The Citadel

by A. J. Cronin

  Seated at the desk before the heavy ledger he felt a frightful straining in his side. But his body, that outer covering of deadness, allowed nothing of that inner throbbing to escape. Before he could speak she had begun to call out the list.

  On and on he went, marking the book, a cross for a visit, a circle for consultation, marking the total of his iniquity. When it was finished she asked, in a voice whose wincing satire he only then observed:

  ‘Well! How much to-day?’

  He did not, could not, answer. She left the room. He heard her go upstairs to her room, heard the quiet sound of her closing the door. He was alone: dry, stricken, bemused. Where am I going? Where in the name of God am I going? Suddenly his eyes fell upon the tobacco sack, full of money, bulging with his cash takings for the day. Another wave of hysteria swept over him. He took up the bag and flung it into the corner of the room. It fell with a dull and senseless sound.

  He jumped up. He was stifling, he could not breathe. Leaving the consulting-room he rushed into the little back yard of the house, a small well of darkness beneath the stars. Here he leaned weakly against the brick dividing wall. He began; violently, to retch.

  Chapter Sixteen

  He tossed restlessly in bed all through the night until, at six in the morning, he at last fell asleep. Awakening late he came down after nine o’clock, pale and heavy eyed, to find that Christine had already breakfasted and gone. Normally this would not have upset him. Now, with a pang of anguish, it made him feel how far they were apart.

  When Mrs Bennett brought him his nicely cooked bacon and egg he could not eat it, the muscles of his throat refused to work. He drank a cup of coffee, then, on an impulse, he mixed himself a stiff whisky and soda, drank that too. He then prepared to face the day.

  Though the machine still held him, his movements were less automatic than before. A faint gleam, a haggard shaft of light had begun to penetrate his dazed uncertainty. He knew that he was on the verge of a great, colossal breakdown. He knew also that if he once fell into that abyss he would never crawl out of it. Cautiously holding himself in, he opened the garage and took out his car. The effort made the sweat spring out on his palms.

  His main purpose this morning was to reach the Victoria. He had made an appointment with Doctor Thoroughgood to see Mary Boland. That, at least, was an engagement he did not wish to miss. He drove slowly to the hospital. Actually he felt better in the car than when he walked – he was so used to driving it had become automatic, reflex.

  He reached the hospital, parked his car, went up to the ward. With a nod to sister he passed along to Mary’s bed, picking up her chart on the way. Then he sat down on the red blanketed edge of the bed, aware of her welcoming smile, of the big bunch of roses beside her, but all the while studying her chart. The chart was not satisfactory.

  ‘Good morning,’ she said. ‘Aren’t my flowers beautiful? Christine brought them yesterday.’

  He looked at her. No flush, but a little thinner than when she came in.

  ‘Yes, they’re nice flowers. How do you feel, Mary?’

  ‘Oh! – all right.’ Her eyes avoided his momentarily, then swept back full of warm confidence. ‘Anyway I know it won’t be for long. You’ll soon have me better.’

  The trust in her words and, above all, in her gaze, sent a great throb of pain through him. He thought, if anything goes wrong here it will be the final smash.

  At that moment Doctor Thoroughgood arrived to make his round of the ward. As he came in, he saw Andrew, and at once advanced towards him.

  ‘Morning, Manson,’ he said pleasantly. ‘Why? What’s the matter? Are you ill?’

  Andrew stood up.

  ‘I’m quite well, thank you.’

  Doctor Thoroughgood gave him an odd glance, then he turned to Mary’s bed.

  ‘I’m glad you asked to see this case with me. Let’s have the screens, sister.’

  They spent ten minutes together examining Mary, then Thoroughgood went over to the alcove by the end window, where, though in full view of the ward, they could not be overheard.

  ‘Well?’ he said.

  Out of the haze Andrew heard himself speak.

  ‘I don’t know how you feel, Doctor Thoroughgood, but it seems to me that the progress of this case isn’t quite satisfactory.’

  ‘There are one or two features,’ Thoroughgood pulled at his narrow little beard.

  ‘It seems to me that there’s some slight extension.’

  ‘Oh, I don’t think so, Manson.’

  ‘The temperature is more erratic.’

  ‘’M, perhaps.’

