The Citadel by A. J. Cronin

First published: 1937

Type of work: Social criticism

Time of work: The first third of the twentieth century

Locale: Two small industrial towns in Wales, Blaenelly and Aberalaw; London; and Stanborough in southwestern England

Principal Characters:

• Andrew Manson, a physician
• Christine Manson, his wife
• Dr. Edward Page, an ailing physician in Blaenelly
• Mrs. Page, his wife
• Dr. Philip Denny, an idealistic physician
• Dr. Freddy Hampron, a former classmate of Manson

The Novel

A. J. Cronin, a physician as well as a writer, himself lived much of the life he attributes to his protagonist, Andrew Manson, in The Citadel. Therefore, he knows whereof he speaks. The novel begins by recounting the life of a medical doctor newly graduated from the not-quite-fashionable University of Dundee, as he commences his first full-fledged medical assignment, to maintain the established practice of Dr. Edward Page, an elderly physician in the industrial town of Blaenelly in Wales’s coal-mining region.

In Blaenelly, Manson meets Christine, a local schoolteacher who is to become h.is wife, and Dr. Philip Denny, who is to become the most influential person in his professional life. As he goes about carrying on Dr. Page’s practice in Blaenelly, Manson begins to realize that the older doctor was not always meticulous in his practice of medicine—Manson’s first awakening to the realities of how a profession that he had idealized is actually practiced day-to-day.

Before long, Mrs. Page unjustly accuses Manson of taking from a patient payment that should have gone to her husband. Actually, the grateful patient has given Manson a small gratuity in appreciation for his attention when he was ill. Manson realizes, however, that he can no longer continue in his present arrangement. The nearby town of Aberalaw needs a physician, and Manson goes before the committee there as an applicant for the job. He impresses the committee and accepts its offer to come to Aberalaw, taking with him Christine, whom he marries on the very day he leaves Blaenelly for his new post.

Manson remains the good, overworked physician. His idealism keeps him working at the highest level of competence of which he is capable. Although he begins to prosper modestly, his concern is with patients more than with the fees they pay him. Before long, it is evident that his patients have great faith in him as a doctor. His greatest professional problem in Aberalaw is the same as his greatest professional problem had been in Blaenelly: The citizenry with whom he must deal have old-fashioned notions of how medicine should be practiced, and the resistance that meets his new ways frustrates him enormously.

As a result, Manson is not always tactful in dealing with people. When a local clergyman comes to him saying that he and his wife do not want to have children yet and asking for advice, Manson, who has just suffered the loss of his first and only child, lashes out at this prominent patient, asking him why he married if he did not want children. Nevertheless, Manson maintains a successful practice in Aberalaw and is able to continue his research, which ultimately leads him to suspect that a cause-and-effect relationship exists between breathing coal dust in the anthracite mines all day and certain serious pulmonary disorders.

The local people do not understand Manson’s research, and some of them harass him and try to prevent him from continuing it. One of them breaks into his laboratory, takes his laboratory animals, and drowns them. Still, Manson persists in his investigations.

When Manson publishes his findings, he is called before the committee that initially hired him. This committee, which is composed of workingmen, is empowered not to renew his contract and, if they find against him, can demand that he be tried before the Medical Aid Society. The hearings are tense, but in the end Manson prevails and is invited to continue in Aberalaw. He and Christine, however, have lived through too much humiliation there, and he declines to remain.

Manson next becomes a physician for the Coal and Metalliferous Mines Fatigue Board. There his idealism is further put to the test. Ignorant men try to limit his research and make it difficult for him to practice the kind of medicine in which he believes. After due consideration, he and Christine leave Wales and go to London, where Manson buys the practice of the late Dr. Foy. It is a somewhat humble practice in a mediocre neighborhood which lies on the fringes of a better one.

Manson renews his old friendship with Freddie Hampton, who was his classmate in medical school at Dundee. Through Freddie and his wife, Manson and Christine meet other physicians, and Manson soon comes to realize that a lucrative cooperation exists among London physicians whereby they call one another in as consultants on their own cases and bill their patients excessive amounts for consulting physicians who have done practically no work, sometimes doing no more than coming into a hospital room and meeting a patient.

As the satisfaction of material gains becomes increasingly apparent to Manson, he begins to do jobs that really are beneath him, simply to get the fee. He pierces a woman’s ears and gets more than twice what he would have been paid for a patient visit in his previous practices. He buys fine clothing for himself and for Christine. They move into expensive quarters, and he purchases their first automobile, a definite sign of material success at that time. Soon he is doing consulting for other doctors and is having them do consulting for him. He stays very busy, becomes quite rich, and has no time for his research.

