Edward K. Barsky (1897–1975): Surgery,activism,and the Spanish Civil War

On 6 June 1950, New York City surgeon Dr Edward K. Barsky became federal inmate No. 85268, surrendering to prison authorities in Washington, DC. Dressed in a brown plaid suit with a yellow hat, red suspenders, and gray necktie, Barsky began his six month sentence for a conviction of contempt of Congress. ¹ As Ernest Hemingway (1899–1961) wrote in a letter protesting Barsky's incarceration, ‘Eddie [Barsky] is a saint. That's where we put our saints in this country – in jail’. ²

Barsky's biography is inseparable from many of the major movements of the twentieth century. Coming of age as a surgeon during the height of the Great Depression, Barsky became politically involved during the Spanish Civil War, volunteering for medical service as leader of the American Medical Bureau to Aid Spanish Democracy (AMB) from 1937 to 1939. With the defeat of Republican Spain, Barsky spearheaded relief efforts for Spanish refugees with the Joint Anti-Fascist Refugee Committee (JAFRC), an organization which came under investigation by the House Un-American Activities Committee in 1945. ³

Despite his unique life combining surgery and political activism and his prominent involvements with both United States and international politics, there is very limited historical analysis on Barsky. This work seeks to investigate some of the major questions surrounding Barsky's biography. Why did the cause of Spain capture Barsky and compel him to leave his career as a surgeon in New York for the frontlines? How did his experiences in Spain impact his views on medicine, war, and the surgeon's craft? Finally, why did his advocacy for Spain cause Barsky's persecution upon his return?

Political awakening (1897–1937)

Dr Edward K. Barsky was born on 6 June 1897. His father was a leading New York surgeon who helped to found Beth Israel Hospital. Barsky attended city public schools and the City College of New York, and medical school at Columbia University. After graduating, he completed postdoctoral studies abroad in Paris, Berlin, and Vienna, but these experiences are not mentioned in his writings and it is unclear how they impacted his professional and political identity. Barsky began his surgical career in the hospital his father helped to found, starting as an intern in 1919 and ultimately attaining the position of associate surgeon in 1934 at Beth Israel. ³

Barsky's interest in the cause of the Spanish Civil War was forged amid the turmoil of the 1930s, when New York became a centre of radical politics and activism. The Communist Party of the United States of America (CPUSA) became increasingly popular, its growth driven partly by the re-orientation of Communist ideology to combat Fascism and align with American ideals.^4,5 As Earl Browder (1891–1973), the Communist nominee for president in 1936 put it: ‘Communism is twentieth-century Americanism’. ⁴ Amidst this shift, Barsky jointed the CPUSA in 1935. ⁶ While there are no sources revealing Barsky's motivations for joining the Party, he may have been impacted by the new foregrounding of antifascism in the new Communist ideology.

In 1936, Spain elected a coalition government of leftist political parties led by a Socialist plurality. The progressive reforms promised by the new government were stringently opposed by the military, the powerful Catholic church, and the landowners. On the morning of 17 July 1936, an insurrection against the Republic began under the command of General Francisco Franco (1892–1975), an action which would mark the beginning of the Spanish Civil War. ⁷

Although the nations of Western Europe proclaimed “non-intervention,” Nazi Germany and Fascist Italy flaunted the agreement and supported the insurrectionists. In America, an embargo was established prohibiting the sales of arms to Spain despite strong support for the Spanish cause in many sectors of society.^7,8 The only European nation to oppose non-intervention and provide support for the Republic was the Soviet Union. ⁹ The brunt of their assistance came from the establishment of the International Brigades in late 1936, an international volunteer army formed to support the Spanish Republic. ⁴ Around 2,800 Americans would join nearly 40,000 comrades from more than 50 countries across the world in the Brigades, naming their unit the Abraham Lincoln Battalion. ¹⁰

