The Citadel

by A. J. Cronin

  The two assistants at the East Surgery were equally unencouraging. Doctor Medley, the elder of the two, a man of nearly fifty, with a clever sensitive face, was unhappily almost stone deaf. But for this affliction, which for some reason the vulgar always found amusing, Charles Medley would have been a very long way from an assistantship in the mining valleys. He was, like Andrew, essentially a physician. As a diagnostician he was remarkable. But when his patients spoke to him he could not hear a word. Of course, he was a practised lip-reader. Yet he was timid, for he often made laughable mistakes. It was quite painful to see his harassed eye fastened, in a kind of desperate inquiry, upon the moving lips of the person speaking to him. Because he was so fearful of making a grave error he never prescribed anything but the smallest dose of any drug. He was not well off, for he had met with trouble and expense over his grown-up family, and like his faded wife he had become an ineffectual, strangely pathetic being who went in dread of Doctor Llewellyn and the Committee lest he should be suddenly dismissed.

  The other assistant, Doctor Oxborrow, was a very different character from poor Medley and Andrew did not like him nearly so well. Oxborrow was a large pasty man with pudgy fingers and a jerky heartiness. Andrew often felt that with more blood in him Oxborrow would have made an admirable bookmaker. As it was Oxborrow, accompanied by his wife, who played the portable harmonium, betook himself on Saturday afternoons to the nearby town of Femely – etiquette precluding his appearing in Aberalaw – and there, in the Market, he would set up his little carpet-covered stand and hold an open-air religious meeting. Oxborrow was an evangelist. As an idealist, a believer in a supreme quickening force in life, Andrew could have admired this fervour. But Oxborrow, alas! was embarrassingly emotional. He wept unexpectedly and prayed even more disconcertingly. Once when confronted by a difficult confinement which defeated his own straining skill, he plumped suddenly upon his knees beside the bed and, blubbering, implored God to work a miracle upon the poor woman. Urquhart, who detested Oxborrow, told Andrew of this incident, for it was Urquhart who, arriving, had got upon the bed in his boots, and successfully delivered the patient with high forceps.

  The more Andrew considered his fellow assistants and the system under which they worked the more he desired to bring them together. As it was, they had no unity, no sense of co-operation, and little friendliness, amongst themselves. They were simply set up, one against the other, in the ordinary competitive way existing in general practice all over the country, each trying to secure as many patients for himself as he could. Downright suspicion and bad feeling were often the result. Andrew had known Urquhart, for instance, when a patient of Oxborrow’s transferred his card to him, take the half finished bottle of medicine from the man’s hand in the surgery, uncork it, smell it with contempt, and explode:

  ‘So this is what Oxborrow’s been givin’ ye! Damn it to hell! He’s been slowly poisonin’ ye!’

  Meanwhile, in the face of this diversity, Doctor Llewellyn was quietly taking his cut from each assistant’s pay cheque. Andrew burned under it, longed to create a different arrangement, to institute a new and better understanding which would enable the assistants to stand together – without subsidising Llewellyn. But his own difficulties, the sense of his own newness to the place, and above all the mistakes he had made at the start in his own district, caused him to be cautious. It was not until he met Con Boland that he decided to make the great attempt.

  Chapter Nine

  One day early in April Andrew discovered a cavity in a back tooth and went, in consequence, upon an afternoon of the following week, in search of the Society’s dentist. He had not yet met Boland and did not know his hours of consultation. When he reached the Square, where Boland’s little surgery stood, he found the door closed and pinned upon it, this red-inked notice: Gone to Extraction. If Urgent apply at House.

  On a moment’s reflection Andrew decided that since he was here, he might at least call to make an appointment so, having inquired the way from one of the group of youths lounging outside the Valley Ice Cream Saloon, he set out for the dentist’s house.

  This was a small semi-detached villa on the upper outskirts of the East side of the town. As Andrew walked up the untidy path to the front door he heard a loud hammering and glancing through the wide-open doors of a dilapidated wooden shed situated at the side of the house he saw a red-haired rangy man in his shirt-sleeves, violently attacking the dismembered body of a car with a hammer. At the same time the man caught sight of him.

  ‘Hello!’ he said.

  ‘Hello!’ Andrew answered a trifle warily.

  ‘What are ye after?’

