The Citadel

by A. J. Cronin

‘What’s all this about, I’d like to know. Isn’t my word good enough for you, Doctor Manson?’ She was a broad, middle-aged woman with untidy iron-grey hair and a harassed, overwrought face. She could barely speak for the heaving of her bosom.

  Andrew’s heart sank. But he took a rigid grip upon himself. He forced a smile. ‘Come now, Nurse Lloyd, don’t misunderstand me. Suppose we talk this over together in the front room.’

  The nurse bridled, swept her eyes to where Evans and his wife, who clutched a little girl of three to her skirts, were listening wide-eyed and alarmed.

  ‘No, indeed, we’ll talk it over here. I got nothing to hide. My conscience is clear. Born and brought up in Aberalaw I was, went to school here, married here, ’ad children here, lost my ’ usband here, and worked here twenty year as district nurse. And nobody ever told me not to use carron oil on a burn or scald.’

  ‘Now listen, nurse,’ Andrew pleaded. ‘Carron oil is all right in its way perhaps. But there’s a great danger of contracture here.’ He stiffened up her elbow by way of illustration. ‘ That’s why I want you to try my dressing.’

  ‘Never ’eard of the stuff. Old Doctor Urquhart don’t use it. And that’s what I told Mrs Evans. I don’t hold with new-fangled ideas of somebody that’s been here no more nor a week!’

  Andrew’s lips were dry. He felt shaky and ill at the thought of further trouble, of all the repercussions of this scene, for the nurse, going from house to house, and talking her mind in all of them, was a person with whom it was dangerous to quarrel. But he could not, he dared not, risk his patient with that antiquated treatment. He said in a low voice:

  ‘If you won’t do the dressing, nurse, I’ll come in morning and evening and do it myself.’

  ‘You can then, for all I care,’ Nurse Lloyd declared, moisture flashing to her eyes. ‘And I ’ope Tom Evans lives through it.’

  The next minute she flounced out of the house.

  In dead silence Andrew removed the dressing once again. He spent nearly half an hour patiently bathing and attending to the damaged arm. When he left the house he promised to return at nine o’clock that night.

  That same evening as he entered his consulting-room the first person to enter was Mrs Evans, her face white, her dark frightened eyes avoiding his.

  ‘I’m sure, doctor,’ she stammered, ‘I do hate to trouble you, but can I have Tom’s card?’

  A wave of hopelessness passed over Andrew. He rose without a word, searched for Tom Evans’s card, handed it to her.

  ‘You understand, doctor, you – you won’t be callin’ any more.’

  He said unsteadily: ‘I understand, Mrs Evans.’ Then as she made for the door he asked – he had to ask – the question: ‘Is the carron oil on again?’

  She gulped, nodded and was gone.

  After surgery, Andrew, who usually tore home at top speed, made the passage to Vale View wearily. A triumph, he thought bitterly, for the scientific method! And again, am I honest or am I simply clumsy? – clumsy and stupid, stupid and clumsy!

  He was very silent during supper. But afterwards, in the sitting-room, now comfortably furnished, while they sat together on the couch before the cheerful fire, he laid his head close to her soft young breasts.

  ‘Oh darling,’ he groaned. ‘ I’ve made an awful muddle of our start!’

  As she soothed him, gently stroking his brow, he felt tears smarting behind his eyes.

  Chapter Six

  Winter set in early and unexpectedly with a heavy fall of snow. Though it was only mid-October, Aberalaw lay so high that hard and bitter frosts gripped the town almost before the leaves had fallen from the trees. The snow came silently through the night, soft drifting flakes, and Christine and Andrew woke to a great glittering whiteness. A herd of mountain ponies had come through a gap in the broken wooden palings at the side of the house and were gathered round the back door. Upon the wide uplands, stretches of rough grass land, all round Aberalaw, these dark wild little creatures roamed in large numbers, starting away at the approach of man. But in snowy weather, hunger drove them down to the outskirts of the town.

  All winter Christine fed the ponies. At first they backed from her, shy and stumbling, but in the end they came to eat from her hand. One especially became her friend, the smallest of them all, a black tangle-maned, roguish eyed creature, no larger than a Shetland, whom they named Darkie.

