Summary of the Citadel

A. J. Cronin
Citadel
The action takes place in the 1920-1930-ies. In Great Britain. In a small mining town Blanelli comes a young doctor Andrew Manson – a new assistant doctor, Dr. Page. When he arrives, he learns that his cartridge is paralyzed and will have to carry a double load. The wife of Page Blodewa, an ungrateful and greedy person, keeps unfriendly and constantly tries to save on Manson.
On his first visit to the sick man, Manson can not make an accurate diagnosis, and only his meeting with Philip Denny, an assistant to another doctor, helps him. He, however, holds defiantly (in the future it is hinted that in this place forgotten by God he was forced to move the turmoil in the family), but tells Manson that this is typhus. Indeed, because of the rusty sewer pipe in the city, an epidemic of typhus begins. Desperate to get the local authorities to solve this problem, Manson and Denny blow it up.
One day, Manson comes to a large family, where one of the children has measles, and learns that the youngest child has gone to school. Wishing to honor the teacher for not observing the quarantine, Manson goes to school. There he meets Miss Christine Barlow. She has a difficult fate: at the age of fifteen she lost her mother, and five years later, because of the accident in the mine, the father, the manager of the Ports mine, and his brother, a mining engineer, died. Gradually, the girl starts to take Manson’s thoughts more and more. Meanwhile, Manson’s reputation as a doctor in the city is growing: he heals from the “insanity” of Imrys Hughes; thanks to his efforts, a newborn child survives a previously barren forty-three-year-old woman. Manson is full of noble aspirations, and it painfully hurts the reasoning of Freddy Hemson’s classmate,
The management of the mine, whose salary consists of Dr. Page, deserves Manson, offering him the place of a doctor, but for ethical reasons he refuses, so as not to damage Dr. Page. Soon after, he receives a check for five guineas from the husband of forty-three-year-old mothers and puts the money in the bank. The director of the bank, who is in close relationship with Mrs. Page, informs her of Manson’s contribution, and the woman accuses the young doctor of having stolen this money from Dr. Page. Manson refutes all charges, forcing Mrs. Page to apologize to him, but after this incident he is forced to look for another job.
After a while he finds a doctor’s place in another mining town, Eberlo, and makes Christine an offer to start a joint life there. But as soon as Manson starts to work, there is a conflict between him and the workers at the mine: he refuses to give them sick leaves for no good reason. However, soon everything is getting better, and he and Christine even fall into higher society – they become friends of the owner of all enterprises in Eberlo Richard Vaughan. For the same period, Manson’s acquaintance with the dentist Kon Koh Boland, an optimist and merry fellow, the father of five children, is necessary. With Boland’s support, Manson tries to beat the doctors to refuse to pay the chief doctor of the city of Llewellyn a tribute of five percent of their income, but his venture fails.
A burning desire to improve the health care system, Manson begins with himself. He is studying hard, and then successfully passes the doctoral degree exam. He is interested in the influence of coal dust on the development of pulmonary diseases in miners; he is fascinated by his scientific research.
Soon it turns out that Christine is waiting for the child, but this happiness does not come true: stumbling on a broken bridge, she is forever deprived of the opportunity to have children. Manson continues his research work, but clouds are gathering over his head. A group of his enemies from among the workers is accusing him of cruel treatment of animals, because in his experiments he used guinea pigs. He is invited to the meeting of the working committee to be removed from office, but he shows them a certificate of his doctorate and he resigns himself.
For the same period, we have an in-depth acquaintance with Richard Stilman, an American specialist in lung diseases, who in his letter highlights the thesis of Manson’s dissertation. Further in the fate of Manson there is a new twist: the Labor Pathology Committee in coal and metal mines invites him to the position of doctor.
Manson and his wife moved to London. However, work in the committee very soon disappoints Manson, since he does not allow him to deal with the real thing. Shocked by... the fact that in the presence of really acute problems, one of the officials seriously discuss with him the size of the bandages that should be in the first aid kit in the mines, Manson resigns.
Begin the painful search for practice in London. For the six hundred pounds that the Mansons managed to save, they can only buy provincial practices in a poor neighborhood. However, Manson is lucky: he manages to cure one of the employees of an expensive store, Marta Cramb, from an allergic rash, and she makes him an advertisement. Thanks to her, Manson gets to the higher world, gets acquainted with rich, prosperous businessmen – through their wives. One of these ladies, Francis Lawrence, eventually becomes Manson’s mistress.
The doctor is experiencing a spiritual rebirth: a clash with wealth corrupts him, and he replenishes the ranks of doctor-grumblers, making meaningless, and sometimes harmful procedures for the sake of money. Christine is concerned that her husband is too fond of money, she begs him not to sell himself, but the thirst for success in high society makes Manson ever greedy to the money. He is part of the community of doctors who refer patients to each other for consultation or surgery, and then share their incomes. Soon, Manson can already afford a cabinet in the most prestigious area, his income is growing steadily.
Meanwhile, the discord with Christine grows, Manson is annoyed by her silent reproach, the fascination with the Bible, and he gladly agrees that she should leave for the summer to Mrs. Vaughan. During the absence of Christine, he first changes it with Francis Lawrence.
But soon the fate of Manson makes another steep turn: he is present during the operation to remove the cyst, which the surgeon Ivory, entering into their community of successful doctors, and with horror for himself is convinced that he does not know how to operate. A simple operation that any student can easily do, leads to the death of the patient on the operating table. Manson’s eyes seem to open: he understands how low he has fallen, and tears with this life.
It turns out that the eldest daughter of Bolanda is sick with consumption, and Manson, disillusioned with the methods used in the Victoria Hospital in London, takes her to the newly opened Sanctuary of Steelman, where the girl is completely cured by pneumothorax.
Returning home, he finds his wife happy and happy: she gaily covers the table. Suddenly she remembers that she forgot to buy her favorite cheese for her husband, and immediately runs to the shop across the road. On the way back, she is hit by a bus.
Manson is hard to survive the death of his wife, which again became spiritually close to him. He sells the practice and, together with Denny, leaves for a quiet abbey where he gradually regains consciousness. They with Denny and Dr. Gope, Manson’s companion for work in the labor pathology committee, have long decided to create somewhere in the province a community of doctors, each of which would specialize in a particular field of medicine. This can put medical care on a qualitatively new level. Friends have already chosen the city and looked for a suitable house for their purposes, when suddenly Manson receives news that he is accused of voluntary and conscious assistance to a person “not registered as a person in the medical profession.” This refers to his involvement in the operation on Mary Boland, which was conducted by Richard Stillman, who does not have a doctor’s diploma. The complaint against Manson was initiated by Dr. Ivory, who had been slurred by him. Manson must appear before the court of the Medical Council. If he is convicted, he will forever lose the right to practice medicine.
The lawyer does not really believe in the success of the case. At the trial, he builds a defense on the fact that Manson was personally responsible for the life of the daughter of a close friend, so he considered it necessary to take her treatment for herself. Yes, says lawyer Gopper, Manson made a false step, but there was nothing deliberate and dishonest in that. The lawyer calls on Manson to repent of everything, but in his ardent speech, Manson turns to history, reminding the court that Louis Pasteur did not have a medical education either, and Erlich, Khavkin and Mechnikov did not have it, which made an invaluable contribution to the development of medicine. Manson urges the medical court to end prejudice and look not at the diploma but on the person’s real contribution to the treatment of patients. The court justifies Manson, stating that he acted “with good intentions, sincerely wanting to act in the spirit of the law,


Summary of the Citadel