcasts could be heard in Canada, and transcripts of some broadcasts were published as pamphlets and circulated. Other members of the blood transfusion unit, such as Sise, would appear alongside Bethune on the broadcasts. An examination of the transcripts of the broadcasts reveals they covered a number of subjects. Sometimes they focused on analysis of the international political situation, always imbued with a heavy Marxist streak. Other times they spoke of the work of the unit and shared anecdotes of their work. Still others provided pro-Republican news on the war effort, which described Nationalist air attacks while declaring Madrid as “the tomb of fascism” (qtd. in Stewart and Majada 31). Bethune was very optimistic about the Republicans’ odds of success, and it showed in the radio broadcasts. He declared on December 29, 1936:
We are happy here [...] because we know that 1937 will see the International Fascists driven from this land forever. Spain will be free and the second great fight against the threat of the New Dark Ages of Fascism will be defeated. All men of good will should not only earnestly desire but must purposefully act towards that end. (qtd. in Stewart and Majada 40)
Astute students of history will note Bethune was overly optimistic in his assessment of the situation. Although his prediction of Republican victory would not be realized, the broadcasts featuring Bethune, which ended on January 5, 1937, raised the profile of the Canadian transfusion unit and provided an English language, pro-Republican news source for North American listeners. When the situation at the institute had begun to degenerate into bureaucratic conflict and power struggles between Bethune and the Spanish doctors under him, the broadcasts were taken over “by an entirely new bureau which [was] formed by Ted Allan, Jean Watts and Herbert Klein” (108).
Departure from Spain
While not an accomplishment of Bethune in Spain, his departure from the country deserves some attention, even in a study of this short length. Roderick Stewart and other Bethune scholars have done much work to piece together what happened, and why the Spanish government, CASD, and the members of the institute turned on Bethune by recalling him to Canada and expelling him from Spain. A combination of revolutionary puritanism, language barriers, bureaucratic and wartime paranoia, personal ambition, and Bethune’s disregard for traditional standards of “moral behaviour” worked together to result in the ouster of a man responsible for savings hundreds, if not thousands, of lives in Spain. Bethune had a tendency to drink to excess and had a variety of romantic and sexual encounters: this alienated some of the more puritanical leftists of CASD or the Institute, such as Henning Sorenson. Sorenson, according to Stewart and Stewart, viewed such things as “bourgeois diversions” (202). Sorenson became so upset with the behaviour of Bethune and his lover, a Swedish journalist named Kasja Rothman who often ran the institute’s daily affairs when Bethune was away, that he left “in disgust,” taking a position with the Sanidad Militar (qtd. in Stewart and Stewart 203). Rothman’s running of the institute also alienated the Spanish doctors who did not want to take orders from a woman or a non-physician, and much less from Bethune’s lover.
A revolving door at the institute of journalists, and of anyone else who Bethune took a liking to, made a number of government agents and some of the more grounded—and the more paranoid—institute members nervous about fascist spies and fifth columnists (202-203). Further exacerbating tensions, Bethune was a terrible linguist, and apparently put in no effort to learn Spanish, straining relations with the Spanish doctors at the institute from the beginning. After receiving complaints about Bethune’s command, likely from the Spanish doctors inside the institute, Sanidad Militar appointed two doctors, Vicente Goyanes and Antonio Culebras, who had been serving under Bethune as joint commanders with him over the unit (Stewart and Majada 101). Culebras and Bethune loathed each other, and Culebras had secretly hired several of his family members to work at the institute. This faction of family members comprised a sizable portion of people at the institute, and they were openly hostile to the Canadians involved. Bethune accused them of being “bourgeois loafers,” and believed them to be fascist sympathizers (102). At this time, Bethune had stopped eating or sleeping properly, and was drinking a great deal (110). His change in behaviour concerned the Canadians at the institute, who contacted the Communist Parties of Canada and of Spain, as well as CASD. CASD recalled Bethune for a variety of reasons, and in no small part because they realized how much use he could be as a propagandist in North America (122). By this point, the transfusion unit was largely self-sufficient and could be run by another person with an understanding of hematology, while he was an ideal candidate to headline a North American speaking tour. Reluctant as he was to depart, he was charismatic and in possession of a great deal of cultural and social capital, and made an excellent headlining speaker and fundraiser across North America.