In New York, the outbreak of war in Spain led to the rapid organization of relief groups for the beleaguered Spanish Republic. Much of the fundraising for these initiatives occurred during packed political rallies at Madison Square Garden. ¹¹ For Barsky, his passion for the cause was sparked at a Garden event, where he heard an impassioned plea for aid from a Spanish lawyer and Catholic priest. As Barsky wrote in his unpublished memoir, A Surgeon Goes to War, ‘These two spoke to us in such a way that we saw a clear issue. A peaceful government made up of many factions trying to restore a measure of social justice, had been attacked by a perjured army’. ¹² Barsky was also motivated by humanitarianism, and a desire to apply his skills as a surgeon to alleviate suffering in Spain. As he wrote, ‘The agony of present-day war must be relieved by that use of our science, its positive use, its humane use…We need to be reminded that man has also studied the art of life’. ¹²

Responding to the need for medical aid to Spain, Barsky was one of the five politically motivated physicians who established the AMB during a meeting at the home of Dr Louis Miller in 1936.^10,12 Affiliated with the North American Committee to Aid Spanish Democracy, the primary mission of the AMB was to provide medical supplies to Spain. Over its first months of fundraising, the AMB collected thousands of dollars in donations and opened more than a hundred chapters nationwide, funding nearly 20 tons of supplies ranging from bandages to ambulances.^4,10 From its inception, the AMB recruited influential physicians to serve in leadership positions and lend credibility to the organization, including Walter Cannon (1871–1945) of Harvard and Henry Sigerist (1891–1957) of Johns Hopkins. ¹³

Throughout the fall of 1936, the overwhelming support for the AMB spurred the organization to change their strategy and send medical personnel along with supplies to Spain. However, it became a challenge for the AMB to find medical personnel willing to abandon their American careers for the front. ⁴ As Barsky put it, ‘To come with us these people were in some cases to give their health; some gave their lives; in all cases they gave their jobs’. ¹²

While the group had secured a nurse leader, Fredricka Martin (1905–1992), there was still no physician to take overall command of the initial unit. The leadership of the AMB briefly considered other candidates, but soon before the planned sailing broached it to Barsky, then 41 and the head of the Purchasing Committee. At first, Barsky found the idea ridiculous, unable to envision leaving his life behind in New York. However, as he wrote, ‘Then somehow all at once I realized that I had been eager to go from the start’. ¹² Many in the AMB, including Martin, were concerned that the surgeon would be risking his life at the front due to the severe stomach ulcers with which he had long suffered. However, if Barsky was unable to sail the whole plan could be scuttled, so the group forged on, putting aside their personal concerns about his fitness. ¹⁴

The final night before departure was frantic with last-minute preparations. On the morning of 16 January 1937, five doctors, six nurses, one pharmacist, and two ambulance drivers set sail from New York Harbour on the Paris. ¹⁵ While others lined the railings, Barsky settled into his third-class bunk, too tired to even undress after the frantic preparations. In his pocket was a small box, pressed into his hand by a physician colleague on the docks as the final whistle blew for departure. Inside was “six grains” of morphine, a harbinger of what lay ahead for the surgeon in Spain. ¹²

Surgeon under fire (1937–1939)

Barsky's politics, worldview, and attitude toward the medical profession were profoundly shaped by his involvement with the Spanish Civil War. As he recalled in his memoir, ‘War is psychologically like hell, supernatural like it, and also, as we have been taught to expect, full of good company’. ¹²

Arriving in Spain in early 1937, Barsky believed that he would find established International Brigade hospitals to support. ⁴ Initially assigned to work within the framework of the International Brigades Medical Services (SSI), it became abundantly clear that the hospital which Barsky had been promised did not exist.^12,16 Barsky soon received a telegram with orders to ‘set up one hundred bed emergency hospital and be ready to receive patients in forty-eight hours’. ¹² The site chosen for the first American hospital in Spain was at El Romeral, close to the site of the major Nationalist offensive at Jarama. ¹⁷ The location selected was a schoolhouse which lacked running water and had only rudimentary electricity. ⁴ Cognizant of the impending influx of wounded troops, the outfit engaged in two days of frenzied preparations, transforming a schoolhouse into a stocked 75-bed hospital. ⁴

