The Citadel

by A. J. Cronin

  ‘Hear, hear,’ boomed Challis, supporting his protégé.

  ‘That is what I was about to say, Robert,’ said Billy peevishly. To him Abbey was still a young man, a student almost, whose interruptions demanded mild reproof. ‘When we decided at our last meeting that the investigation must be pursued Doctor Manson’s name immediately suggested itself to me. He has opened up this question and must be given every opportunity to pursue it. We wish him, gentlemen,’ this being for Andrew’s benefit he twinkled at him bushily along the table, ‘ to visit all the anthracite mines in the country, and possibly later we may extend this to all the coal mines. Also we wish him to have every opportunity for clinical examination of the miners in the industry. We will afford him every facility – including the skilled bacteriological services of our young friend Doctor Hope. In short, gentlemen, there is nothing we will not do to ensure that our new Medical Officer presses this all-important matter of dust inhalation to its ultimate scientific and administrative conclusion.’

  Andrew drew one quick and furtive breath. It was splendid, splendid – better than he had ever hoped. They were going to give him a free hand, back him up with their immense authority, turn him loose on clinical research. They were angels, all of them, and Billy was Gabriel himself.

  ‘But, gentlemen,’ Billy suddenly piped, shuffling himself a new deal from his coat pockets. ‘Before Doctor Manson goes on with this problem, before we can feel ourselves at liberty to allow him to concentrate his efforts upon it, there is another and more pressing matter which I feel he ought to take up.’

  A pause. Andrew felt his heart contract and began slowly to sink as Billy continued:

  ‘Doctor Bigsby of the Board of Trade has been pointing out to me the alarming discrepancy in the specifications of industrial first-aid equipments. There is, of course, a definition under the existing Act, but it is elastic and unsatisfactory. There are no precise standards, for example, as to the size and weave of bandages, the length, material and type of splints. Now, gentlemen, this is an important matter and one which directly concerns this Board. I feel very strongly that our medical officer should conduct a thorough investigation and submit a report upon it before he begins upon the problem of inhalation.’

  Silence. Andrew glanced desperately round the table. Dodd-Canterbury, with his legs outstretched, had his eyes on the ceiling. Gadsby was drawing diagrams upon his blotter, Whinney frowning, Challis inflating his chest for speech. But it was Abbey who said:

  ‘Surely, Sir William, this is matter either for the Board of Trade or the Mines Department.’

  ‘We are at the disposal of each of these bodies,’ squeaked Billy. ‘We are – hee! hee! – the orphan child of both.’

  ‘Yes, I know. But after all, this – this bandage question is comparatively trivial and Doctor Manson …’

  ‘I assure you, Robert, it is far from trivial. There will be a question in the House presently. I had that from Lord Ungar only yesterday.’

  ‘Ah!’ Gadsby said, lifting his ears. ‘ If Ungar is keen we have no choice.’ Gadsby could toady with deceptive brusqueness, and Ungar was a man he wished particularly to please.

  Andrew felt driven to intervene.

  ‘Excuse me, Sir William,’ he stumbled. ‘I – I understood I was going to do clinical work here. For a month I have been kicking about in my office and now if I’m to …’

  He broke off, looking round at them. It was Abbey who helped him.

  ‘Doctor Manson’s point is very just. For four years he’s been working patiently at his own subject and now, having offered him every facility to expand it, we propose sending him out to count bandages.’

  ‘If Doctor Manson has been patient for four years, Robert,’ Billy squeaked, ‘he can be patient a little longer. Hee! Hee!’

  ‘True, true,’ boomed Challis. ‘ He’ll be free for silicosis eventually.’

  Whinney cleared his throat. ‘Now,’ Hope muttered to Andrew, ‘the Nag is about to neigh.’

  ‘Gentlemen,’ Whinney said. ‘For a long time I have been asking this Board to investigate the question of muscular fatigue in relation to steam heat – a subject which, as you know, interests me deeply, and which, I venture to say, you have hitherto not given the consideration it so richly merits. Now it appears to me, that if Doctor Manson is going to be diverted from the question of inhalation it would be an admirable opportunity to pursue this all-important question of muscular fatigue …’

  Gadsby looked at his watch. ‘ I have an appointment in Harley Street in exactly thirty-five minutes.’

