Page 3 of The Citadel


  ‘You were right. It was enteric. I ought to be shot for not recognising it. I’ve got five cases. I’m not exactly overjoyed at having to come here. But I don’t know the ropes. I rang the MO and couldn’t get a word out of him. I’ve come to ask your advice.’

  Denny, half slewed round in his chair by the fire, listening, pipe in mouth, at last made a grudging gesture. ‘ You’d better come in.’ With sudden irritation, ‘Oh! and for God’s sake take a chair. Don’t stand there like a Presbyterian parson about to forbid the banns. Have a drink? No! I thought you wouldn’t.’

  Though Andrew stiffly complied with the request, seating himself and even, defensively, lighting a cigarette, Denny seemed in no hurry. He sat prodding the dog Hawkins with the toe of his burst slipper. But at length, when Manson had finished his cigarette, he said with a jerk of his head:

  ‘Take a look at that, if you like!’

  On the table indicated a microscope stood, a fine Zeiss, and some slides. Andrew focused a slide then slid round the oil immersion and immediately picked up the rod-shaped clusters of the bacteria.

  ‘It’s very clumsily done, of course,’ Denny said quickly and cynically, as though forestalling criticism. ‘Practically botched, in fact. I’m no lab. merchant, thank God! If anything I’m a surgeon. But you’ve got to be jack-of-all-trades under our bloody system. There’s no mistake, though, even to the naked eye. I cooked them on agar in my oven.’

  ‘You’ve got cases too?’ Andrew asked with tense interest.

  ‘Four! All in the same area as yours.’ He paused. ‘And these bugs come from the well in Glydar Place.’

  Andrew gazed at him, alert, burning to ask a dozen questions, realising something of the genuineness of the other man’s work, and beyond everything, overjoyed that he had been shown the focus of the epidemic.

  ‘You see,’ Denny resumed with that same cold and bitter irony. ‘Paratyphoid is more or less endemic here. But one day soon, very soon, we’re going to have a pretty little blaze up. It’s the main sewer that’s to blame. It leaks like the devil and seeps into half the low wells at the bottom of the town. I’ve hammered at Griffiths about it till I’m tired. He’s a lazy, evasive, incompetent, pious swine. Last time I rang him I said I’d knock his block off next time I met him. Probably that’s why he welshed on you to-day.’

  ‘It’s a damned shame,’ Andrew burst out, forgetting himself in a sudden rush of indignation.

  Denny shrugged his shoulders. ‘He’s afraid to ask the Council for anything in case they dock his wretched salary to pay for it.’

  There was a silence. Andrew had a warm desire that the conversation might continue. Despite his hostility towards Denny, he found a strange stimulus in the other’s pessimism, in his scepticism, his cold and measured cynicism. Yet now he had no pretext on which to prolong his stay. He got up from his seat at the table and moved towards the door, concealing his feelings, striving to express a formal gratitude, to give some indication of his relief.

  ‘I’m much obliged for the information. You’ve let me see how I stand. I was worried about the origin, thought I might be dealing with a carrier, but since you’ve localised it to the well it’s a lot simpler. From now on every drop of water in Glydar Place is going to be boiled.’

  Denny rose also. He growled. ‘It’s Griffiths who ought to be boiled.’ Then with a return of his satiric humour, ‘ Now, no touching thanks, doctor, if you please. We shall probably have to endure a little more of each other before this thing is finished. Come and see me any time you can bear it. We don’t have much social life in this neighbourhood.’ He glanced at the dog and concluded rudely, ‘Even a Scots doctor would be welcome. Isn’t that so, Sir John?’

  Sir John Hawkins flogged the rug with his tail, his pink tongue lolling derisively at Manson.

  Yet, going home via Glydar Place, where he left strict instructions regarding the water supply, Andrew realised that he did not detest Denny so much as he had thought.

  Chapter Four

  Andrew threw himself into the enteric campaign with all the fire of his impetuous and ardent nature. He loved his work and he counted himself fortunate to have been afforded such an opportunity so early in his career. During these first weeks he slaved joyfully. He had all the ordinary routine of the practice on his hands, yet somehow he got through with it, then turned exultantly to his typhoid cases.