The first ambulance from the front arrived carrying 25 wounded. As Barsky described, ‘The faces of the soldiers were gray, their torn clothes the color of Earth. The wounds were of types we had never seen before: ghastly ones of the skull, the abdomen, the extremities’. ¹² Beginning with a skull case, Barsky and his operating staff worked for forty hours nonstop. In the bitter cold of the operating room, where proper heating had not yet been installed, Barsky struggled to keep hold of the icy instruments, his hands so chapped that he was afraid of becoming unsterile by breaking his own skin. ¹²

Operating on a young Spanish boy with a kidney destroyed by shrapnel, the surgeon was at the most delicate stage of the operation when the theatre went black. An air raid had cut electricity. As Barsky described, ‘Nobody move, I said…I reached out for a clamp in the dark, clamped the pedicle, and went on with the operation in the darkness’. ¹² While the Spanish boy made a full recovery, many of the gravely wounded were beyond the aid of surgery. ¹² Barsky estimated that in the first ten days of operating at Romeral, 50% of the unit's patients ultimately perished. ¹² The three International Brigade hospitals, including the converted schoolhouse at El Romeral, treated an estimated 2500 wounded during the first few days of fighting, serving any who needed medical assistance. ¹⁶

For Barsky, the only way to cope with the constant stream of wounded was to suppress his feelings of moral outrage through a singular focus on the task at hand. As he wrote, ‘We could not give vent to our feelings of pity, anger or horror. We could not afford to speculate on war, its terror, its misery…I don’t mean to say we became hard-hearted. In moments of rest we consumed ourselves with sorrow. But we had to keep ourselves efficient’. ¹² As Barsky spent more time with the victims of the senseless violence at the front, many of whom were civilians, he increasingly resorted to his work in the operating theatre to relieve his outrage.

Through observation and experimentation, Barsky sought to improve upon the existing methods of military medical delivery. Barsky noticed that the conditions of patients arriving at the frontline hospitals were much more dire than necessary. For Barsky, the solution was to bring the frontline hospital to the wounded. This was achieved through the innovation of the “auto-chir,” an operating room on wheels. Barsky heralded the auto-chir, citing the reduced time between injury and definitive care and rate of infections.^12,18

Along with improving medical organization on the battlefield, Barsky also sought to improve surgical outcomes. As Barsky recalled a fellow physician commenting in the first days of his time at the front, wartime medicine ‘s not yet an exact science, it is an art’. ¹² Barsky's contributions to wartime medicine in Spain stemmed both from his ingenuity as well as his meticulous observations on patients, which led to the innovation of new surgical methods. In a chapter in A Surgeon Goes to War titled “Some Notes on Surgical Practices,” he detailed his approach to different traumatic injuries. He helped to pioneer techniques dealing with open chest wounds and made observations about the treatment of complex fractures in which he stressed the need to keep traumatic wounds open in order to prevent infection. ¹²

Barsky's notes on the use of treatment of open traumatic fractures emphasized prompt surgery to debride dead tissue followed by the application of a plaster cast, leaving the wound open to heal by secondary intention underneath. Barsky felt that this method decreased the rate of infections which were common with compound fractures treated with primary closure. ¹² These notes mirror the “Spanish method” popularized by Catalan surgeon Josep Trueta i Raspall (1897–1977), who reported on the outcomes of “closed treatment” of compound fractures with surgical debridement and plaster casts. In a series of over a thousand patients, many of whom were treated after bombings in Trueta's home city of Barcelona, less than 10% became infected in an era before the widespread use of antibiotics. Trueta's “method” was adopted widely and his treatise on the topic was the basis of training for many Western surgeons during the World War II. While Barsky may have interacted with Trueta during his time in Barcelona, it is unclear whether Barsky had direct input into the development of his “method.” However, the unmistakable similarities in the methods suggest that an evolution of the practices used to treat open fractures was occurring across Republican-held Spain. ¹⁸

