In one particularly poignant episode of M*A*S*H, Hawkeye Pierce, the hero surgeon whose vaudevillian antics and humanitarian commitment dominate the show, expounds to the company chaplain, “War isn’t Hell. War is war, and Hell is Hell. And of the two, war is a lot worse...There are no innocent bystanders in Hell. War is chock full of them—little kids, cripples, old ladies.” Though often dismissed as fluff, the show’s meditations on the absurdities of warfare redefined the public’s understanding of war and the nation’s perception of its men and women of medicine.
The main characters in M*A*S*H see medicine as more than an exact science. They conceive the role of doctors in war to be deeply philosophical and informed by the personal experience of war. This commitment to reexamining the societal obligations of medical practitioners is rooted in the literary awakening of the dawning horrors of early twentieth century warfare and the radicalism of the children of World War I.
Paul Fussell, the disillusioned war hero turned great American historian and literary scholar, wrote in his masterpiece, The Great War and Modern Memory, of the birth of a literary cynical humanitarianism born in the absurdity of trench warfare during the First World War. The protagonists of his history are stuck in an all-consuming “satire of circumstance,” distrustful of propaganda, pondering death as they stare it straight in the face. At this moment in the war-torn fields of Flanders and France, Fussell argues, the subversive literary humanism that restructured English literature and brought about the truest reckoning with the random horrors of war that the world had seen was born.
Just months before the First World War erupted into the chaos no one had foreseen, Thomas Hardy, imagining the dead confusing the practice rounds of war for the coming of Judgement Day, wrote these immortal words in his poem “Channel Firing”:
The glebe cow drooled. Till God called, ‘No;
It’s gunnery practice out at sea
Just as before you went below;
The world is as it used to be
To Hardy, the advance of war is ominous, evil, and a sign of deflated morality. The absurdity of war is a spoof on the biblical Judgement Day. Men are to be judged heroes or cowards against the meaningless metrics of “patriotism” and “honor”. In “Channel Firing”, Hardy reminds us that there is something far more important than nationalism or violence, that humanity and religion are truly the measures of worth. His portrait of the dead is cynical, farcical, and deeply sarcastic, but it is imbued with the hope of a future reckoning with the humane that became the rallying cry for generations of humanitarians and pacifists.
This absurd reality along the battlefields of Western Europe, those immortal months of meaningless death, made it possible six decades later for a young Italian-American Vaudeville star named Alan Alda to deliver stingingly sarcastic monologues over the gaping wounds of teenagers, also engaging in small-scale and cathartic sabotage of the military war machine.
The horror of the three generations between the First World War and the Vietnam War, the success of M*A*S*H in particular, altered permanently the public understanding of the role of a doctor. The American doctor became less the man or woman in a white coat stabbing us with long needles or lecturing restless children on the importance of personal hygiene. Instead, doctors and nurses became the ground troops of sanity, the near divine messengers of humanitarian anti-authoritarianism.
At its core, humanitarian medicine is not simply an act of healing or an application of science. It is innately subversive and anti-authoritarian. Humanitarian medicine is the embodiment of the cynical stubbornness of Wilfred Owen in a rotting trench or Hawkeye Pierce in a makeshift operating room in Korea: the stubbornness not to lose a single life, not to lose a single memory.