The Citadel

Part OneThe book is about a new doctor whose name is Andrew Manson. Andrew is a 24-year-old man who finds his first job, as a doctor, at a small village named Drineffy. This village is buried deeply in the English country. Most of the residents of the village are miners and live there with their families.
Andrew’s life there has some hard knocks because the work is too hard and the medical system is very bad. Andrew has to work for Dr. Page, a 60-year-old man, who spends all his time in bed because of a strange illness. Dr. Page is one of the three doctors the Mining Company pays in order to treat the miners and their families. He gives a share of this money to Andrew, but Andrew has to work alone because of Dr. Page's illness.
Andrew’s first case is a young woman who has fever. Andrew is not sure about the cause of the fever, but Denny, who works for the second doctor of the Mining Company, advises him to consider typhoid fever.
Denny is right. The bad condition of the sewer makes the water of the well full of bacteria. So, Andrew and Denny decide to blow up the sewer in order to force the Area Medical Officer to build a new one.
Three months later Andrew visits school of Drineffy where a young, attractive woman teaches. Her name is Christine. Andrew likes her, but they argue because of the illness of a boy. Andrew feels bad about that argument and he doesn’t miss the chance to see Christine again when they are both invited to supper at Mrs. Bramwell’s house. He goes there and apologizes to Christine.
As a result, a few days later, she invites him to her house, where he asks her if she wants to go out with him one evening. The answer is positive.
Andrew feels very good and is looking for a serious case in order to impress Christine, but he has only simple cases to attend to. The first serious case comes. Dr. Dramwell believes that one of his patients is mad. He calls Andrew because he needs a second opinion. Andrew arrives, but he understands that the patient is not mad and that he has a hormone problem. He gives his treatment and goes to Christine to tell her about his success.

Part Two
Andrew seems to be a very skilled doctor. He does a very good job when the second serious case comes. Joe Morgan’s wife is pregnant and she is expecting their first baby but she has a long and difficult birth. After several hours the baby is born, but it is lifeless and the mother is close to death. Andrew, first, manages to save the mother and then brings the baby back to life. He is very pleased. “I have done something good at last”, says to himself.

Not only Andrew is pleased, but Joe Morgan too. He visits Andrew, offers him a check of 5 pounds, telling him that this money is his and not for Dr. Page! However, this check brings troubles to Andrew. Dr. Page’s sister finds out that he keeps all 5 pounds without giving to Dr. Page a share and shouts at him. She accuses him that he is trying to take over Dr. Page’s practice. Because of that incident Andrew decides to resign and gives her a month’s notice.

So, Andrew is looking for a new post now, but he does not receive any answer to his letters. Finally, he hears that the Aberalaw Medical Society is looking for a new man and he tries to apply for the post. A week later, Andrew goes to Aberalaw to be examined by the Society’s committee. He doesn’t say anything to Christine because he wants to surprise her. Several doctors are there for the post but, finally, the committee’s choice is Andrew due to two letters received by Dr. Denny and Dr. Page. Both of them praise his work.

But there is one last thing. The committee thinks that the post should be given to a married man. This is the moment that Andrew decides to ask Christine to marry him. He returns to Drineffy, he goes directly to her house and proposes. The answer is again positive. They are both happy and they are moving to Aberalaw. However, every beginning is difficult. The Miners in Aberalaw are used to take sick notes from their doctor in order not to work, although there are capable to do it. Andrew refuses to give them the sick notes for no reason and he argues with one of them. As a result nobody wants him to be their doctor and Andrew loses most of his patients while his salary is reduced.

Part Three
On the last Sunday in March, Denny, Andrew’s friend from Drineffy, visits Andrew and Christine. They are delighted to see him. Denny stays there all day and the three of them have great time. He takes the last train to Drineffy. This visit of Denny makes Andrew understand that there is no friendship between the doctors of Aberalaw. He must improve the relations and also he must do something about that unfair arrangement of paying part of their salaries to Dr. Llewellyn, the head doctor of Aberalaw.
But he is the only one who thinks that way! Or is he not? Two weeks later he meets Con Boland. He is the Society’s dentist. Dr. Boland is pour and, although he has three children to raise, he also has to pay part of his salary to Dr. Llewellyn. They both decide that they must do something about that and Andrew invites all doctors to his house to discuss and informs Dr. Liewellyn about it. All the doctors of Aberalaw have a long discussion until Andrew tells them that he has told to Dr. Liewellyn about their gathering. It was then when three of them decide to leave being afraid that they will be dismissed. The conversation stops.
Andrew lives the whole matter behind and decides to take a degree. In order to take it he must study and do some practical work in medicine. Christine helps him. All this needs great effort and Andrew loses weight and becomes thinner in the face. Finally he studies all the subjects that he could be examined and he goes to London. The first examiner is very strict and Andrew answers the five of the six questions. But the second examiner has good manners and this makes Andrew more confident. He answers everything else and he manages to get that degree!
As soon as Andrew gets home he is told that a terrible accident happened in the mine and one of his patients, Sam Bevan, is trapped. Andrew runs to the mine, reaches Sam and realizes that his arm has to been caught somewhere. He works in a hurry to release him and the other miners manage to bring Sam back to the surface just before the collapse of the mine. Andrew has done again a very good job.
After saving Sam’s life Andrew’s popularity increases and most of his old patients return to him. Everything seems to be better now. It is Christmas and he receives presents from his patients. Andrew invites one of them for lunch and after that Christine tells him that she is pregnant! But this child is not meant to be born. Christine has an accident. She falls while crossing a bridge and she losses the baby.
Andrew starts to feel like leaving Aberalaw. The only thing that keeps him there are his experiments which he is doing all this time. He is doing a research into coal dust. He has important information about the effect of the coal dust on the miners’ lunges. In order to prove his findings, he decides to do some tests on small animals. But he does think about getting permission. The committee finds out about these experiments and orders him to attend an inquiry. During the inquiry there are many complains against Andrew from people that don’t like him. Andrew in order to defend himself reads a letter from a university in Scotland, which offers him another degree in recognition of his coal dust discoveries. The committee decides that he can keep his post but he does not feel pleased and gives a month’s notice.

