The Citadel is a beautiful study of an idealistic young doctor who attempts to swim against the tide of the established medical ethics and the unorganized system, who, though almost drowned by it in the cause, courageously extricates himself and swims ashore conscientiously.
This story of the young Scottish doctor, Andrew Manson, is one inspirational story. Beginning his career as the medical assistant to a doctor in a South Wales mining community, he receives his first blow in the understanding that his learning at the medical school is inadequate to cater to the actual illnesses of the people. Slowly, with the help of a senior colleague and a little practical experience, he develops a scientific method of diagnosis and treatment. But in so doing, he is in for war, for he must face many difficulties since his method is against the traditionally established medical ethics. On top of it, Dr. Manson must face the jealousies and rivalries of the old practitioners who saw him as a threat to their practices. He is driven from place to place, but nowhere could he find his ideal system. Frustrated, he then swims in line with the established system for a time and finds himself slowly drowning in the benefits and money it brings. But one horrible incident wakes up the dormant idealist in him and thereon, he defies the system resorting to the beneficial yet unorthodox more scientific methods of treatment.
Based on his own experiences as a physician, in this semi-autobiographical novel, Cronin pours out his own views on an organized medical system, boldly confronting the established traditional medical ethics. Cronin wanted a change in the system, to establish an ordered method where the doctors could work conscientiously and in accordance with the Hippocratic Oath. He succeeded in his mission as this groundbreaking novel served to inspire the formation of the National Health Service (NHS).
The novel is mostly medical fiction, but it is also a good portrayal of a doctor’s life, the hardships they face in carrying out their duties, the struggle to keep a decent professional front amidst financial difficulties, and the normal human feelings of love, separation, loss, grief, and hope. The sympathetic presentation of these professional men, showing that they are also humans with feelings in their non-professional capacity is really touching. Cronin may not be a literary genius, but his presentation of them is genuine and heartfelt. Andrew Manson earns readers’ sympathy, and though his conduct is not always noble, he is a likable hero, because he feels real and human. And so are the other characters. Even those you don’t like are relatable. Reading the story was almost like reading a true story.
For a newbie to Cronin, I’m pleasantly surprised by how much I enjoyed the story and his simplistic writing. There is no pretension or any unnecessary adornment. He connects us with the characters effortlessly. And though his writing is simple, there is a power in its simplicity which makes the story stay with you long after you finish reading it. That is the ability of a good storyteller, and Cronin qualifies as one.