The Cidadel

Andrew Manson takes up his first post as a newly qualified doctor – in a Welsh mining town. The tight-knit communities of the Welsh valleys present Manson with plenty of daily challenges, not only with regard to the poor sanitation and the spread of disease, but in opposition to those who suspect his honesty and outspokenness. His refusal to take the line of least resistance lands him in trouble with some of the established members of society, but he does make a good friend in Philip Denny, and meets his future wife in Christine Barlow, the local, equally idealistic school teacher. Manson is offered a better position in a larger town, but once again when his integrity does not allow for unscrupulous dispensing and money-making schemes, Andrew and Christine are forced yet again to move on. Andrew’s research into lung diseases takes the Manson’s to London, but Andrew misses front-line diagnosis and he soon takes the plunge in buying a run-down surgery.
Frustrated at not earning enough money to live on, Manson’s principles begin to fray at the edges, and when lucrative ways of making easy money from wealthy patients and private clinics begin to take-over from his everyday surgeries and pioneering work, his standards begin to slip. Christine is unhappy with the change in her husband, dislikes the city, and cares nothing for fur coats and fancy furniture. When matters come to a crisis point and Manson is in danger of losing everything, he’s forced to examine everything he holds dear.

Astonishing to discover that this novel written in 1937 and set in 1924 inspired the creation of the NHS. There are many enlightening passages and ideas which clearly illustrate the need of trustworthy medical care for all, regardless of social standing and the ability to pay.
Manson is deliberately challenging, and I enjoyed the journey of his development through the stages of his career. As a work of fiction it didn’t have the huge impact of The Stars Look Down, but this is a straightforward novel written in a biographical style and because the author was a medical professional, full of interesting facts and plenty to say. 

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