At the age of 30, in 1905, Schweitzer answered the call of The Society of the Evangelist Missions of Paris, which was looking for a physician. The committee of this missionary society was not ready to accept his offer, considering his Lutheran theology to be "incorrect". He could easily have obtained a place in a German evangelical mission, but wished to follow the original call despite the doctrinal difficulties. Amid a hail of protests from his friends, family and colleagues, he resigned from his post and re-entered the university as a student in a three-year course towards the degree of Doctorate in Medicine, a subject in which he had little knowledge or previous aptitude. He planned to spread the Gospel by the example of his Christian labour of healing, rather than through the verbal process of preaching, and believed that this service should be acceptable within any branch of Christian teaching. Even in his study of medicine, and through his clinical course, Schweitzer pursued the ideal of the philosopher-scientist. By extreme application and hard work, he completed his studies successfully at the end of 1911. His medical degree dissertation was another work on the historical Jesus,
Die psychiatrische Beurteilung Jesu. Darstellung und Kritik (The psychiatric evaluation of Jesus. Description and criticism), published in English in 1948 as
The Psychiatric Study of Jesus. Exposition and Criticism. He defended
Jesus' mental health in it. In June 1912, he married
Helene Bresslau, municipal inspector for orphans and daughter of the Jewish pan-Germanist historian
Harry Bresslau. In 1912, now armed with a medical degree, Schweitzer made a definite proposal to go as a physician to work at his own expense in the Paris Missionary Society's mission at
Lambaréné on the
Ogooué river, in what is now Gabon, in Africa, then a French colony. He refused to attend a committee to inquire into his doctrine, but met each committee member personally and was at last accepted. Through concerts and other fund-raising, he was ready to equip a small hospital. In early 1913, he and his wife set off to establish a hospital, the
Hôpital Albert Schweitzer, near an existing mission post. The site was nearly 200 miles, 14 days by raft, upstream from the mouth of the Ogooué at
Port Gentil (
Cape Lopez). It was accessible to external communications, but downstream of most tributaries, so that internal communications within Gabon converged towards Lambaréné. occupies most of Gabon.
Lambaréné is marked centre left. In the first nine months, he and his wife had about 2,000 patients to examine, some travelling many days and hundreds of kilometres to reach him. In addition to injuries, he was often treating severe
sandflea and
crawcraw infections,
yaws, tropical
eating sores, heart disease, tropical
dysentery, tropical
malaria,
sleeping sickness,
leprosy, fevers, strangulated
hernias,
necrosis, abdominal tumours and chronic
constipation and
nicotine poisoning, while also attempting to deal with deliberate poisonings,
fetishism and fear of
cannibalism among the
Mbahouin. Schweitzer's wife,
Helene Schweitzer, served as an anaesthetist for surgical operations. After briefly occupying a shed formerly used as a chicken hut, in late 1913 they built their first hospital of
corrugated iron, with a consulting room and operating theatre and with a dispensary and sterilising room. The waiting room and dormitory were built, like native huts, of unhewn logs along a path leading to the boat landing. The Schweitzers had their own bungalow and employed as their assistant Joseph, a French-speaking
Mpongwe, who first came to Lambaréné as a patient. After
World War I broke out in July 1914, Schweitzer and his wife, German citizens in a French colony when the countries were at war, were put under supervision by the French military at Lambaréné, where Schweitzer continued his work. In 1917, exhausted by over four years' work and by tropical
anaemia, they were taken to
Bordeaux and interned first in
Garaison and then from March 1918 in
Saint-Rémy-de-Provence. In July 1918, after being transferred to his home in Alsace, he was a free man again. At this time Schweitzer, born a German citizen, had his parents' former pre-1871 French citizenship reinstated, and became a French citizen. Working as a medical assistant and assistant-pastor in
Strasbourg, he advanced his project on the philosophy of civilization, which had occupied his mind since 1900. By 1920, his health recovering, he was giving organ recitals and doing other fund-raising work to repay borrowings and raise funds for returning to Gabon. In 1922, he delivered the Dale Memorial Lectures in the
University of Oxford, and from these in the following year appeared Volumes I and II of his great work,
The Decay and Restoration of Civilization and
Civilization and Ethics. The two remaining volumes, on
The World-View of Reverence for Life and a fourth on the Civilized State, were never completed. In 1924, Schweitzer returned to Africa without his wife, but with an Oxford undergraduate,
Noel Gillespie, as his assistant. Everything was heavily decayed, and building and doctoring progressed together for months. He now had
salvarsan for treating syphilitic ulcers and
framboesia. Additional medical staff, nurse (Miss) Kottmann and Dr. Victor Nessmann, joined him in 1924, and Dr. Mark Lauterberg in 1925; the growing hospital was staffed by native orderlies. Later Dr. Trensz replaced Nessmann, and Martha Lauterberg and Hans Muggenstorm joined them. Joseph also returned. In 1925–6, new hospital buildings were constructed, and also a ward for white patients, so that the site became like a village. The onset of famine and a dysentery epidemic created fresh problems. Much of the building work was carried out with the help of local people and patients. Drug advances for sleeping sickness included
Germanin and . Trensz conducted experiments showing that the non-amoebic strain of dysentery was caused by a paracholera
vibrion (facultative anaerobic bacteria). With the new hospital built and the medical team established, Schweitzer returned to Europe in 1927, this time leaving a functioning hospital at work. He was there again from 1929 to 1932. Gradually his opinions and concepts became acknowledged, not only in Europe, but worldwide. There was a further period of work in 1935. In January 1937, he returned to Lambaréné and continued working there throughout World War II.
Hospital conditions In 1953, the journalist
James Cameron visited Lambaréné, when Schweitzer was 78, and found significant flaws in the practices and attitudes of Schweitzer and his staff. The hospital suffered from squalor and was without modern amenities, and Schweitzer had little contact with the local people. Cameron did not make public what he had seen at the time: according to a BBC dramatisation, he made the unusual journalistic decision to withhold the story, and resisted the expressed wish of his employers to publish an exposé. The poor conditions of the hospital in Lambaréné were also famously criticized by Nigerian professor and novelist
Chinua Achebe in his essay on
Joseph Conrad's novel
Heart of Darkness: "In a comment which has often been quoted Schweitzer says: 'The African is indeed my brother but my junior brother.' And so he proceeded to build a hospital appropriate to the needs of junior brothers with standards of hygiene reminiscent of medical practice in the days before the germ theory of disease came into being." Schweitzer felt that patients were better off, and the hospital functioned better given the severe lack of funding, if patients' families lived on the hospital grounds during treatment. Surgical survival rates were, Berman asserts, as high as in many fully equipped western hospitals. The volume of patients needing care, the difficulty of obtaining materials and supplies, and the scarcity of trained medical staff willing to work long hours in the remote setting for almost no pay all argued for a spartan setting with an emphasis on high medical standards nevertheless. ==Schweitzer's views==