  ‘Excuse me for suggesting it – I appreciate our relative positions perfectly, but this case means a great deal to me. Under the circumstances would you not consider pneumothorax? You remember I was very anxious we should use it on Mary, when the case came in.’

  Thoroughgood glanced sideways at Manson. His face altered, set into stubborn lines.

  ‘No, Manson. I’m afraid I don’t see this as a case for induction. I didn’t then – and I don’t now.’

  There was a silence. Andrew could not utter another word. He knew Thoroughgood, his crotchety obstinacy. He felt spent, physically and morally, unable to pursue an argument which must be fruitless. He listened with an immobile face while Thoroughgood ran on, airing his own views about the case. When the other concluded and started to go round the remaining beds he went over to Mary, told her he would call again to see her the following day and left the ward. Before he drove away from the hospital he asked the lodge porter to ring up his house to say he would not be in for lunch.

  It was now not far off one o’clock. He was still distressed, wrapped in painful self-contemplation, and faint for want of food. Near Battersea Bridge he stopped outside a small cheap tea-room. Here he ordered coffee and some hot buttered toast. But he could only drink the coffee, his stomach revolted at the toast. He felt the waitress gazing at him curiously.

  ‘Ain’t it right?’ she said. ‘I’ll change it.’

  He shook his head, asked her for his check. As she wrote it he caught himself stupidly counting the shiny black buttons on her dress. Once, a long time ago, he had gazed at three pearly buttons in a Drineffy schoolroom. Outside, a yellow glare hung oppressively above the river. As from a distance he remembered that he had two appointments this afternoon at Welbeck Street. He drove there slowly.

  Nurse Sharp was in a bad temper, her usual humour when he asked her to come in on Saturdays. Yet she also inquired if he felt ill. Then, in a softer voice, for Doctor Hamson was a particular object of her regard, she told him that Freddie had rung him twice since lunch time.

  When she went out of the consulting-room he sat at his desk staring straight in front of him. The first of his patients arrived at half past two – a heart case, a young clerk from the Mines Department, who had come to him through Gill, who was genuinely suffering from a valvular complaint. He found that he was spending a long time over this case, taking especial pains, detaining the young man earnestly while he carefully went over the details of the treatment. At the end as the other fumbled for his thin pocket-book he said quickly:

  ‘Please don’t pay me now. Wait until I send your bill.’

  The thought that he would never send the bill, that he had lost his thirst for money and could once again despise it, comforted him strangely.

  Then the second case came in, a woman of forty-five, Miss Basden, one of the most faithful of his followers. His heart sank at the sight of her. Rich, selfish, hypochondriacal, she was a younger, a more egotistic replica of that Mrs Raeburn he had once seen with Hamson in Sherrington’s Home.

  He listened wearily, his hand on his brow, while, smiling, she launched into an account of all that had happened to her constitution since her visit to him a few days before. Suddenly he raised his head.

  ‘Why do you come to me, Miss Basden?’

  She broke off in the middle of a sentence, the pleased expression still fixed upon the upper part of her fac
e, but her mouth dropping slowly open.

  ‘Oh, I know I’m to blame,’ he said. ‘I told you to come. But there’s nothing really wrong with you.’

  ‘Doctor Manson!’ she gasped, unable to believe her ears.

  It was quite true. He realised, with cruel insight, that all her symptoms were due to money. She had never done a day’s work in her life, her body was soft, pampered, overfed. She did not sleep because she did not exercise her muscles. She did not even exercise her brain. She had nothing to do but cut coupons and think about her dividends and scold her maid and wonder what she, and her pet Pomeranian, would eat. If only she would walk out of his room and do something real. Stop all the little pills and sedatives and hypnotics and cholagogues and every other kind of rubbish. Give some of her money to the poor. Help other people and stop thinking about herself! But she would never, never do that, it was useless even to demand it of her. She was spiritually dead and, God help him, so was he!

  He said heavily:

  ‘I’m sorry I can’t be of any further service to you. Miss Basden. I – I may be going away. But I’ve no doubt you’ll find other doctors, round about here, who will be only too happy to pander to you.’

  She opened her mouth several times like a fish gasping for air. Then an expression of positive apprehension came upon her face. She was sure, quite sure, that he had gone out of his mind. She did not wait to reason with him. She rose, hastily gathering her belongings together, and hurried from the room.

  He prepared to go home, shutting the drawers of his desk with an air of finality. But before he got up Nurse Sharp bounced into the room, smiling.