  The ponies would eat any kind of food, scraps of loaf, potato and apple rinds, even orange peel. Once, in fun, Andrew offered Darkie an empty match-box. Darkie munched it down, then licked his lips, like a gourmet eating pâté.

  Though they were so poor, though they had to bear many things, Christine and Andrew knew happiness. Andrew had only pence to jingle in his pockets, but the Endowment debt was almost settled and the furniture instalments were being paid. Christine, for all her fragility and look of inexperience, had the attribute of the Yorkshire woman, she was a housewife. With the help only of a young girl named Jenny, a miner’s daughter from the row behind, who came daily for a few shillings each week, she kept the house shining. Although four of its rooms remained unfurnished, and discreetly locked, she made Vale View a home. When Andrew came in tired, almost defeated by a long day, she would have a hot meal on the table which quickly restored him.

  The work of the practice was desperately hard – not alas! because he had many patients, but because of the snow, the difficult ‘climbs’ to the high parts of his district, the long distances between his calls. When it thawed and the roads turned to slush, before freezing hard again at night, the going was heavy and difficult. He came in so often with sodden trouser ends that Christine bought him a pair of leggings. At night when he sank into a chair exhausted she would kneel and take off these leggings, then his heavy boots, before handing him his slippers. It was not an act of service but of love.

  The people remained suspicious, difficult. All Chenkin’s relations – and they were numerous, since inter-marriage was common in the valleys – had become welded into a hostile unit. Nurse Lloyd was openly and bitterly his enemy and would run him down as she sat drinking tea in the houses which she visited, listened to by a knot of women from the Row.

  In addition he had to contend with an ever-increasing irritation. Doctor Llewellyn was using him for anaesthetics far oftener than he judged fair. Andrew hated giving anaesthetics – it was mechanical work which demanded a specialised type of mind, a slow and measured temperament which he certainly did not possess. He did not in the least object to serving his own patients. But when he found himself requisitioned three days a week for cases he had never seen before, he began to feel that he was shouldering a burden which belonged to someone else. Yet he simply dare not risk a protest for fear of losing his job.

  One day in November, however, Christine noticed that something unusual had upset him. He came in that evening without hailing her gaily and, though he made pretence of unconcern, she loved him too well not to detect from the deepened line between his eyes and a score of other minute signs, that he had received an unexpected blow.

  She made no comment during supper and afterwards she began to busy herself with some sewing beside the fire. He sat beside her, biting on his pipe, then all at once he declared:

  ‘I hate grousing, Chris! And I hate bothering you. God knows I try to keep things to myself!’ This, considering that he poured his heart out to her every night, was highly diverting. But Christine did not smile as he continued:

  ‘You know the hospital, darling. You remember going over it our first night. Remember how I loved it and raved about opportunities and chances of doing fine work there, and everything. I thought a lot about that didn’t I, darling? I had great ideas about our little Aberalaw Hospital?’

  ‘Yes, I know you did.’

  He said stonily:

  ‘I needn’t have deluded myself. It isn’t the Aberalaw Hospital. It’s Llewellyn’s Hospital.’

  She was silent, her eyes concerned, waiting for him to explain.


  ‘I had a case this morning, Chris!’ He spoke quickly now, at white heat. ‘ You’ll note that I say had! – a really early apical pneumonia in one of the anthracite drillers, too. I’ve told you often how terribly interested I am in their lung conditions. I’m positive there’s a big field for research work there. I thought to myself – here’s my first case for hospital – genuine chance for charting and scientific recording. I rang up Llewellyn, asked him to see the case with me, so that I could get it into the ward!’ He stopped to take a swift breath, then rushed on:

  ‘Well! Down came Llewellyn, limousine and all. Nice as you please, and damned thorough in his examination. He knows his work inside out, mind you, he’s an absolute topnotch man. He confirmed the diagnosis, after pointing out one or two things I’d missed, and absolutely agreed to take the case into hospital there and then. I began to thank him, saying how much I would appreciate coming into the ward and having such good facilities for this particular case.’ He paused again, his jaw set. ‘Llewellyn gave me a look at that, Chris, very friendly and nice. “You needn’t bother about coming up, Manson,” he said. “I’ll look after him now. We couldn’t have you assistants clattering around the wards” – he took a look at my leggings – “ in your hob-nail boots –”’ Andrew broke off with a choking exclamation. ‘Oh! What’s the use going over what he said! It all boils down to this – I can go tramping into miners’kitchens, in my sopping raincoat and dirty boots, examining my cases in a bad light, treating them in bad conditions, but when it comes to the hospital – ah! I’m only wanted there to give the ether!’