Perhaps the most significant advance during the Spanish Civil War was the popularization of blood transfusion. The conflict saw the innovation of the blood bank, as well as the widespread use of transfused blood at mobile hospitals. ¹⁹ Although the science of ABO blood group compatibility had been developed in the early twentieth century and blood transfusions had been sporadically used during World War I, there had been no large-scale blood banking. With the leadership of Norman Bethune (1890–1939), a Canadian thoracic surgeon, the Instituto Hispano-Canadiense de Transfusion de Sangre was founded to connect Spanish blood donors with victims. At its height, the blood bank provided up to 100 transfusions daily and operations were extended from Madrid to battlefields in the rest of the country. Efficient blood banking was truly perfected by Federico Durán Jurá (1905–1957) , a haematologist who founded the first large-scale blood bank in Barcelona. Through the duration of his work in Barcelona, Jurá collected a list of 30,000 donors and an estimated 9000 litres of banked blood available to Catalans impacted by the widespread bombing of the city by the Nationalists. This operation was the direct precursor to modern blood banking. ¹⁸

In Barsky's frontline hospitals, he relied on deliveries of banked blood from the Instituto Hispano-Canadiense de Transfusion de Sangre to the frontlines. When supplies ran low, each member of the hospital staff was blood-typed and often gave whole blood directly to assist wounded patients in the operating room. Barsky credited the transfusion service for saving countless lives on the battlefield. As he wrote, ‘the transfusion service which was developed in Spain is now a guide for army transfusion services all across the world’. ¹² Barsky's focus on the medical aspects of his work in Spain allowed him to reside on the forefront of medical innovation. As Barsky wrote, ‘The methods which we improved in Spain can at best merely point the way toward some improved techniques in war surgery. Or better, they might point the way to a slightly improved technique of civilian practice, for war surgery like war itself will soon be, I hope, obsolete’. ¹²

While the impact of wartime medical innovations on civilian practice can be hard to discern, the advances which Barsky helped to pioneer had a direct impact on later battlefields, including those of World War II. ¹⁶ Direct connections can be appreciated from Barsky's observations concerning blood transfusion, wound care, and the reorganization of battlefield medical delivery. The improvements in organization devised in Spain would be widely adopted and save lives on the battlefields of World War II and later be connected to the Mobile Army Surgical Hospital (MASH) units utilized by the United States in Korea and Vietnam.^16,19

In the spring of 1937, Barsky expanded American medical activities in Spain with two new hospitals. The first was built in the hamlet of Tarancón around March 10, and the second was opened at Villa Paz, a palatial re-purposed manor which had formerly been an estate of the Spanish Bourbon monarchs. The hospitals continued to receive waves of casualties as the Nationalists attempted to retake Madrid. ¹⁷ As spring faded into scorching summer, Barsky moved his focus to the southern Cordoba front, where he led a mobile medical unit to the town of Pozoblanco. ¹⁷ By this time, AMB reinforcements had arrived and increased the outfit to 113 people, allowing the unit to operate several hospitals currently. ¹⁹ Among the reinforcements were Dr Irving Busch (1896–1960) and Dr Sidney Vogel (1904–1986), New York City surgeons. Throughout its service in Spain, the AMB was defined by its progressive stance toward the inclusion of both women and under-represented groups. Stories of volunteers like Dr Frances Vanzant, a female gastroenterologist, and Salaria Kea, a Black female nurse and activist, emphasize the integral role of women in the operation of hospitals and the care of injured and ill patients.^4,20

Barsky's time in Pozoblanco was interrupted by a telegram requesting he return to Paris for a conference. ¹² Barsky set out on the long overland journey from Pozoblanco to Perpignan, the gateway to France and a world away from the conflict in Spain. As Barsky wrote, ‘I had to leave Spain to understand it.’ ¹² On the road, Barsky fully realized the social conditions and widespread poverty of the Spanish countryside. As he wrote, ‘How could the Spaniards fight so bravely when they had been starved from birth?…It seemed to me then that those desperate boys were fighting for all that was good against all that was bad’. ¹²