  ‘Doctor Hamson to see you! He’s come round himself instead of telephoning.’

  The next minute Freddie was there, airily lighting a cigarette, flinging himself into a chair with an air of purpose in his eye. His tone had never been friendlier.

  ‘Sorry to bother you on a Saturday, old man. But I knew you were here, so I brought round the old mountain to Mahomet. Now look here, Manson. I’ve heard all about the operation yesterday and I don’t mind telling you I’m darn well glad. It’s about high time you had an inside slant on dear friend Ivory.’ Hamson’s voice took on a sudden vicious twist. ‘I think you ought to know, old chap, that I’ve been rather falling out with Ivory and Deedman lately. They haven’t been playing the game with me. We’ve been running a little pool together, and very profitable it was, but now I’m pretty well sure these two are twisting me out of some of my share. Besides which, I’m about sick of Ivory’s bloody side. He’s no surgeon. You’re damned well right. He’s nothing but a damned abortionist. You didn’t know that, eh? Well, take it from me as gospel. There’s a couple of nursing-homes not one hundred miles from this house where they do nothing else – all very pretty and above-board of course – and Ivory’s the head scraper! Deedman isn’t much better. He’s nothing but a sleek dope peddler and he isn’t so smart as Ivory. One of these days he’s going to get it in the neck from the DDA. Now you listen to me, old man, I’m speaking to you for your own good. I’d like you to throw them over and come in with me. You’ve been too damn green. You haven’t been getting your proper whack. Don’t you know that when Ivory gets a hundred guineas for an operation he hands back fifty – that’s how he gets them, you see! And what has he been handing you! – a measly fifteen or maybe twenty. It isn’t good enough, Manson! And after this bit of botching yesterday I damn well wouldn’t stand for it. Now I’ve said nothing to them yet, I’m too smart for that, but here’s my scheme, old man. Let’s ditch them altogether, you and me, and start a little partnership of our own. After all we were old pals at college, weren’t we? I like you. I’ve always liked you. And I can show you a hell of a lot.’ Freddie broke off to light another cigarette, then he smiled agreeably, expansively, exhibiting his possibilities as a potential partner. ‘You wouldn’t believe the stunts I’ve pulled. D’you know my latest. Three guineas a time injections – of sterile water! Patient came in one day for her vaccine. I’d forgotten to order the damn thing, so rather than disappoint, pumped in the H2O. She came back the next day to say she’d had a better reaction than from any of the others. So I went on. And why not? It all boils down to faith and the bottle of coloured water. Mind you I can plug the whole pharmacopoeia into them when it’s necessary. I’m not unprofessional. Lord, no! It’s just that I’m wise, and if you and I really get together, Manson – you with your degrees and me with my savvy – we’d simply skim the pool. There’s got to be two of us, you see. You want second opinions all the time. And I’ve got my eye on a smart young surgeon – hell of a lot better than Ivory! – we might snaffle him later. Eventually we might even have our own nursing-home. And then we’d be in Klondyke.’

  Andrew remained motionless and stiff. He had no anger against Hamson, only a bitter loathing of himself. Nothing could have shown him more blastingly how he stood, what he had done, where he had been going, than this suggestion of Hamson’s. At last, seeing that some answer was demanded of him, he mumbled:

  ‘I can’t go in with you, Freddie. I’ve – I’ve suddenly got sick of it. I think I’ll chuck it here for a bit. There are too many jackals in this square mile of country. There’s a lot of good men, trying to do good work, practising honestly, fairly, but the rest of them are just jackals. It’s the jackals who give all these unnecessary injections, whip out tonsils and appendices that aren’t doing any harm, play ball amongst one another with their patients, split fees, perform abortions, back up pseudo-scientific remedies, chase the guineas all the time.’

  Hamson’s face had slowly reddened.

  ‘What the hell!’ he spluttered. ‘What about yourself?’

  ‘I know, Freddie,’ Andrew said heavily. ‘I’m just as bad. I don’t want any ill-feeling between us. You used to be my best friend.’

  Hamson jumped up.

  ‘Have you gone off your rocker or what?’

  ‘Perhaps. But I’m going to try and stop thinking of money and material success. That isn’t the test of a good doctor. When a doctor earns five thousand a year he’s not healthy. And why – why should a man try to make money out of suffering humanity?’