  He was interrupted by the ringing of the telephone. Gazing at him with sympathy she rose, after a moment, to answer it. He could hear her speaking in the hall. Then, very hesitatingly she returned.

  ‘It’s Doctor Llewellyn on the phone, I’m – I’m terribly sorry, darling. He wants you tomorrow at eleven for – for an anaesthetic.’

  He did not answer, but remained with his head bowed despondently between his clenched fists.

  ‘What shall I tell him, darling?’ Christine murmured anxiously.

  ‘Tell him to go to hell!’ he shouted; then passing his hand across his brow. ‘No, no. Tell him I’ll be there at eleven,’ he smiled bitterly, ‘at eleven sharp.’

  When she came back she brought him a cup of hot coffee – one of her effectual devices for combating his moods of depression.

  As he drank it he smiled at her wryly.

  ‘I’m so dashed happy here with you, Chris. If only the work would go right. Oh! I admit there’s nothing personal or unusual in Llewellyn’s keeping me out of the wards. It’s the same in London, in all the big hospitals everywhere. It’s the system. But why should it be, Chris? Why should a doctor be dragged off his case when it goes into hospital? He loses the case as completely as if he’d lost the patient. It’s part of our damn specialist-GP system and it’s wrong, all wrong! Lord! why am I lecturing you though? As if we hadn’t enough worries of our own. When I think how I started here! What I was going to do! And instead – one thing after another – all gone wrong!’

  But at the end of the week he had an unexpected visitor. Quite late, when he and Christine were upon the point of going upstairs, the door bell rang. It was Owen, the secretary to the Society.

  Andrew paled. He saw the secretary’s visit as the most ominous event of all, the climax of these struggling unsuccessful months. Did the Committee want him to resign? Was he to be sacked, thrown out with Christine into the street, a wretched failure? His heart contracted as he gazed at the secretary’s thin diffident face, then suddenly expanded with relief and joy as Owen produced a yellow card.

  ‘I’m sorry to call so late, Doctor Manson, but I’ve been detained late at the office, I didn’t have time to look in at the surgery. I was wondering if you would care to have my medical card. It’s strange in a way, me being secretary to the Society, that I haven’t ever bothered to fix up. The last time I visited a doctor I was down in Cardiff. But now, if you’ll have me, I’d greatly appreciate to be on your list.’

  Andrew could scarcely speak. He had handed over so many of these cards, wincing as he did so, that now to receive one, and from the secretary himself, was overwhelming.

  ‘Thank you, Mr Owen – I’ll – I’ll be delighted to have you.’

  Christine, standing in the hall, was quick to interpose.

  ‘Won’t you come in, Mr Owen. Please?’

  Protesting that he was disturbing them, the secretary seemed nevertheless willing to be persuaded into the sitting-room. Seated in an armchair, his eyes fixed reflectively upon the fire, he had an air of extraordinary tranquillity. Though in his dress and speech he seemed no different from an ordinary working man he had the contemplative stillness, the almost transparent complexion of the ascetic. He appeared for some moments to be arranging his thoughts. Then he said:

  ‘I’m glad to have the opportunity of talking to you, doctor. Don’t be down-hearted if you’re havin’ a bit of a setback to begin with, like! They’re a little stiff, the folks here, but they’re all right at heart. They’ll come after a bit, they’ll come!’ Before Andrew could intervene he continued:

  ‘You haven’t heard of Tom Evans, like? No? His arm has turned out very bad. Ay, that stuff you warned them against did exactly what you was afraid of. His elbow’s gone all stiff and crooked, he can’t use it, he’s lost his job at the pit over it. Ay, and since it was at home he scalded himself, he don’t get a penny piece of compo.’

