Book Review

Ma Haide: The Saga of American Doctor George Hatem in China

N Engl J Med 1994; 330:582-583February 24, 1994

Article

Ma Haide: The Saga of American Doctor George Hatem in China
By Sidney Shapiro. 215 pp., illustrated. San Francisco, Cypress Press, 1993. ISBN: 0-934643-01-6

This is an interesting book about a physician, George Hatem, also know as Ma Haide, who may well be to medicine in the 20th century what Rudolf Virchow was to medicine in the 19th century and Benjamin Rush in the 18th: the preeminent healer of and through the body politic. Sidney Shapiro, an attorney and longtime friend of Ma Haide, summons the pertinent facts to make an irrefutable case for a medical hero.

George Hatem was born September 26, 1910, in Buffalo, New York, the oldest son of poor Lebanese immigrants who were Maronite Catholics. Despite the family's poverty, Hatem's bright mind and optimistic though sometimes rebellious spirit won him recognition as a superior student. The family moved about in search of a livelihood, and Hatem graduated at the top of his high-school class in Greenville, North Carolina. His family supported his further education, though according to Hatem, his father “starved” and his brother had to relinquish his place in college. Hatem graduated from the University of North Carolina and attended medical school at the American University in Beirut, Lebanon. Later, he transferred to the University of Geneva in Switzerland and graduated in 1933.

Perhaps as a lark but explicitly to learn more about his special interest, venereal diseases, Hatem and two of his classmates traveled to one of the most disease-ridden, decadent cities of the 1930s, Shanghai. To gain experience and survive, they established the Kiukiang Road Clinic, with Hatem as venereologist. The sheer magnitude of human suffering in China all but overwhelmed Hatem. In searching for a way to comprehend what was happening about him, he became interested in communism. He joined study groups, and his awareness of the destructive effects of oppressive social conditions led to a lifelong dedication to helping people.

Never one for halfway measures, Hatem in 1936 undertook a dangerous journey to Yunnan, the center of constructive social action and headquarters of the Chinese Communist Party. The hazards and trials of his journey to Yunnan marked the beginning of a practice of medicine under the most trying conditions; on one occasion, he was blown out of his office by Japanese bombs.

Hatem never returned to the United States, nor did his beliefs ever waver. He became the first foreign member of the Chinese Communist Party and, eventually, a Chinese citizen. And, despite accusations by party members that Hatem was a foreign spy, he established a remarkable healing presence and harnessed the will of the Chinese people to eliminate venereal disease from their country. If he had not been handicapped by the Cultural Revolution, he probably would have eliminated leprosy as well. By the time Hatem died, in 1988, his accomplishments had received worldwide recognition.

Shapiro's account lacks the scholarly insight of a Harvey Cushing writing about Osler, but the civic genius of physicians of revolution is there for the reading. Ma Haide experienced revolution as a life-and-death reality, much as Virchow did in fighting at the barricades in 1845 and as Rush did in signing our Declaration of Independence. As Virchow confronted typhoid and Rush confronted yellow fever, Ma Haide went directly to the plague and encountered it as it was. He literally grasped the leper's hand. His unswerving dedication to a courageous personal vision of medical service is similar to the single-mindedness of Virchow and Rush. Like them, Ma Haide saw the patient against the full circumstances of community, nation, and world. Like them, he was indefatigable, working through the night after his staff had dropped from exhaustion. Like them, he found delight in the company of simple men and women, even though Rush eventually became something of a curmudgeon. In one respect, Hatem was unlike other physicians of revolution: he published little of his thinking, or so it seems from this account's slim bibliography. Most important, he, like Virchow and Rush, grasped every opportunity to organize and encourage others to achieve their full potential by sharing his vision. Oh, that the author might have shared the larger picture as well.

The reader is encouraged to think of this account not as an exotic happenstance but as a medical checkpoint in our tumultuous era. Those struggling to reform U.S. health care would do well to take heed of Hatem, the teacher. Repeatedly, he emphasized that each nation must fashion its own system of health care but must do so through the will of its people, lest the effort fail. We need to adapt this insight to our complex and perplexing situation. Hatem came up against the problem of access in a nation deprived of resources, yet through prevention accomplished the unimaginable: health care for most, if not all, of the Chinese people. We approach the problem of access in a confusion of riches, yet in allocating scarce health care resources we too must address, as he did, the rights of the individual and the rights of the community, an issue resolved only by the will of the people. This biography of a contemporary medical hero can be read to understand the caliber of medical leadership that we need to find our way to health care reform.

The writing is flawed, with too many typographic errors and medical errors (606 is not penicillin), no index, and not even a simple map. Most Western readers need a map to see that the distance from Jaingxi to Shaanxi is comparable to a route from South Carolina to upper Michigan by way of Oklahoma. This account serves well the wait for a definitive biography.

Ralph Crawshaw, M.D.
Portland, OR 97210-2859