Suffering with inflammatory jaundice which had developed over the course of the long drive, Barsky finally arrived in Paris bedraggled, exhausted, and violently ill. ¹² Ultimately, Barsky spent four months away from the front, recovering and embarking upon a speaking tour of the United States. He also organized the U.S. West Coast Medical Unit for Spain, led by esteemed thoracic surgeon Dr Leo Eloesser of Stanford (1881–1976). ¹⁷

Barsky returned to Spain in November 1937, about a month before the vicious Nationalist counterattack on the frigid provincial capital of Teruel. The American unit was summoned toward Teruel to establish a field hospital. As Barsky wrote, ‘When the orders came, we knew that we were to go over the mountains of Aragon up to Teruel. The Spaniards who were helping in the hospital said we would never get there’. ¹² The Spanish advice would prove prescient, as the advance toward Teruel devolved into chaos. ¹⁷ Climbing switchback turns and high mountain passes in blinding snow, the drivers used ice to cool overheating radiators. ¹² Descending, the surgeon's ambulance continually slid off the road. Showing his trademark cantankerousness, Barsky demanded control of the vehicle. As he wrote, ‘Finally, I decided no matter how good a driver my chauffeur was that I was a better one. I took the wheel.’ James Neugass (1905–1949), Barsky's chauffeur, remembered the drive slightly differently in his diary, ‘B. [Barsky] gets his arm in front of my eyes at just the wrong time’.^12,21

Finally, the AMB made it to the front, establishing a surgical unit close to Teruel. ²¹ The arrival of the first batch of wounded led Barsky to establish a new personal record: 50 hours straight operating. ¹² Situated dangerously close to the front, Barsky and his colleagues operated for weeks around the clock as the Nationalists fought to re-capture the city. ¹² As Barsky wrote of a particularly heavy wave of casualties in early 1938, ‘I used to think that if everyone in the world could glimpse that triage room for just one moment that there would be no more war. But a surgeon cannot think things like that too often’. ¹²

During March 1938, fascist forces launched a tremendous offensive on the Loyalist contingent, beginning the Great Retreats. ⁴ As the offensive began to gain steam, the mobile hospitals in which Barsky treated wounded became increasingly dangerous. Exposed to almost-continuous bombing, Barsky ordered the construction of zig-zag trenches to protect from bombardment. ²² A frightening moment occurred when a bomb made direct contact on the mobile unit, instantly killing a chauffeur, two patients, and injuring a nurse. ²² Barsky, buried in dirt by the blast, rushed to the operating room, where fellow surgeon Dr Freedman had continued to operate throughout the blast. However, nurse Helen Freeman had suffered a skull fracture and severe shrapnel wounds to her arm from the explosion. Barsky performed emergency surgery, managing to save her arm. The Americans were soon forced to evacuate the mobile hospital, joining the masses attempting to reach the rear. ¹²

Amidst the chaos of the retreats, Barsky arrived at headquarters in Barcelona on March 18 and was appointed Surgeon-in-chief of all 22 International Brigade hospitals in Spain. ¹² On 22 March 1938 Neugass, suffering from shrapnel in his neck, scalp, and back, asked Barsky for his permission to leave Spain, hoping to return home to write about his experiences. He recorded Barsky's response: ‘O.K., I’ll send you out. But who the hell is going to send me out?’ ²¹ Neugass did not think that the surgeon looked well. He wrote, ‘The Major [Barsky] is not very well. He lives and fulfills the obligations of his new job, not on the little bread and the few oranges his stomach will retain, not on the many cigarettes he smokes, but on the power of his will’. ²¹ As Barsky framed his malaise, ‘I was not only extremely worn out but I got to seeing again and again our dead patients. No surgeon can bear to lose a life…the sense of guilt would haunt me and in spite of myself I would live over certain operations which I thought had been forgotten’. ¹²