  Perhaps he was lucky in this, his first assault. As the end of the month drew near, all his enteric patients were doing well and he seemed to have confined the outbreak. When he thought of his precautions, so rigidly enforced – the boiling of the water, the disinfection and isolation, the carbolic soaked sheet on every door, the pounds of chloride of lime he had ordered to Doctor Page’s account and himself shot down the Glydar drains, he exclaimed in elation: ‘It’s working. I don’t deserve it. But by God! I’m doing it!’ He took a secret, detestable delight in the fact that his cases were mending quicker than Denny’s.

  Denny still puzzled, exasperated him. They naturally saw each other often because of the proximity of their cases. It pleased Denny to exert the full force of his irony upon the work which they were doing. He referred to Manson and himself as ‘ grimly battling with the epidemic’ and savoured the cliché with vindictive relish. But for all his satire, his sneers of ‘don’t forget, doctor, we’re upholding the honour of a truly glorious profession,’ he went close to his patients, sat on their beds, laid his hands upon them, spent hours in their sickrooms.

  At times Andrew came near to liking him for a flash of shy, self-conscious simplicity, then the whole thing would be shattered by a morose and sneering word. Hurt and baffled, Andrew turned one day in the hope of enlightenment to the Medical Directory. It was a five-year-old copy on Doctor Page’s shelf, but it held some startling information. It showed Philip Denny as an honours scholar of Cambridge and Guy’s, a MS of England, holding – at that date – a practice with an honorary surgical appointment in the ducal town of Leeborough.

  Then, on the tenth day of November, Denny unexpectedly rang him up.

  ‘Manson! I’d like to see you. Can you come to my place at three o’clock? It’s important.’

  ‘Very well. I’ll be there.’

  Andrew went into lunch thoughtfully. As he ate the cottage pie that was his portion he felt Blodwen Page’s eye fastened on him with a certain inquiry.

  ‘Who was that on the phone? So it was Denny, eh? You don’t have to go around with that fellow. He’s no use at all.’

  He faced her bluntly. ‘On the contrary, I’ve found him a great deal of use.’

  ‘Go on with you, doctor!’ Miss Page seemed put out by his reply. ‘He’s reg’lar queer. Mostly he don’t give medicine at all. Why, when Megan Rhys Morgan, who had to have medicine all her life, went to him he told her to walk two mile up the mountain every day and stop bogging herself with hogwash. These was his very words. She came to us after, I can tell you, and has had bottles and bottles of splendid medicine from Jenkins ever since. Oh! he’s an insulting devil. He has got a wife somewhere by all accounts. Not livin’ with him. See! Mostly he’s drunk also. You leave him alone doctor, and remember you’re workin’ for Doctor Page.’

  As she flung the familiar injunction at his head Andrew felt a quick rush of anger sweep over him. He was doing his utmost to please her, yet there seemed no limit to her demands. Her attitude, whether alternating between dryness or jollity, seemed always designed to get the last ounce out of him. He felt a sudden unreasonable anger. His first month’s pay was already three days overdue, perhaps an oversight upon her part, yet one which had worried and annoyed him considerably. At the sight of her there, assured and self-contained, sitting in judgment upon Denny, his feelings got the better of him. He said with sudden heat: ‘ I’d be more likely to remember that I’m working for Doctor Page if I had my month’s salary, Miss Page.’

  She reddened so indignantly that he was sure the matter had altogether escaped her mind. She held her head very erect
. ‘You shall have it. The idea!’

  For the rest of the meal she sat in a huff, not looking at him, as though he had insulted her. And, indeed, he was conscious of an equal annoyance against himself. He had spoken without thinking, without wishing to offend her. He felt that his quick temper had placed him in a false position.

  As he went on with his lunch he could not help reflecting on the relations which existed between Miss Page and himself. The truth was that, from the first moment when he had entered Bryngower, he had sensed that they were unsympathetic to one another. Perhaps the fault lay on his side – the realisation made him moodier than ever – he knew that his manner was stiff and difficult.