  Whinney turned angrily to Gadsby. Co-professor Challis supported him with a gusty:

  ‘Intolerable impertinence.’

  Tumult seemed about to break.

  But Billy’s urbane yellow face peered from behind its whiskers at the meeting. He was not disturbed. He had handled such meetings for forty years. He knew they detested him and wanted him to go. But he was not going – he was never going. His vast cranium was filled with problems, data, agenda, obscure formulae, equations, with physiology and chemistry, with facts and figments of research, a vaulted incalculable sepulchre, haunted by phantoms of decerebrated cats, illumined by polarised light and all rosy hued by the great remembrance that, when he was a boy, Lister had patted him upon the head. He declared guilelessly:

  ‘I must tell you, gentlemen, I have already as good as promised Lord Ungar and Doctor Bigsby that we shall assist them in their difficulty. Six months ought to suffice, Doctor Manson. Perhaps a little longer. It will not be uninteresting. It will bring you into contact with people and things, young man. You remember Lavoisier’s remark concerning the drop of water! Hee! Hee! And now, touching Doctor Hope’s pathological examination of the specimen from Wendover Colliery in July last …’

  At four o’clock, when it was all over, Andrew threshed the matter out with Gill and Hope in Gill’s room. The effect of this Board, and perhaps of his increasing years, was to implant in him the beginnings of restraint. He neither raved nor furiously split his infinitives but contented himself merely with stabbing a neat pattern with a government pen upon a government desk.

  ‘It won’t be so bad,’ Gill consoled. ‘It means travelling all over the country, I know – but that can be rather pleasant. You might even take Mrs Manson with you. There’s Buxton now – that’s a centre for all the Derbyshire coalfields. And at the end of six months you can begin your anthracite work.’

  ‘He’ll never get the chance,’ Hope grinned. ‘He’s a bandage-counter – for life!’

  Andrew picked up his hat. ‘The trouble with you, Hope, is – you’re too young.’

  He went home to Christine. And the following Monday, since she resolutely refused to miss a gay adventure, they bought a second-hand Morris for sixty pounds and started out together upon the Great First Aid Investigation. It is to be admitted they were happy as the car sped up the highway to the North, and Andrew, having given a simian impersonation of Billy Buttons steering the car with his feet, remarked:

  ‘Anyway! Never mind what Lavoisier said to the drop of water in eighteen-thirty-two. We’re together, Chris!’

  The work was imbecile. It consisted in the inspection of the first-aid materials kept at different collieries throughout the country: splints, bandages, cotton wool, antiseptics, tourniquets and the rest. At the good collieries the equipment was good; and at poor collieries the equipment was poor. Underground inspection was no novelty to Andrew. He made hundreds of underground inspections, crawling miles along haulage ways to the coal face to view a box of bandages carefully planted there half an hour beforehand. At small pits in hardy Yorkshire he overheard under-managers whisper aside:

  ‘Run down, Geordie, and tell Alex to go to the chemist’s …’ then, ‘Have a chair, doctor, we’ll be ready for ye in a minute!’ In Nottingham he comforted temperance ambulance men by telling them cold tea was a superior stimulant to brandy. Elsewhere, he swore by whisky. But mostly he did the work with alarming conscientiousness
. He and Christine found rooms in a convenient centre. Thereafter he combed the district in the car. While he inspected, Christine sat and knitted at a distance. They had adventures, usually with landladies. They made friends, chiefly among the mining inspectors. Andrew was not surprised that his mission provoked these hard-headed, hard-fisted citizens to senseless laughter. It is to be regretted that he laughed with them.

  And then in March they returned to London, resold the car for only ten pounds less than they had paid for it, and Andrew set about writing his report. He had made up his mind to give the Board value for its money, to offer them statistics by the tubful, pages of tables, charts and divisional graphs showing how the bandage curve rose as the splint curve fell. He was determined, he told Christine, to show them how well he had done the work and how excellently they had all wasted their time.

  At the end of the month when he had rushed a rough draft through to Gill, he was surprised to receive a summons from Doctor Bigsby of the Board of Trade.

  ‘He’s delighted with your report,’ Gill fluttered, as he escorted Andrew along Whitehall. ‘I shouldn’t have let the cat out. But there it is! It’s a lucky start for you, my dear fellow. You’ve no idea how important Bigsby is. He’s got the whole factory administration in his pocket!’