In Barcelona, Barsky wrote, ‘The Spanish experience has proved to me that this determination, this valor, this heritage, is a common heritage of all people in their struggle toward a better life’. ¹² He would continue in his post as the head of the Sanitary Services of the International Brigades until January 1939, departing with the final foreign volunteers from Spain. The city of Barcelona would fall on January 26, and the rest of Spain capitulated on April 1. Franco and Fascism had won. ¹⁶ Yet, despite defeat, Barsky was left with a deep dedication to the Republican cause and an abhorrence for war. As he wrote, ‘we still cannot imagine that thing which is the reality of war…I feel that when men and women realize what war is, what it means to all concerned, wars will cease. I am conscious that many have said this before: it is the eternal message of those who return’. ¹²

Relief and persecution (1939–1975)

After his departure from Spain in early 1939, Barsky returned to New York City and his position as a surgeon at Beth Israel Hospital. Barsky married and had a daughter. ³ However, he was unable to forget his experiences in Spain and his deep sympathy for the Spanish people, who suffered an immediate wave of repression in the wake of Franco's victory. Thousands of Republicans were executed and untold numbers of other survivours fled the country as refugees. ²³ Barsky became intimately involved in relief organizations for Spanish refugees which ultimately coalesced into the Joint Anti-Fascist Refugee Committee (JAFRC). ²⁴ The JAFRC was officially inaugurated on 11 March 1942, with a mission to aid Spanish refugees and protest against the Franco regime. ⁶

Barsky served as national chairman and as an influential organizer. As Dr Hugh Cabot, a physician from the Boston suburbs, wrote in a letter to Barsky, ‘You have not only the courage to carry out your convictions but the very rare ability to make them come alive for other people. In other words, you are not only a doer but a prophet’. ²⁵ The relief activities of the JAFRC aided Republican refugees and former Loyalist fighters, with a particular focus on Spanish refugees across Europe, North Africa, and Mexico. In Mexico, the organization helped to resettle Spanish refugees and built a hospital which was renamed the Edward K. Barsky Sanatorium in 1945.^6,26 In a 1947 speech for the JAFRC celebrating the anniversary of the founding of the Spanish Republic, Barsky said, ‘The Spanish Republicans in exile are the heroic symbol of the forces which will save the world from its own destruction…Let us never fail them or we fail ourselves’. ²⁷

Through the organization's activism, the JAFRC came under significant domestic surveillance. From declassified FBI files, it is clear that the JAFRC was considered a threat to American security from its inception. Part of this stemmed from a belief that the elements who formed the JAFRC were Communist and had transformed the organization into a communist “front.” ²⁸ With the end of World War II and the emergence of the Soviet Union as a major geopolitical threat, Communism was faced with increased suspicion in the United States. Due to his leadership of the organization, Barsky was also considered a threat and heavily scrutinized by the FBI. ²⁹ Barsky was subpoenaed by the House Committee on Un-American Activities (HUAC) on 10 December 1945 to appear before the committee.^6,30 HUAC was spearheaded by Texas conservative Martin Dies (1900–1972) as a backlash to FDR's New Deal policies in an effort to root out Communists and subversives in prominent positions in society. ⁴ However, the House committee would not find the substantive evidence of Communist activities within the JAFRC which they sought.

HUAC asked Barsky and the JAFRC for access to financial and organizational records. ⁴ However, Barsky maintained vehemently that the JAFRC was purely a relief organization, citing the organization's recognition by FDR's War Relief Board as proof of its legitimacy. ⁶ After postponing the proceedings, Barsky refused to submit to HUAC's request. For Barsky, speaking in a 1969 interview with Richard Avedon (1923–2004), the legendary American portraitist, and writer Doon Arbus, the decision to defy the committee was simple,

‘Cause when you go before the Un-American Activities Committee…you’re somebody…who has something to do with…something. And that something should be a matter of principle to you. The Un-American Activities Committee had no principles…They were un-American. So when I was up there any they asked me questions…I wouldn’t answer ‘em…  ³¹