  And there was no doubt that Blodwen Page was a most estimable woman, a good and economical housewife, who never wasted a moment of her time. She had many friends in Drineffy, everyone spoke well of her. And, indeed, her unsparing devotion to her brother, her unstinted loyalty to his interests made her almost a paragon.

  Nevertheless, to Andrew she was always a little sterile, a spare dry spinster whose smile could never quite convince him of real warmth. If only she had been married, been surrounded by a family of romping children, she would have pleased him better.

  After lunch she rose and, a moment later, called him into the sitting-room. Her mood was dignified, even austere.

  ‘Here is your money then, doctor. I have found that my assistants prefer to be paid in cash. Sit down and I will count it for you.’

  She herself was seated in the green plush armchair and in her lap were a number of pound notes and her black leather purse.

  Taking up the notes, she began to count them meticulously into Manson’s hand – ‘One, two, three, four.’ When she had given him twenty she opened her purse and, with the same exactitude, counted out sixteen shillings and eightpence. She then remarked:

  ‘I think that is correct, doctor, for one month. We agreed on a salary of two hundred and fifty a year.’

  ‘It’s quite correct,’ he said awkwardly.

  She gave him a pale glance.

  ‘So now you know I don’t intend to cheat you, doctor.’

  Andrew left the house in a smouldering irritation. Her rebuke stung him the more because he felt it to be justified.

  Only when he reached the post office, bought a registered envelope and posted the twenty pounds to the Glen Endowment – he kept the silver as pocket money for himself – he saw Doctor Bramwell approaching and his expression lightened further. Bramwell came slowly, his large feet pressing down the pavement majestically, his seedy black figure erect, uncut white hair sweeping over the back of his soiled collar, eyes fixed on the book he held at arm’s length. When he reached Andrew, whom he had seen from half-way down the street, he gave a theatrical start of recognition.

  ‘Ah! Manson, my boy! I was so immersed, I almost missed you!’

  Andrew smiled. He was already on friendly terms with Doctor Bramwell, who, unlike Nicholls, the other ‘listed’ doctor, had given him a cordial welcome on his arrival. Bramwell’s practice was not extensive, and did not permit him the luxury of an assistant, but he had a grand manner, and some attitudes worthy of a great healer.

  He closed his book, studiously marking the place with one dirty forefinger, then thrust his free hand picturesquely into the breast of his faded coat. He was so theatrical he seemed hardly real. But there he was, in the main street of Drineffy. No wonder Denny had named him the Lung Buster.

  ‘And how, my dear boy, are you liking our little community? As I told you when you called upon my dear wife and myself at The Retreat, it isn’t so bad as it might appear at first sight. We have our talent, our culture. My dear wife and I do our best to foster it. We carry the torch, Manson, even in the wilderness. You must come to us one evening. Do you sing?’

  Andrew had an awful feeling that he must laugh. Bramwell was continuing with unction:

  ‘Of course, we have all heard of your work with the enteric cases. Drineffy is proud of you, my dear boy. I only wish the chance had come my way. If there’s any emergency in which I can be of service to you, call upon me!’

  A sense of compunction – who was he that he should be amused by the older man? – prompted Andrew to reply.

  ‘As a matter of fact, Doctor Bramwell, I’ve got a really interesting secondary mediastinitis in one of my cases, very unusual. You may care to see it with me if you’re free.’

  ‘Yes?’ queried Bramwell with a slight fall in his enthusiasm. ‘ I don’t wish to trouble you.’

  ‘It’s just round the corner,’ Andrew said hospitably. ‘And I’ve got half an hour to spare before I meet Doctor Denny. We’ll be there in a second.’

  Bramwell hesitated, looked for a minute as though he might refuse, then made a damped gesture of assent. They walked down to Glydar Place and went in to see the patient.

  The case was, as Manson had inferred, one of unusual interest, involving a rare instance of persistence of the thymus gland. He was genuinely proud to have diagnosed it and he experienced a warm sense of communicative ardour as he invited Bramwell to share the thrill of the discovery.

