"The Citadel" by A. J. Cronin

The Citadel is the book that launched Cronin's career as a best-selling novelist. It is regarded as having been influential in the setting up of the NHS.

It is a very simply told tale of a young idealistic doctor in the 1920 to 1930s who works in a Welsh mining village before becoming a GP in London and being sucked in by the Harley Street crowd. It is fascinating as a document in social history, showing the conditions and abuses of the medical profession of that time. It has a lot of detail about individual diseases, many of which have now been wiped out by better working  conditions, less poverty, better sanitation and antibiotics. The drugs and medicines proscribed by the doctors (which they make up themselves) are often useless and blatant attempts to make money from a gullible (and ill) public.

The start of the book is constructed in little episodes. Just after young Dr Andrew Manson has arrived as a completely wet-behind-the-ears newly-qualified medical assistant, assisting the practice owner who has had a stroke, he teams up with another young idealistic assistant to blow up some sewers which are leaking into the water supply. He assists at a difficult birth. He goes underground after a fall at the mine to amputate an arm so that a young miner can be taken out. It is a classic television series format: individual episodes linked by character and a slow background development of his relationship. He gets married and moves to another town. He gets further qualifications and moves to London. There, in business for himself, he starts to exploit a few lucky breaks and becomes a society doctor. His marriage starts to fall apart.

I preferred the start when the adventures were more isolated to the longer sweep of the later parts. But the book is sparsely written and it is difficult to say why it had such appeal. The life and death situations inherent to medical practice make it exciting and Cronin is not afraid of some finely judged sentimentality (nothing too slushy) which often brought a lump to my throat. But this isn't great literature: it is a well told narrative.

Other Cronin books I have read are:

• The Keys of the Kingdom: a perfect gem of a book about a Catholic missionary to China. Read it!
• Adventures of a Black Bag: short stories which launched Doctor Finlay's Casebook. Of historical interest.
• Hatter's Castle: about the fall of a prideful bully

March 2016; 294 pages