  ‘I want to make an appointment with the dentist. I’m Doctor Manson.’

  ‘Come in,’ said the man, hospitably waving the hammer. He was Boland.

  Andrew entered the wooden shed which was littered with portions of an incredibly old motor-car. In the middle stood the chassis, supported on wooden egg-boxes, and actually presenting the evidence of having been sawn in half. Andrew glanced from this extraordinary spectacle of engineering to Boland.

  ‘Is this the extraction?’

  ‘It is,’ Con agreed. ‘When I’m inclined to be slack in the surgery I just up to my garage and put a little bit in on my car.’

  Apart from his brogue, which was thick enough to be cut with a knife, he used the words garage, meaning the falling down shed, and car, as applied to the fallen down vehicle, with an accent of unmistakable pride.

  ‘You wouldn’t believe what I’m doing now,’ he went on, ‘ that’s to say unless you’re mechanical-minded like myself. I’ve had her five year this little car of mine and, mind ye, she was three year old when I got her. Ye mightn’t believe it seeing her sthripped but she goes like a hare. But she’s small, Manson, she’s small by the size of my family now. So I’m in the process of extendin’ her. I’ve cut her, ye see, right across her middle, and that’s where I’ll slip in a good two feet of insertion. Wait till ye see her finished, Manson!’ He reached for his jacket. ‘ She’ll be long enough to take a regiment. Come away now, to the surgery, and I’ll fix your tooth.’

  At the surgery which was almost as untidy as the garage and, it must be confessed, equally dirty, Con filled the tooth, talking all the time. Con talked so much and so violently that his bushy red moustache was always dewed with beads of moisture. His shock of chestnut hair, which badly needed cutting, kept getting into Andrew’s eyes, as he bent over, using the amalgam filling which he had tucked under his oily finger-nail. He had not bothered to wash his hands – that was a trifle with Con! He was a careless, impetuous, good-natured, generous fellow. The more Andrew knew Con the more he was utterly captivated by his humour, simplicity, wildness and improvidence. Con, who had been six years in Aberalaw, had not a penny to his name. Yet he extracted a vast amount of fun from life. He was mad on ‘mechanics’, was always making gadgets and he idolised his motor-car. The fact that Con should possess a motor-car was in itself a joke. But Con loved jokes, even when they were against himself. He told Andrew of the occasion when, called to extract the decayed molar of an important Committee-man he had gone to the patient’s house with, as he imagined, his forceps in his pocket only to find himself reaching for the tooth with a six-inch spanner.

  The filling complete, Con threw his instruments into a jelly jar containing lysol, which was his light-hearted notion of asepsis, and demanded that Andrew should return to the house with him to tea.

  ‘Come on, now,’ he insisted hospitably. ‘ You’ve got to meet the family. And we’re just in time. It’s five o’clock.’

  Con’s family were, in fact, in the process of having tea when they arrived but were obviously too accustomed to Con’s eccentricities to be disturbed by his bringing in a stranger. In the warm, disordered room Mrs Boland sat at the head of the table with the baby at her breast. Next came Mary, fifteen, quiet, shy – ‘the only dark-haired one and her dad’s favourite,’ was Con’s introduction – who was already earning a decent wag
e as a clerk to Joe Larkins, the bookmaker, in the Square. Beside Mary was Terence, twelve, then three other younger children sprawling about, crying out to be taken notice of by their father.

  There existed about this family, except perhaps for the shyly conscious Mary, a careless gaiety which entranced Andrew. The room itself spoke with a gorgeous brogue. Above the fireplace beneath the coloured picture of Pope Pius X, which bore a strip of Easter palm, the baby’s napkins were drying. The canary’s cage, uncleaned but bursting with song, stood on the dresser beside Mrs Boland’s rolled-up stays – she had previously removed them in the cause of comfort – and a split bag of puppy biscuits. Six bottles of stout, newly in from the grocer, were upon the chest of drawers, also Terence’s flute. And in the corner were broken toys, odd boots, one rusty skate, a Japanese parasol, two slightly battered prayer books and a copy of Photo-bits.