Bethune’s Speaking Tour
Bethune left Spain in May 1937, and, according to the estimation of David Lethbridge in the collection of RCMP files he assembled, Bethune: The Secret Police File, “By the end of September , he had addressed at least thirty thousand people, and raised thousands of dollars for the blood transfusion service” (7). Travelling from coast to coast across Canada with stops in the United States, Bethune raised an enormous amount of money in the midst of horrible economic circumstances. Despite this, he was at times a reluctant propagandist. Bethune wished to remain in Spain, and later wished to return, but was too effective in his capacity as fundraiser for the Committee to Aid Spanish Democracy and as a recruitment tool for Canadians to join the International Brigades. Long classified, a collection of RCMP files is ironically the most comprehensive catalogue of Bethune’s achievements and influence on his speaking tour. From reading snippets of his speeches and the accompanying police documents, it becomes clear that in his appearances Bethune not only wished to advance the anti-fascist cause, but that he also hoped to inspire others across North America to take up his communist way of thinking. As Lethbridge writes in the introduction to the collection of files:
The secret police documents provide the richest source of Bethune’s thought during this critical time, and add immeasurably to our knowledge of his politics. It is evident that Bethune’s experience in Spain had led to a maturation of his politics. Bethune’s speeches during 1937 were not just inspiring or radical, they were specifically Communist speeches, revolutionary speeches: they analyzed imperialism, the Spanish war, and the growth of fascism in Canada, on the basis of class struggle. (7)
Such speeches, while perhaps valuable to the cause of the Communist Party in fomenting revolutionary tendencies among the populace, also had their downside: they often alerted listeners who may have been just as anti-communist as they were anti-fascist about Bethune’s political stripe. He had been instructed by the Communist Party of Canada to conceal his membership to avoid frightening off prospective donors. Nonetheless, other RCMP documents suggest a large number of people were attracted to the anti-fascist cause following the speeches. Documents 38 and 39 of Lethbridge’s Bethune: The Secret Police Files reveal the RCMP believed Bethune’s speeches “heavily encouraged” volunteers to join the Mac-Paps (96, 97-8). One such document claims a single speech in Vancouver inspired at least eight relief camp inhabitants to join the International Brigades. Within a week they were “entrained to the East en route to Spain” (97).
Despite these successes, even one of the police informants who infiltrated the speaking events could tell Bethune was not happy to be on a speaking tour of the country, rather than back in the action of Spain. An RCMP report indicates that Bethune appears to have little inclination to follow Communist Party directives and “was quite definite in stating that he is more interested in blood transfusion operations than in political maneuvers” (Lethbridge 97). After a few months of the grueling touring schedule, sometimes speaking multiple times in one day before travelling on as quickly as possible, Bethune was desperately trying to return to Spain. He planned to take with him “a Ford station wagon donated by a group of Manitoba farmers and a copy of The Heart of Spain” (Stewart and Stewart 223). After months of including his planned return to Spain in his speeches, in mid August he was informed that this was impossible: CASD and his former colleagues at the institute did not want him to return, and the Spanish government had barred his return at their request and due to the numerous personality and bureaucratic conflicts that had arisen between Bethune and the military health directorate, Sanidad Militar (225). In the wake of this disappointing news, Bethune would eventually turn his obsessive attention to another anti-fascist cause: aiding Mao’s Eighth Route Army in resisting the fascist Japanese invaders in China.
The Heart of Spain
Accompanying Bethune on his speaking tour was the propaganda film he had commissioned, The Heart of Spain. Bethune was in part convinced to leave Spain by an argument mounted by his fellow institute members that he was more useful touring North America with the film and raising funds. Bethune had long been mulling over the idea of The Heart of Spain when he heard about a young Hungarian filmmaker, Geza Kárpáthi, also known as Charles Korvin, who he commissioned to make the film, and for whom he ordered filmmaking equipment from Paris (Stewart and Majada 86). Herbert Klein, an American writer and regular guest of the institute, also worked on the film.
A newspaper account from the People’s Advocate of Vancouver reported on the presentation of The Heart of Spain and on Bethune’s accompanying speech. The article speaks to the efficacy of the film as a piece of propaganda:
If the stark realism – glimpses of children’s bodies being lifted from shattered houses, of troops of the People’s Army on the offensive, of the actual work of the Canadian medical unit and, throughout it all, a woman’s heartrending sobs – were not enough to rouse a sympathetic audience, then Dr. Bethune himself with his human approach to the many questions he touched upon, his free style interspersed with humor, brought his audience out of its seats in a spontaneous demonstration worthy of a people’s front. (143)
Images of pieces of artillery firing are juxtaposed with donors at the transfusion unit’s headquarters, who are shown clenching their fists after the removal of the needle. The symbolism of the clenched fist raised in resistance—the anti-fascist salute—is clear. This scene, and many others, draws parallels between the armed resistance of the Republican forces and the resistance through donation to the war effort of the citizens of Madrid. Such links between citizen and Republican soldier surely drew more generous donations from North American audiences (Heart of Spain).
Between his work with the blood transfusion unit and as a propagandist, Bethune contributed enormously to the Republican cause in Spain. Taken with the politics of the anti-fascist struggle, he also found a place in which to indulge his desire for adventure and his caring inclinations toward children, the wounded, and the otherwise vulnerable. Bethune’s legacy and his time in Spain have been subjects of contention, whitewashing, and manipulation for political means. In part because of this controversy, he remains one of the most dynamic and interesting Canadians of the twentieth century.