  ‘You bloody fool,’ said Hamson distinctly. He swung round and went out of the room.

  Again Andrew sat woodenly at his desk, alone, desolate. He got up at last and drove home. As he approached his house he was conscious of the rapid beating of his heart. It was now after six o’clock. The whole trend of his weary day seemed working upwards to its climax. His hand trembled violently as he turned his latch-key in the door.

  Christine was in the front room. The sight of her pale still face sent a great shiver through him. He longed for her to ask, to show some concern as to how he had spent these hours away from her. But she merely said, in that even non-committal voice:

  ‘You’ve had a long day. Will you have some tea before the surgery?’

  He answered:

  ‘There won’t be any surgery to-night.’

  She glanced at him:

  ‘But Saturday – it’s your busiest night.’

  His answer was to write out a notice stating that the surgery was closed to-night. He walked along the passage, pinned it upon the surgery door. His heart was now thumping so violently he felt that it must burst. When he returned along the passage she was in the consulting-room her face paler still, her eyes distraught.

  ‘What is the matter?’ she asked in a strange voice.

  He looked at her. The anguish in his heart tore at him, broke through in a great rush that swept him beyond all control.

  ‘Christine!’ Everything within him went into that single word. Then he was at her feet, kneeling, weeping.

  Chapter Seventeen

  Their reconciliation was the most wonderful thing that had happened to them since they first fell in love. Next morning, which was Sunday, he lay beside her, as in those days at Aberalaw, talking, talking and, as though years had slipped from him, pouring out his heart to her. Outside the quiet
of Sunday was in the air, the sound of bells, soothing and peaceful. But he was not peaceful.

  ‘How did I come to do it?’ he groaned restlessly. ‘Was I mad, Chris, or what? I can’t believe it when I look back on it. Me – getting in with that crowd – after Denny, and Hope – God! I should be executed.’

  She soothed him. ‘It all happened with such a rush, dear. It would have swept anyone off their feet.’

  ‘No, but honestly, Chris. I feel like going off my head when I think about it. And what a hell of a time it must have been for you! Lord! it ought to be a painful execution!’

  She smiled, actually smiled. It was the most marvellous experience to see her face stripped of that frozen blankness, tender, happy, solicitous of him. Oh, God! he thought: we’re both living again.

  ‘There’s only one thing to be done,’ he brought his brows together determinedly. Despite his nervous brooding he felt strong now, freed from a haze of illusion, ready to act. ‘We’ve got to clear out of here. I’m in too deep, Chris, far too deep. I’d only be reminded at every turn of the fake stuff I’d been doing, yes and maybe get pulled back. We can easily sell the practice. And oh! Chris, I’ve got a wonderful idea.’

  ‘Yes, darling?’

  He relaxed his nervous frown to smile at her diffidently, tenderly.

  ‘How long is it since you called me that? I like it. Yes, I know, I deserved it – oh, don’t let me start thinking again, Chris! – this idea, this scheme – it hit me whenever I woke up this morning. I was worrying all over again about Hamson having asked me to join up with his rotten team idea – then suddenly it struck me, why not a genuine team? It’s the sort of thing they have amongst doctors in America – Stillman always cracks it up to me, even though he isn’t a doctor himself – but we just don’t seem to have gone in for it here much. You see, Chris, even in quite a small provincial town you could have a clinic, a little team of doctors, each doing his own stuff. Now listen, darling, instead of sticking in with Hamson and Ivory and Deedman why don’t I get Denny and Hope together and form a genuine threesome? Denny does all the surgical work – and you know how good he is! – I handle the medical side, and Hope is our bacteriologist! You see the benefit of that, we’re each specialising in our own province and pooling our knowledge. Perhaps you remember all Denny’s arguments – and mine too – about our hidebound GP system – how the general practitioner is made to stagger along, carrying everything on his shoulders, an impossibility! Group medicine is the answer to that, the perfect answer. It comes between State medicine and isolated, individual effort. The only reason we haven’t had it here is because the big men like keeping everything in their own hands. But oh! Wouldn’t it be wonderful, dear, if we could form a little front-line unit, scientifically and – yes, let me say it – spiritually intact, a kind of pioneer force to try and break down prejudice, knock out the old fetishes, maybe start a complete revolution in our whole medical system.’