  But, as he drank his tea, Andrew was most fascinated by Mrs Boland – he simply could not keep his eyes from her. Pale, dreamy, unperturbed, she sat silently imbibing endless cups of black boiled tea while the children squabbled about her and the baby openly drew his nourishment from her generous fount. She smiled and nodded, cut bread for the children, poured out the tea, drank and gave suck, all with a kind of abstracted placidity, as though years of din, dirt, drabness – and Con’s ebullience – had in the end exalted her to a plane of heavenly lunacy where she was isolated and immune.

  He almost upset his cup when she addressed him, gazing over the top of his head, her voice meek, apologetic.

  ‘I meant to call on Mrs Manson, doctor. But I was so busy –’

  ‘In the name of God!’ Con rolled with laughter. ‘Busy, indeed! She hadn’t a new dress – that’s what she means. I had the money laid by – but damn it all, Terence or one of them had to have new boots. Never mind, mother, wait till I get the car lengthened and we’ll whirl ye up in style.’ He turned to Andrew with perfect naturalness. ‘ We’re hard up, Manson. It’s the devil! We’ve plenty of grub, thank God, but sometimes we’re not so fancy with the duds. They’re a stingy lot on the Committee. And, of course, the big chief gets his whack!’

  ‘Who?’ Andrew asked, astonished.

  ‘Llewellyn! He takes his fifth from me as well as you!’

  ‘But what on earth for?’

  ‘Oh! he sees a case or two for me occasionally. He’s taken a couple of dentigerous cysts out for me in the last six years. And he’s the X-ray expert when that’s needed. But it’s a bugger.’ The family had bundled out to play in the kitchen so Con could speak freely. ‘Him and his big saloon. The damn thing’s all paint. Let me inform ye, Manson, once I was comin’ up Mardy Hill behind him in my own little bus when I make up my mind to step on the gas, Bejasus! Ye should have seen his face when I give him my dust.’

  ‘Look here, Boland,’ Andrew said quickly. ‘This business of Llewellyn’s cut is a shocking imposition. Why don’t we fight it?’

  ‘Eh?’

  ‘Why don’t we fight it?’ Andrew repeated in a louder voice. Even as he spoke he felt his blood rise. ‘It’s a damned injustice. Here we are hard up, trying to make our way – Listen, Boland, you’re the very man I’ve been wanting to meet. Will you stand in with me on this? We’ll get hold of the other assistants. Make a big united effort –’

  A slow gleam irradiated Con’s eyes.

  ‘Ye mean, ye want to go after Llewellyn?’

  ‘I do.’

  Con impressively extended his hand.

  ‘Manson, my boy,’ he declared momentously. ‘We’re together from the start.’

  Andrew raced home to Christine full of eagerness, thirsting for the fight.

  ‘Chris! Chris! I’ve found a gem of a chap. A red-haired dentist – quite mad – yes, like me. I knew you’d say that. But listen, darling, we’re going to start a revolution.’ He laughed excitedly. ‘Oh, Lord! If old man Llewellyn only knew what was in store for him!’

  He did not require her caution to go carefully. He was determined to proceed with discernment in everything he did. He began therefore, the following day, by calling upon Owen.

  The secretary was interested and emphatic. He told Andrew that the agreement in question was a voluntary one between the head doctor and his assistants. The whole thing lay outside the jurisdiction of the Committee.

  ‘You see, Doctor Manson,’ Owen concluded, ‘Doctor Llewellyn is a very clever, well-qualified man. We count ourselves fortunate to have him. But he has a handsome remuneration from the Society for acting as our Medical Superintendent. It is you assistant doctors who think he ought to have more –’

  ‘Do we hell,’ thought Andrew. He went away satisfied, rang up Oxborrow and Medley, made them agree to come to his house that evening. Urquhart and Boland had already promised to be there. He knew, from past conversations, that every one of the four loathed losing a fifth of his salary. Once he had them together the thing was done.

  His next step was to speak to Llewellyn. He had decided on reflection that it would be underhand not to make some disclosure of his intention beforehand. That afternoon he was at the hospital giving an anaesthetic. As he watched Llewellyn go through with the operation, a long and complicated abdominal case, he could not repress a feeling of admiration. Owen’s remark was absolutely true: Llewellyn was amazingly clever, not only clever but versatile. He was the exception, the unique instance, which – Denny would have contended – proved the rule. Nothing came amiss to him, nothing floored him. From public health administration, every bye-law of which he knew by heart, to the latest radiological technique, the whole range of his multifarious duties found Llewellyn blandly expert and prepared.