Part Four
Now, Andrew has to find another post. Actually, he wants to buy a practice, but the three hundred pounds he has in the bank are not enough. He receives several letters as a result of printing of his research in a number of medical papers. In one of them the Coal and Mines Board wishes him to be their Medical Officer. This is the post he and Christine are looking for. Andrew answers the letter and accepts the job. So, they move to London and Andrew goes to the offices of the Coal and Mines Board, but he discovers that there is nothing for him to do for a whole month when the next meeting of the Board is due. He is disappointed, but he decides to use that time in order to explore London with Christine.

The month passes by and the meeting comes. The President of the Board welcomes him and tells him that he has to make a report about the medical materials in mines. This is the second disappointment for Andrew who thought that he was going to do some research. The report takes six months and in the end he decides that he does not like his job any more and he informs the Board that he is leaving.

Andrew’s dream is a practice and he spends all his savings on one in Paddington area of London. The problem is that only a few patients go to his practice and he does not earn much money. Andrew and Christine are poor and they go to a cheap food shop owned by Mrs. Smith for their meals. Mrs. Smith is fond of Christine and promises Andrew that she will send him patients.

Mrs. Smith keeps her promise and sends Miss Cramb to Andrew’s practice. She suffers from a rare skin disease. Andrew advises her to avoid a list of foods which are the cause of the disease. Ten days later she was cured. Miss Cramb is working in a large dress shop and she tells about the doctor who cured her to everyone in that shop. Several girls from the shop start to visit Andrew and increase his profit. But Andrew earns more money by visiting Miss Everett, an old, rich woman who pays him a pound every time he gives her his treatment. He wants to succeed, so he buys two suits and a car because he wants to have the right appearance for the rich patients he intends to have.

Part Five and Six
Andrew decides that in order to succeed he has to sacrifice his beliefs about the medical system. The people that go to his surgery, now, are so many that he can no longer take the time to give them proper attention. He prepares a large quantity of two different kinds of medicine and gives a bottle of them to each of his patients no matter if they need it or not. Of course this is an easy way to make money. Moreover, a new post is offered to Andrew in one of the oldest and most famous hospitals in London, Victoria Hospital. He is a rich doctor now. But his way of succeeding it is wrong. Not only does he give bottles of medicine for no reason, but he also sends patients to a friend of him and the patients have to pay both of them.

Christine is not happy about all this. She thinks that Andrew has changed, that he is not the man she met and loved back in Drineffy. She decides to leave him alone for a couple of weeks in order to have a break because they argue all the time.

While Christine is not home, Con Boland, the dentist of Aberalaw visits Andrew. His daughter, Mary, is ill and Con needs Andrew’s help. Andrew promises that he will treat her.

One of the patients whom Andrew sends to his friend is Harry Vielder. Harry has a pain in his stomach and he needs a simple operation. Andrew’s friend, Ivory, operates on him and Andrew is watching the whole process. But he understands that Ivory is not a very good doctor and because of him, Harry dies. This rings a bell for Andrew. He is very sad and angry with Ivory who did the operation so badly. He returns home and when Christine asks him how much money he has made, he throws the money across the room shouting: “Oh, God. What have I done?”

Andrew does not sleep that night. He thinks only of Mary Boland now. What happened to Harry Vielder must not happen to Mary. She is in Victoria Hospital, but her progress is not at all satisfactory. Andrew thinks that Mary needs a surgery, but Dr. Thoroughgood, a doctor of the hospital, believes that a surgery is not necessary. Andrew does not know what to do.

The unsuccessful operation of Harry Vielder has changed him. He does not care about money any more. Not only does he stop giving useless medicines to his patients, but he also tells them that those who are not really ill should not visit him again in the future. He decides not to take advantage of his patients in the future in order to make money.

Next morning he visits Mary in Victoria Hospital. He wants to take her to another, new, hospital built by Mr. Stillman. Mr. Stillman is not a doctor, but he has done more for medicine than thousands of men with degrees. So, he and Nurse Sharp drive Mary to this new hospital where Mr. Stillman operates on her. As a result, in a few days Mary is just fine. Christine and Andrew are happier than ever. He is not thinking of money any more and she thinks only of him. They have plans for the future. Andrew wants to sell his practice and start working with two good friends of him, Denny and Hope. Christine finds this plan brilliant and Andrew sends letters to these two friends.

But something bad happens. Christine has an accident. She is run over by a bus, she dies and Andrew breaks down. Denny arrives to help him and he decides to take Andrew to a lonely village by a beautiful river in the mountains. The fresh air and the exercise make him feel better, but he receives a letter that informs him that he is in trouble. The General Medical Council decides to hold an inquiry because Andrew sent a patient to a man who is not really a doctor, Mr. Stillman.

Mr. Hopper, the lawyer employed by Andrew, suggests that he should control his feelings during the inquiry, but Andrew does the exactly opposite thing. He starts talking about the things that are wrong with the medical profession, about how few things they learn in the medical school and finally about Stillman and how good he is in what he does. That’s it. The Council is going to disqualify him. The President asks everyone to leave the room in order to make a decision. After a while, they all come back again. The President says: “we decided to allow you to continue to practice medicine”. Andrew is now free to work with Denny and Hope and make their own little hospital.

The end.