  It took them some time to reach Doctor Bigsby. They had to sit with their hats in two ante-rooms before gaining admission to the final chamber. But there was Doctor Bigsby, at last, thick-set and cordial, with a dark grey suit and darker grey spats, double-breasted waistcoat and a bustling efficiency.

  ‘Sit down, gentlemen. This report of yours, Manson. I’ve seen the draft and though it’s early to speak I must say I like the look of it. Highly scientific. Excellent graphing. That’s what we want in this department. Now as we’re out to standardise equipment in factories and mines you ought to know my views. First of all I see you recommend a three inch bandage as the major bandage of the specification. Now, I prefer the two and a half inch. You’ll agree there, won’t you?’

  Andrew was irritated: it may have been the spats.

  ‘Personally, so far as the mines are concerned, I think the bigger the bandage the better. But I don’t think it makes a hell of a lot of difference!’

  ‘Eh? – what?’ Reddening behind the ears. ‘ No difference?’

  ‘Not a bit.’

  ‘But don’t you see – don’t you realise the whole principle of standardisation is involved. If we suggest two and a half inch and you recommend three inch there may be enormous difficulty.’

  ‘Then I’ll recommend three inch,’ Andrew said coolly.

  Doctor Bigsby’s hackles rose, it was possible to see them rising.

  ‘Your attitude is difficult to understand. We’ve been working for years towards the two and a half inch bandage. Why – Don’t you know how much this matters …’

  ‘Yes, I know!’ Andrew equally lost his temper. ‘Have you ever been underground? I have. I’ve done a bloody operation, lying on my guts in a puddle of water, with one safety lamp and no head room. And I tell you straight any finicky half-inch difference in your bandage doesn’t matter a tinker’s curse.’

  He passed out of the building more swiftly than he had entered, followed by Gill who wrung his hands, and lamented all the way to the Embankment.

  When he got back Andrew stood in his room, sternly regarding the traffic on the river, and bustling streets, the buses running, trams clanging over bridges, the movement of human people, all the pulsing, vivid flow of life. ‘I don’t belong to this outfit in here,’ he thought with a surge of impatience. ‘I should be out there – out there!’

  Abbey had given up attending the Board meetings. And Challis had disheartened him, even to the point of panic, by taking him to lunch the week before and warning him that Whinney was lobbying hard, would try to put him on to his muscular fatigue investigation before the silicosis question was touched. Andrew reflected, with a despairing pretence at humour: ‘If that happens, on top of the bandages, I might as well take a reader’s ticket for the British Museum.’

  Walking home from the Embankment he found himself peering enviously at the brass plates bolted on area railings outside the houses of doctors. He would stop, watch a patient mount to the door, ring the bell, be admitted – then, walking moodily on, he would visualise the ensuing scene, the interrogations, the swift production of stethoscope, the whole thrilling science of diagnosis. He was a doctor, too, wasn’t he? At least, once upon a time …

  Towards the end of May, in this frame of mind, he was walking up Oakley Street about five in the evening when he suddenly saw a crowd of people gathered round a man lying on the pavement. In the gutter alongside was a shattered bicycle and, almost on top of it, a drunkenly arrested motor lorry.

  Five seconds later Andrew was in the middle of the crowd, observing the injured man who, attended by a kneeling policeman, was bleeding from a deep wound in the groin.

  ‘Here! Let me through. I’m a doctor.’

  The policeman, striving unsuccessfully to fix a tourniquet, turned a flustered face.

  ‘I can’t stop the bleeding, doctor. It’s too high up.’

  Andrew saw that it was impossible to tourniquet. The wound was too high up in the iliac vessel and the man was bleeding to death.

  ‘Get up,’ he said to the policeman. ‘ Put him flat on his back.’ Then making his right arm rigid, he leant over and thrust his fist hard into the man’s belly over the descending aorta. The whole weight of his body, thus transmitted to the great vessel, immediately arrested the haemorrhage. The policeman removed his helmet and wiped his forehead. Five minutes later the ambulance arrived. Andrew went with it.

  Next morning Andrew rang up the hospital. The house surgeon answered brusquely after the fashion of his kind:

  ‘Yes, yes, he’s comfortable. Doing well. Who wants to know?’

