“The Citadel” by A. J. Cronin, is a groundbreaking novel initially published in 1937, and well-liked for its handling of the controversial issue of medical ethics. The book was credited for setting a basis for the creation of a free National Health Service (NHS) in 1948 due to its exposure of unfair and inadequate services in the medical sector. Cronin uses moral lessons, dramatic plot and clear characters to convey his message to the reader. The book is very relevant and timely in the current society just as it was when it was written. By presenting to the reader how he started his medical career in Wales in the 20th century, and the challenges and ethical issues he faced in the course of his career, Cronin makes the reader interested in the book as the issues he addresses are similar to the daily problems doctors face in the medical sector (Cronin, 1937).
Throughout the book, Cronin addresses issues which still remain unresolved up to date in the medical sector for instance, he talks about how reimbursement patterns impact on doctors’ behaviors. He advocates for the establishment of incorporated, multispecialty group practices, as well as the need for clinical research as a way of improving public health. He also depicts the difficulty facing some doctors in balancing their personal lives with their professional responsibilities (Cronin, 1937). All these issues are not new to us.
In “The Citadel”, Cronin discusses various themes which include: inequity and injustice in the medical field, integrity, diligent patient care, hard work, and scholarly curiosity as the keys to success in medicine. He also talks about the need for doctors to update their skills through education in order to remain relevant and provide best services to patients. This is demonstrated in his statement, “Ignorance, ignorance, pure damned ignorance. There ought to be a law to make doctors keep up to date. It’s all the fault of our rotten system. There ought to be compulsory post-graduate classes to be taken every five years” (Cronin, 1937, p. 105). However, the dominating theme throughout the novel is the need to do something useful to make a difference in other people’s lives. We see Cronin work as an assistant, a doctor in a government hospital, as well as a private practitioner (Cronin, 1937, p. 299).
Cronin uses various literary devices in his book, for instance, he uses irony, where he talks about the ineffectiveness of the best-paid doctors, as well as the significant contributions of non-physicians such as Louis Pasteur (Cronin, 1937, p. 395). Cronin also uses humor in his book, perhaps to take the sting out of his story for instance when he says, “And now, gentlemen, we pass to elemi a concrete resinous exudation, the botanical source of which is undetermined, but is probably Canarium commune, chiefly imported from Manilla, employed in ointment form, one in five, an admirable stimulant and disinfectant to sores and issues” (Cronin, 1937, p. 350). In addition, symbolism has also been used in this book such as, for example, the title “The Citadel”, which symbolizes Manson’s deep-rooted medical integrity. This is evident when we see him battling with materialistic temptation to realize his integrity.
In conclusion, “The Citadel” is a very groundbreaking, informative and interesting novel that is very readable and friendly to the reader. One thing is clear from this wonderful book, it is that the world of medicine is not just a business where doctors enrich themselves materially, but an opportunity to utilize ones knowledge and experience to lessen people’s sufferings and better their lives.
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