The Citadel

This book was given to me by a good friend when I first started medical school. "For those hard times while trying to conquer your own citadel," the inscription read. Slightly melodramatic perhaps, but I had to admit that I was interested and the first paragraph draws you right in.

The main character is Andrew Manson, a young doctor just out of medical school, fresh, naive, and headstrong and eager to start practising medicine. His first post takes him to an obscure mining village in Wales where he arrives to find that he will be very much on his own. He has to use common-sense, his wits, and only a little of what he learnt in medical school to survive.

Having become established in the mining village he decides to quit his job and move elsewhere for various reasons-a trend which he establishes throughout the book in his constant search for something more, for success. On the way he falls in love, he finds good friends, he finds bad friends, and he finds success-or at least he thinks he does. For success takes the shape of a very lucrative practice in a well to do part of London, full of people who are not really sick but need something to spend their money on. Eventually, he is forced to question himself and all that he has become. Is he a good doctor or did that get lost somewhere along the way? The circumstances of his revelation are all too forceful.

When I first picked up this book I was sceptical. My friend had given me an old edition and looking at the dusty old cover, I questioned what possible relevance this book, written some 80 years ago, could have to modern medicine. Even though a lot has changed since then I think this book still has a lot to say. Medicine has always been a career-oriented profession. We all are searching for our dream jobs. We all want to find our niche. A J Cronin's message is clear. Don't get too hung up on where this niche will be. Don't consign this book to some dusty back shelf in the library. Give it a read. Or if not, just read the first sentence. You'll probably find you want to keep going.

Andreas Zafiropoulos, fourth year medical student, University of Oxford
Email: andreas.zafiropoulos@medical­school­offices.oxford.ac.uk


studentBMJ 2001;09:261-304 August ISSN 0966-6494