  Andrew muttered an expression of regret. He had no rancour against Evans, merely a sense of sadness at the futility of this case which had so needlessly gone wrong.

  Owen was again silent, then in his quiet voice he began to tell them about his own early struggles, of how he had worked underground as a boy of fourteen, attended night school and gradually ‘ improved himself’, learned typing and shorthand, and finally secured the secretaryship of the Society.

  Andrew could see that Owen’s whole life was dedicted to improving the lot of the men. He loved his work in the Society because it was an expression of his ideal. But he wanted more than mere medical services. He wanted better housing, better sanitation, better and safer conditions, not only for the miners, but for their dependants. He quoted the maternity mortality rate amongst miners’ wives, the infantile mortality rate. He had all the figures, all the facts at his finger ends.

  But, besides talking, he listened. He smiled when Andrew related his experience with the sewer in the typhoid epidemic at Drineffy. He showed a deeper interest in the view that the anthracite workers were more liable to lung trouble than other underground workers.

  Stimulated by Owen’s presence, Andrew launched into this subject with great ardour. It had struck him, as the result of many painstaking examinations, how large a percentage of the anthracite miners suffered from insidious forms of lung disease. In Drineffy many of the drillers who came to him complaining of a cough or ‘a bit of phlegm in the tubes’ were in reality incipient or even open cases of pulmonary tuberculosis. And he was finding the same thing here. He had begun to ask himself if there was not some direct connection between the occupation and the disease.

  ‘You see what I mean?’ he exclaimed eagerly. ‘ These men are working in dust all day, bad stone dust in the hard headings – their lungs get choked with it. Now I have my suspicion that it’s injurious. The drillers, for instance, who get most of it – they seem to develop trouble more frequently than, say, the hauliers. Oh! I may be on the wrong track. But I don’t think so! And what excites me so much is – oh, well! it’s a line of investigation nobody has covered much. There’s no mention in the Home Office list of any such industrial disease. When these men are laid up they don’t get a penny piece of compensation!’

  Roused, Owen bent forward, a vivid animation kindling his pale face.

  ‘My goodness, doctor. You’re really talkin’! I never heard anything so important for a long time.’

  They fell into a lively discussion of
the question. It was late when the secretary rose to go. Apologising for having stayed so long, he pressed Andrew whole-heartedly to proceed with his investigation, promising him all the help in his power.

  As the front door closed behind Owen he left behind him a warm impression of sincerity. And Andrew thought, as at the Committee-meeting when he had been given the appointment, that man is my friend.

  Chapter Seven

  The news that the secretary had lodged his card with Andrew spread quickly through the district, and did something to arrest the run of the new doctor’s unpopularity.

  Apart from this material gain both Christine and he felt better for Owen’s visit. So far the social life of the town had completely passed them by. Though Christine never spoke of it there were moments during Andrew’s long absences upon his round when she felt her loneliness. The wives of the higher officials of the Company were too conscious of their own importance to call upon the wives of medical aid assistants. Mrs Llewellyn, who had promised undying affection, and delightful little motor trips to Cardiff, left cards when Christine was out and was not heard of again. While the wives of Doctors Medley and Oxborrow of the East Surgery – the former a faded white rabbit of a woman, the latter a stringy zealot who talked West African missions for one hour by the second-hand Regency clock – had proved singularly uninspiring. There seemed indeed to be no sense of unity or social intercourse amongst the medical assistants or their wives. They were indifferent, unresistant and even downtrodden, in the attitude they presented to the town.

  One December afternoon, when Andrew was returning to Vale View by the back road which led along the brow of the hill he saw approaching a lanky yet erect young man of his own age whom he recognised at once as Richard Vaughan. His first impulse was to cross to the other side to avoid the oncoming figure. And then, doggedly, came the thought: Why should I? I don’t care a damn who he is!

  With his eyes averted he prepared to trudge past Vaughan when, to his surprise, he heard himself addressed in a friendly, half-humorous tone.