The Citadel (by AJ Cronin)

(Amazon UK link)

I’m pretty sure I had heard of AJ Cronin, and his novel ‘The Citadel’, but it’s not one I had ever read. Nor would I have been likely to, until it was chosen for our local book group. We like to read books from a variety of cultures and historical periods, including some classics. I was able to order it inexpensively from a second-hand bookshop, and embarked on it with some trepidation, expecting that it might be rather dull.

I was, therefore, pleasantly surprised to find a very readable, interesting novel. While based on the author’s experience as a doctor in the UK in the 1920s, the characters and situations are fictional. But I found them entirely believable, quite shocking at times; this starts just a hundred years ago, well after the end of World War I. 

Andrew Manson is the hero of the book, and it’s told from his perspective. Newly qualified and full of idealism, he arrives at a small mining village in Wales where he is about to take up his first job. He is supposedly the assistant of an older doctor, but quickly discovers that Dr Page is a bed-bound invalid, unlikely to recover and unable to work. The house is run by his dour sister, who doles out meagre portions of food and appears to have no sense of humour.

Andrew gradually settles in, learning not just about the local illnesses and customs, but how to appease, pacify and earn the trust of people around him. They are suspicious of a stranger, particularly one with new ideas and suggestions. Andrew, in his turn, is shocked to realise that the doctors around him are still living in the past century as far as medical practice is concerned, so overworked that they have no chance to update their skills or read medical journals. 

It’s an interesting read, almost in the style of the various ‘vet’ and similar books that were popular several decades later. We follow Andrew on his rounds, see him gradually settling in, and root for him to make some friends and succeed in some cures. He falls in love, takes up other posts, observes medical malpractice, suffers bereavements, takes risks… it’s quite compelling reading at times. 

I didn’t like some of the events which happened, particularly towards the end; nor did I believe it was possible to recover so quickly from something shocking that I really didn’t see coming, shortly before the climax of the book. And while the characters were three-dimensional and realistic, I didn’t feel any empathy with any of them - there doesn’t seem to be much depth of characterisation. Andrew himself is rather naive and a bit annoying at times, particularly in his treatment of some of those closest to him. He is tempted by money and fame in a way that seems incompatible with his earlier idealism. 

Apparently this novel was very well received, and it’s likely that its contents helped in the establishment of the excellent National Health Service. So it has a very positive outcome. As a piece of social history it’s also revealing and useful, a stark reminder that whatever the current state and problems of the NHS in the UK, it’s still vastly superior to the old systems. 

Recommended. I understand that a TV series was made, based on this book (my edition shows a photo from it) and it's in print regularly as well as widely available second-hand. Make sure you buy the full edition rather than one that was edited for school use. 

Review copyright 2024 Sue's Book Reviews