Free Download Here - pdfsdocuments2.comArchibald Cronin The Citadel.pdf Free Download Here. To AJ Cronin, whose works strengthened my decision to become a doctor Life and work of Archibald Joseph Cronin.A J Cronin's Citadel - The LancetA J Cronin's Citadel. A J Cronin's novel The Citadel attracted heated criticism from other doctors. 'Cronin's distinguished achievement.No one could have written as fine, honest, and moving a study of a young doctor as The Citadel without possessing great literary taste and skill.' -The Atlantic Monthly A groundbreaking novel of its time and a National Book Award winner.

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The BJGP Library is a new regular column in the Out of Hours section where contributors write a 600-word article relating to a single book, usually a novel, that is important to them. It could be a recently read book, still fresh in the mind; or it could be one etched into your memory from many years past. It doesn’t have to be a medical book and it doesn’t have to be a recognised ‘classic’ of literature — although many contributors may well choose books that fall into one or both of those camps. The aim is to give free rein to inform, educate, and inspire our readers in the best traditions of the BJGP. Over time we will build up a library of essential books for the discerning reader and, en route, offer an illuminating insight to the contributors and their own motivations. When I went to work in general practice in South Wales in the early 1980s, I kept in touch with Stuart Douglas, Regius Professor of Medicine at the University of Aberdeen, where I had graduated.

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As a houseman at Glasgow Royal Infirmary in the 1930s, he had injected the first dose of penicillin given to a patient in the west of Scotland. My letters reminded him of The Citadel, AJ Cronin’s partly-autobiographical novel about a young Scottish doctor, Dr Andrew Manson, who started, as Cronin did, in general practice in South Wales, before getting his medical degree by research, becoming an Inspector of Mines, and setting up in private practice in Harley Street, London. Professor Douglas recalled how sensational the novel was at the time, scandalising the medical profession and alarming the public, with a narrative showing that, while the interests of patients and doctors usually overlapped, they did not always coincide. Cronin worked as a doctor for 11 years, before a 6-month period of convalescence from duodenal ulcer (now curable with a short course of antibiotics) allowed him to write his first novel. He never practised medicine again, but mined his clinical experience to literary effect, becoming best known to television audiences for Dr Finlay’s Casebook, a series produced in black and white in the 1960s by the BBC, and re-made in colour in the 1990s by STV.

I had read The Citadel as a medical student, and now encountered the truthfulness of Cronin’s account of general practice in South Wales in the 1920s. From Julian Tudor Hart in Glyncorrwg, I learned that Cronin’s tale of a GP dynamiting a leaking sewer, which was infecting the local water supply and causing endemic typhoid, so that the town council finally had to deal with it, was based on a true event at Aberdare in the Cynon Valley. Manson’s first big clinical success was to revive an apparent still birth, transferring the child rapidly between baths of hot and cold water.

Although Cronin based this on a real case of his own, I could never find out, from my mystified paediatric teachers at the medical school in Aberdeen, the basis of this unorthodox approach. Cronin worked in Tredegar, Aneurin Bevan’s home village, and had first-hand experience of the ‘mini-NHS’, organised around miners and their families, which provided the example and template for the universal coverage that Bevan later introduced. A theme of the book is the essentially limited nature of individual clinical practice, especially when doctors compete for patients, and the potential strength of doctors working together within an organised system.

The sensation of the novel, however, came from its description of the medical profession at that time, as Manson with MD and MRCP, moves to Harley Street and private practice, socialises with the rich and famous, loses his moral compass, commits adultery, and becomes rich, selling bogus treatments to the worried well. After he assists at a botched operation and accuses the surgeon of murder, the profession closes ranks, charging Manson with unprofessional conduct, as a result of his having referred a tuberculous patient to a medically-unqualified pioneer of induced pneumothorax. The patient recovered. Manson’s speech to the GMC, supporting scientific advance from whatever source (including the medically-unqualified Louis Pasteur), and attacking closed professionalism, is the climax of the novel. King Vidor’s classic black and white film, starring Robert Donat as Manson, stays true to most of the actions and dialogue in the book, especially in South Wales. His wife Christine (played by Rosalind Russell) and best friend Dr Philip Denny (the young Ralph Richardson) hold firm to Manson’s starting values and are horrified by his professional rise and moral descent.

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Only one survives to see his redemption; Cronin chose to kill off one of them, while King Vidor killed off the other. It is said that the novel’s effect on public opinion, when it was published in 1937, paved the way for Bevan’s NHS.

It remains a riveting read, a work of fiction, but nevertheless, a potent reminder of what the NHS replaced. And for one of my colleagues, with no family background in the profession, it was why she entered medicine.

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I enjoyed the articles about the distinguished author AJ Cronin in the September issue. – However, in these days of concerns about how we treat whistle-blowers, an important and telling piece of information was omitted by both authors. By writing about the ‘humbug’ of private medicine in the 1930s, Dr Cronin became persona non grata to a significant swathe of the medical establishment. When he died in 1981, 44 years after the publication of The Citadel, his obituary in the Lancet consisted of one line.