The Citadel

Set in the 20's and 30's of Britain, this fascinating novel recounts the evolution of a young Scottish doctor embarking upon his career. We follow his struggles from the mines of Wales to posh London and beyond. Committed to helping mankind, hard working though of modest means, Andrew Manson arrives fresh out of medical school--with all the enthusiasm and idealism of youth. Eager to dedicate himself to improving the lives of his rustic patients, Andrew dedicates many hours to private study in his chosen field of lung disease. But young Andrew is buffeted by fate for many years; although lucky in his choice of a life partner (school teacher Christine Barlow), he encounters opposition at every turn--from his employers, institutions, quacks and busybodies. Each move promises to be an upgrade, but he is rarely permitted to enjoy the change for long. He does meet a few decent young men in his travels, but he gradually chafes under the system which perpetuates greed and ignorance-the medical establishment in general, to which Cronin refers as the Citadel. Only a fool-hardy person would seek to attack such a mighty establishment, for the GMC can always strike a doctor off for misconduct-real or perceived. Cronin's style is highly readable, with much dialogue and interesting plotting. In fact he offers teaser sentences of woe as unexpected foreshadowing in the last paragraph of chapters which seem to end well. We witness the erosion of Andrew's ideals as he falls victim to the wealthy lifestyle of London's West End milieu. But the more he gains in the eyes of the world, the less he cherishes his faithful, patient wife. Chris struggles in her own private torment, desperately seeking to ally him with old and true friends, who might bring him back to the standards of their early marriage, when they were poor but very happy. Which path will the would-be medical reformer ultimately choose? Will the Citadel shut him out or crush his humanity at the end? A wonderful, timeless classic.

I picked up this book because it was mentioned in my great-grandmother's diary from 1941. Written in the 30s, it tells the tale of a young Scottish doctor in the 20s, as he goes from a small-town doctor in a rough situation to a well-paid London doctor with a fancy office.The story's written with intelligence, as the doctor ponders various ways to deal with the bureaucracy he faces. He deals with incompetent doctors, old doctors that have no desire to learn new treatments, young doctors more concerned with money and prestige than patient care.And, as he gets absorbed into the system, the doctor begins to be lured in by the money. He starts to prescribe the 'easy' solution to patients, even if it's not the right answer, so that they're happy and he gets more cash. He does finally realize, in the end, that working for the patients is more important than gaining lots of cash, but only after some hard lessons.I have a few small complaints with the story. One is that the wife could have been a really interesting character, but she's a little flat. She is sad when he becomes money-hungry, and draws back, but that's it. She was a schoolteacher when he met her, and it's made clear that she's very intelligent. But still she just sort of goes along with him, making his meals, wishing things could be better, but far be it for her to actually help out. She tries to get his friends to see him one night to bring back his old ways, but when that fails, "ah well".My other complaint is that he slides far too easy from a passionate patient-first attitude into a "cash is nice" mentality. But that was necessary for the plot to progress.Definitely a great book to read to learn about life in the 20s to 40s, from the small towns of Wales to the busy streets of London. Interesting details about the damage that mines caused to the lungs of the mineworkers, and the ways that doctors worked with each other and treated their patients. A great read!

"Be careful what you wish for because you just might getit" could express the moral of Cronin's THE CITADEL. I first read THE CITADEL in December of 1984. Then I read some of Cronin's other books.... They are all well written stories with deep moral purpose. They would be worth reading if you like THE CITADEL. But THE CITADEL is a special book. Its 5 star ranking is deserved. You don't have to be an aspiring physician to be attracted to its story or to recognize its universal theme. It's one of those quiet books that should be required reading.... END

I was typing up descriptions of books I bought in a box lot to sell and decided this one was in just too poor condition to sell, but it was medical, which always interests me, so I decided I should read it first before throwing it out (it's literally falling apart), AND BOY, AM I GLAD I DID! I found it totally absorbing, but surprisingly not so much from the medical aspect as from the simple human drama aspect. The cover emphasizes its focus on the corrupt medical system it describes, but to me it was more about a man losing himself in the pursuit of money & prestige, and having a crisis brought on by the death of a patient, that turns him back around, back to the idealistic doctor we liked in the beginning of the book. There were numerous British words I didn't know what they referred to, but I found I was able to just skip over them & keep reading without losing the essence of the plot or the sense of timing/tension/drama that kept bringing me back to read more.

A.J. Cronin's recently reprinted 1937 novel The Citadel is an old fashioned good story with a moral about falling into and being redeeming from the sin of avarice. Andrew Manson is a young doctor who starts this novel as an assistant to a disabled physician in a Welsh mining town. Although his boss -- really his boss' domineering and greedy wife -- make sure that he earns next to nothing despite doing all of the work of the practice, Andrew learns the joy of healing and discovers the challenges of scientific medicine. While there, he also meets his wife, Christine, who in many ways is his better self. Andrew's idealism -- or bullheadedness -- causes him to move from this position to the next, at the same time acquiring impressive credentials, including a MD degree for his thesis studying the effects of silica dust on miners. Then he becomes seduced by money and prestige, buying a down-and-out London practice, becoming a "pill-pusher" to pay the rent, acquiring a few "society" patients, and at last practicing in the manner best suit to maximize income, rather than care for patients. The crisis, when it comes, involves the tubercular daughter of a good friend, whom Andrew refers to a non-physician for experimental (and successful) treatment. Andrew very nearly loses his license to practice, but in the process rediscovers what excites him about medicine. I will not spoil the ending by recounting here what happens to Andrew and Chris; suffice to say that this is both a good and noble read, worthy of many reprintings and readings at the century's end.