Christine is distressed at the change in her husband, but she remains loyal to him. Then one day, when she leaves the house to buy something for him, she is run down in the street outside their house and is killed. Manson, who is already struggling with the guilt of having bungled a surgery, is disconsolate when his wife dies. His old friend Philip Denny takes him to Wales, and there the two of them decide to open the sort of medical practice that their earlier idealism suggested would suit both them and humankind best. Manson still gets into trouble by practicing medicine that seems unconventional to many of his colleagues and by employing techniques that are ahead of his times, but he is vindicated in the end.

The Characters

The architecture of Cronin’s novel is not complicated. It progresses from start to finish in a straight line. It employs no radical or avant-garde literary techniques. Cronin’s work enjoys so much popularity that by 1958, seven million copies of his books had been sold, exclusive of translations, which account for another large body of sales (Russian translations alone having sold three million copies by the early 1960’s).

This remarkable popularity is accounted for largely by the fact that Cronin is a master of characterization. His conflicting characters evoke and sustain the kind of popular interest that the characters on television soap operas such as Dallas and Falcon Crest have in the 1980’s, despite their obvious differences.

Andrew Manson is the innocent, sincere, hardworking professional that people wish every doctor might be. He marries the compassionate, attractive Christine, who is cast from the same mold as the idealistic teacher in Emlyn Williams’ The Corn Is Green (1938). Manson is pitted against the forces of ignorance and evil that plague society. He is ahead of his time, and he often has to pay the penalty for being so advanced.

Juxtaposed to Manson is the dying Dr. Page, a doddering old man who seems never to have been a very good doctor. His wife is domineering, avaricious, ignorant, and unjust, quite the opposite of Christine. When Manson leaves Blaenelly, he finds the situation in Aberalaw no better, because the forces of ignorance are again in control, and even though these forces, as represented by the committee that reviews Manson, do not defeat him, he believes that he must move on, away from people who have marched on his house and have drowned his laboratory animals in an attempt to thwart his research. He flees similar ignorance when he finally capitulates, leaves his post with the Coal and Metalliferous Mines Fatigue Board, and moves to London.

In London, his old classmate Freddie Hampton and Freddie’s physician friends, people such as Dr. Charles Ivory and Dr. Paul Freedman, represent another side of medicine. These men could be reasonably competent physicians. Some of them are bright and sophisticated. They are no less dedicated than Manson, but their dedication is to improving their own lives, while his has always been to improving the lives of others.

Dr. Philip Denny, Manson’s friend from Blaenelly, represents another path that Manson can take—that of the man of medicine who has not abandoned his idealism—and he arrives just in time to keep Manson from abandoning his own dreams forever. The two now go about doing what physicians are meant to do, serving patients and engaging in research to help humankind.

Cronin’s main characters are warm and sympathetic. He uses stereotypes to provide the contrast needed to show his main characters in the proper light. The formula, although far from new or inventive, works well for Cronin in The Citadel and in most of his other books.

Critical Context

The Citadel is a variation on the debunking sorts of books that Sinclair Lewis wrote in the 1920’s. Whereas Lewis’ Main Street: The Story of Carol Kennicott (1920), Babbitt (1922), Arrowsmith (1925), and Elmer Gantry (1927) debunked small-town America and such institutions as the business world and the Church, Cronin, in broad sweeps, exposed the forces that lead idealistic physicians to lose their idealism and to fit the unfavorable stereotypes that many people have of them.

Debunking books have often drawn substantial audiences, and books such as those of Lewis and Cronin point in the direction of the more specific, investigative books that are characteristic of an age of modern consumerism. Ralph Nader’s Unsafe at Any Speed (1965), for example, has attracted many readers and sent a chill through Detroit’s automobile industry. Long before the rise of modern consumerism, books such as Frank Norris’ The Octopus (1901), an expose of the railroads’ exploitation of farmers, and Upton Sinclair’s The Jungle (1906), an expose of the meat-packing industry, had a major impact on their readers.

It is in a milder version of this tradition that The Citadel can be placed. Despite its criticism of the medical profession, The Citadel is more in the spirit of James Herriot’s All Creatures Great and Small (1972) than in the spirit of the muckrakers of the early twentieth century or of the investigative writers of the modern age of consumerism. Nevertheless, it joins hands with other novels of social criticism to form a tradition that persists to the present day.

Bibliography

“Authors: Sort of Unsanctimonious,” in Newsweek. LVIII (December 4, 1961), p. 109.

Cronin, A. J. Adventures in Two Worlds, 1952.

Dunaway, Philip, and George DeKay, eds. Turning Point: Fateful Moments That Revealed Men and Made History, 1958.

Ferguson, Otis. Review in The New Republic. XCII (September 22, 1937), p.195.

Kazin, Alfred. Review in The New York Times. September 12, 1937, sec. VII, p. 6.

Time. Review. September 13, 1937, p. 62.