Barsky's decision may also have been motivated by the practical fear of exposing Spanish refugees if their identities became public. ⁶ Due to the refusal of Barsky to provide the records, he was cited for contempt of Congress by a vote of 339-4. ³² Barsky was sentenced to six months’ imprisonment in a “common jail.” ³² He launched a spirited legal defence, but despite a protracted fight of over three years, his conviction was upheld. ⁴ Congressman Leo Isaacson (1925–1978), in remarks delivered on the floor of Congress, called the persecution of the committee a ‘shabby legal fiction,’ an example of the HUAC's intention to ‘pillory thousands of decent Americans for daring to be generous to the first victims of fascist attack’. ³³ Barsky began his incarceration on 7 June 1950, at the federal penitentiary in Petersburg, Virginia. ⁶ In Washington, a line of Lincoln Brigade protesters filed past the White House fence, holding signs which read “No Jail for Franco's Foes.” ⁴ Truman, however, would not be swayed. Barsky lost 23 pounds during his captivity and was only permitted two visits per month. ³⁴ After his privations in prison and the backlash against the JAFRC, Barsky resigned completely from the organization in early 1951, two months after he was released. ⁶

Barsky's conviction spurred New York State medical authorities to revoke his medical license, a final injustice for the surgeon. Even though Barsky was not guilty of anything approaching medical malfeasance, the Committee on Grievances suspended Barsky's license for six months. ⁶ In the extensive legal battle to follow, Barsky's case was appealed all the way to the Supreme Court. Thousands of physicians united to file an Amici Curiae petition on his behalf, citing his impeccable qualities as a surgeon and citizen. ³⁵ However, the nation's highest court ruled to uphold the surgeon's sanction in a 6-3 decision with Barsky v. Board of Regents. ³⁶ Justice William O. Douglas (1898–1980) wrote in his 1954 dissenting opinion, ‘When a doctor cannot save lives in America because he is opposed to Franco in Spain, it is time to call a halt and look critically at the neurosis that has possessed us’. ³⁷ Douglas’ opinion argued that the New York State Board of Regents violated two tenets of the Constitution, with Barsky being judged only on his alleged ties to communist leanings, representing a trespass on his individual rights. As he wrote, ‘Dr Barsky's license to practice medicine has been suspended, not because he was a criminal, not because he was a Communist, not because he was a ‘subversive’, but because he had certain unpopular ideas and…was an officer of the Joint Anti-Fascist Refugee Committee’. ³⁷

HUAC, in close coordination with the FBI and with the help of the courts and local authorities, had effectively sentenced Barsky to internal exile, unable to practise medicine and express his political support for a free Spain. However, Barsky would not be cowed. On 25 October 1954, Barsky's medical licenscwas re-instated by the New York State Board of Regents. ³⁸ For the remainder of his life, Barsky would continue to combine his life as a surgeon with political activism. Barsky returned to Beth Israel Hospital as a consulting surgeon. His specialty, in tune with his commitment to progressive ideals, focused on surgical cases involving workmen's compensation. ⁶ His political dedication to progressive causes also continued. He supported organized labour in New York City, and was directly involved with the District Council 65 as a “security plan panel physician.” ³ He also was involved in labour action at Beth Israel Hospital, participating in a strike in 1962 to recognize the union status of hospital workers. ⁶

Barsky was also deeply connected with the Medical Committee on Human Rights (MCHR) in the 1960s, serving on the original executive board of the organization. ³⁹ The MCHR sought to provide essential medical services to civil rights workers operating in hostile Southern communities and support community health projects for underserved populations. ⁴⁰ Along with his civil rights activism, the surgeon also protested the Vietnam War. Barsky continued in a consulting role at Beth Israel until his death. ⁶

However, Spain would remain his life's defining cause. As Barsky would recount in an interview with Avedon, ‘Spain and the work with the Joint Anti-Fascist Refugee Committee…that work and the things around it meant something to me. And you got to have something in life. Something must mean something to you’. ³¹ Yet, Barsky would not live to see the free Spain he fought for, dyingon 11 February 1975. ² Nine months later, he was followed by Franco. ⁴¹