  After the operation, while Llewellyn was washing up Andrew went to him, jerkily tugging off his gown.

  ‘Excuse me for mentioning it, Doctor Llewellyn – but I couldn’t help noticing the way you handled that tumour, it was awfully fine.’

  Llewellyn’s dull skin tinged with gratification. He beamed affably.

  ‘Glad you think so, Manson. Come to speak of it, you’re improvin’ nicely with your anaesthetics.’

  ‘No, no,’ Andrew muttered. ‘I’ll never be much good at that.’

  There was a pause. Llewellyn went on soaping his hands equably. Andrew, at his elbow, cleared his throat nervously. Now that the moment had come he found it almost impossible to speak. But he managed to blurt out:

  ‘Look here, Doctor Llewellyn. It’s only right to tell you – all we assistants think our salary percentage payments to you unfair. It’s an awkward thing to have to say, but I – I’m going to propose they are done away with. We’ve got a meeting at my house tonight. I’d rather you knew that now, than afterwards. I – I want you to feel I’m at least honest about it.’

  Before Llewellyn could reply, and without looking at his face, Andrew swung round and left the theatre. How badly he had said it. Yet anyway, he had said it. When they sent him their ultimatum, Llewellyn could not accuse him of stabbing him in the back.

  The meeting at Vale View was fixed for nine o’clock that evening. Andrew put out some bottled beer and asked Christine to prepare sandwiches. When she had done this, she slipped on her coat and went round to Vaughans’ for an hour. Strung with anticipation, Andrew stumped up and down the hall, striving to collect his ideas. And presently the others arrived – Boland first, Urquhart next, Oxborrow and Medley together.

  In the sitting-room, pouring beer and proffering sandwiches, Andrew tried to initiate a cordial note. Since he almost disliked him he addressed Doctor Oxborrow first.

  ‘Help yourself, Oxborrow! Plenty more in the cellar.’

  ‘Thanks, Manson.’ The evangelist’s voice was chill. ‘ I don’t touch alcohol in any shape or form. It’s against my principles.’

  ‘In the name of God!’ Con said, out of the froth on his moustache.

  As a beginning it was not auspicious. Medley, munching sandwiches, kept his eyes all the time on the alert, his face wearing the stony anxiety of the deaf. Already the beer was
increasing Urquhart’s natural belligerence; after glaring steadily at Oxborrow for some minutes he suddenly shot out:

  ‘Now I find myself in your company, Doctor Oxborrow, maybe you’ll find it convenient to explain how Tudor Evans, Seventeen Glyn Terrace, came off my list on to yours.’

  ‘I don’t remember the case,’ said Oxborrow, pressing his finger-tips together aloofly.

  ‘But I do!’ Urquhart exploded. ‘It was one of the cases you stole from me, your medical reverence! And what’s more –’

  ‘Gentlemen!’ cried Andrew in a panic. ‘ Please, please! How can we ever do anything if we quarrel amongst ourselves? Remember what we’re here for.’

  ‘What are we here for?’ Oxborrow said womanishly. ‘ I ought to be at a case.’

  Andrew, standing on the hearth-rug, his expression taut and earnest, took a grab at the slippery situation.

  ‘This is the way of it, then, gentlemen!’ He drew a deep breath. ‘I’m the youngest man here and I’m not long in this practice but I – I hope you’ll excuse all that! Perhaps it’s because I am new that I get a fresh look at things – things you’ve been putting up with too long. It seems to me in the first place that our system here is all wrong. We just go hacking and muddling through in the antediluvian way like we were ordinary town and country GP’s fighting each other, not members of the same Medical Society with wonderful opportunities for working together! Every doctor I’ve met swears that practice is a dog’s life. He’ll tell you he drudges on, run off his feet, never a minute to himself, no time for meals, always on call! Why is that? It’s because there’s no attempt at organisation in our profession. Take just one example of what I mean – though I could give you dozens. Night-calls! You know how we all go to bed at night, dreading we’ll be wakened up and called out. We have rotten nights because we may be called out. Suppose we knew we couldn’t be called out. Suppose we arranged, for a start, a co-operative system of night work. One doctor taking all night-calls for one week and then going free of all night-calls for the rest of that month, while the others take their turn. Wouldn’t that be splendid! Think how fresh you’d be for your day’s work –’