  ‘Oh,’ mumbled Andrew from the public phone box. ‘Nobody.’

  And that, he thought bitterly, was exactly what he was: nobody, doing nothing, getting nowhere. He endured it till the end of the week then quietly, without fuss, he handed in his resignation to Gill for transmission to the Board.

  Gill was upset, yet admitted that a premonition of this sad event had troubled him. He made a neat little speech which concluded:

  ‘After all, my dear fellow, I have realised that your place is – well, if I may borrow a wartime comparison – not at the base but – er in the front line with the – er – troops.’

  Hope said:

  ‘Don’t listen to the rose-cultivating penguin fancier! You’re lucky. And I’ll be after you if I keep my reason – as soon as my three years are up!’

  Andrew heard nothing about the Board’s activities on the question of dust inhalation until months later when Lord Ungar raised the question dramatically in the House, quoting freely from medical evidence afforded him by Doctor Maurice Gadsby.

  Gadsby was acclaimed by the Press as a Humanitarian and a Great Physician. And Silicosis was, in that year, scheduled as an industrial disease.

  Part Four

  Chapter One

  They began their search for a practice. It was a jagged business – wild peaks of expectation followed by wilder plunges of despair. Stung by a consciousness of three successive failures – at least so he construed his departures from Drineffy, Aberalaw and the MFB – Andrew longed to vindicate himself at last. But their total capital, increased by stringent saving during the last months of salaried security, was no more than six hundred pounds. Though they haunted the medical agencies and reached for every opportunity offered in the columns of the Lancet it appeared that this sum was scarcely adequate as purchase money for a London practice.

  They never forgot their first interview. Doctor Brent, of Cadogan Gardens, was retiring, and he offered a nice nucleus suitable for a well-qualified gentleman. It seemed, on the face of it, an admirable chance. An extravagant taxi, for fear that someone speedier might snatch the plum, rushed them to Doctor Brent who
m they found to be a white haired, pleasant, almost demure little man.

  ‘Yes,’ Doctor Brent said modestly. ‘It’s a pretty good pitch. Nice house too. I want only seven thousand pounds for the lease. There’s forty years to run and the ground rent’s only three hundred a year. As to the practice – I thought the usual – two years’ premium for cash, eh, Doctor Manson?’

  ‘Quite!’ Andrew nodded gravely. ‘You’d give a long introduction, too? Thank you, Doctor Brent. We’ll consider it.’

  They considered it over threepenny cups of tea in the Brompton Road Lyons.

  ‘Seven thousand – for the lease!’ Andrew gave a short laugh. He thrust his hat back from his corrugated brow, stuck his elbows on the marble table. ‘ It’s pretty damnable, Chris! The way these old fellows hang on with their back teeth. And you can’t prise them loose unless you’ve got money. Isn’t that an indictment of our system! But rotten as it is, I’ll accept it. You wait! I’m going to attend to this money question from now on.’

  ‘I hope not,’ she smiled. ‘ We’ve been moderately happy without it.’

  He grunted. ‘ You won’t say that when we start to sing in the street. Check, miss, please.’

  Because of his MD, MRCP, he wanted a non-panel, non-dispensing practice. He wanted to be free of the tyranny of the card system. But as the weeks went on he wanted anything, anything that offered him a chance. He inspected practices in Tulse Hill, Islington and Brixton and one – the surgery had a hole in the roof – in Camden Town. He got the length of debating with Hope – who assured him that on his capital it was suicide – the plan of taking a house and setting out his plate on chance.

  And then, after two months, when they had reached the point of desperation, all at once Heaven relented and allowed old Doctor Foy to die, painlessly, in Paddington. Doctor Foy’s obituary notice, four lines in the Medical Journal, caught Andrew’s eye. They went, their enthusiasm all spent, to No 9 Chesborough Terrace. They saw the house, a tall, leaden hued sepulchre with a surgery at the side and a brick garage behind. They saw the books which indicated that Doctor Foy had made perhaps £500 a year, mainly from consultations, with medicine, at the rate of 3s 6d. They saw the widow, who assured them timidly that Doctor Foy’s practice was sound and had once been excellent with many ‘good patients’ coming to the ‘front door’. They thanked her and left without enthusiasm.