  But Doctor Bramwell, despite his protestations, seemed unattracted by the opportunity. He followed Andrew into the room haltingly, breathing through his nose, and in lady-like fashion approached the bed. Here he drew up and, at a safe range, made a cursory investigation. Nor was he disposed to linger. Only when they left the house, and he had inhaled a long breath of the pure fresh air, did his normal eloquence return. He glowed towards Andrew.

  ‘I’m glad to have seen your case with you, my boy, firstly because I feel it part of a doctor’s calling never to shrink from the danger of infection and secondly because I rejoice in the chance of scientific advancement. Believe it or not, this is the best case of inflammation of the pancreas I have ever seen!’

  He shook hands and hurried off, leaving Andrew utterly nonplussed. The pancreas, thought Andrew dazedly. It was no mere slip of the tongue which had caused Bramwell to make that crass error. His entire conduct at the case betrayed his ignorance. He simply did not know. Andrew rubbed his brow. To think that a qualified practitioner, in whose hands lay the lives of hundreds of human beings, did not know the difference between the pancreas and the thymus, when one lay in the belly and the other in the chest – why, it was nothing short of staggering!

  He walked slowly up the street towards Denny’s lodging, realising once again how his whole orderly conception of the practice of medicine was toppling about him. He knew himself to be raw, inadequately trained, quite capable of making mistakes through his inexperience. But Bramwell was not inexperienced and because of that his ignorance was inexcusable. Unconsciously Andrew’s thoughts returned to Denny who never failed in his derision towards this profession to which they belonged. Denny at first had aggravated him intensely by his weary contention that all over Britain there were thousands of incompetent doctors distinguished for nothing but their sheer stupidity and an acquired capacity for bluffing their patients. Now he began to question if there were not some truth in what Denny said. He determined to reopen the argument this afternoon.

  But when he entered Denny’s room, he saw immediately that the occasion was not one for academic discussion. Philip received him in morose silence with a gloomy eye and a darkened forehead. Then, after a moment, he said:

  ‘Young Jones died this morning at seven o’clock. Perforation.’ He spoke quietly, with a still, cold fury. ‘And I have two new enterics in Ystrad Row.’

  Andrew dropped his eyes, sympathising, yet hardly knowing what to say.

  ‘Don’t look so smug about it,’ Denny went on bitterly. ‘It’s sweet for you to see my cases go wrong and yours recover. But it won’t be so pretty when that cursed sewer leaks your way.’

  ‘No, no! Honestly, I’m sorry,’ Andrew said impulsively. ‘We’ll have to do something about it. We must write to the Ministry of Health.’

  ‘We could write a dozen letters,’ Philip answered, with grim restraint.
‘And all we’d get would be a doddering commissioner down here in six months’ time. No! I’ve thought it all out. There’s only one way to make them build a new sewer.’

  ‘How?’

  ‘Blow up the old one!’

  For a second Andrew wondered if Denny had taken leave of his senses. Then he perceived something of the other’s hard intention. He stared at him in consternation. Try as he might to reconstruct his changing ideas, Denny seemed fated to demolish them. He muttered:

  ‘There’ll be a heap of trouble – if it’s found out.’

  Denny glanced up arrogantly.

  ‘You needn’t come in with me, if you don’t want to.’

  ‘Oh, I’m coming in with you,’ Andrew answered slowly. ‘But God knows why!’

  All that afternoon Manson went about his work fretfully regretting the promise he had given. He was a madman, this Denny, who would, sooner or later, involve him in serious trouble. It was a dreadful thing that he now proposed, a breach of the law which, if discovered, would bring them into the police-court and might even cause them to be scored off the medical register. A tremor of sheer horror passed over Andrew at the thought of his beautiful career, stretching so shiningly before him, suddenly cut short, ruined. He cursed Philip violently, swore inwardly a dozen times that he would not go.

  Yet, for some strange and complex reason, he would not, could not draw back.

  At eleven o’clock that night Denny and he started out in company with the mongrel Hawkins for the end of Chapel Street. It was very dark with a gusty wind and a fine spatter of rain which blew into their faces at the street corners. Denny had made his plan and timed it carefully. The late shift at the mine had gone in an hour ago. A few lads hung about old Thomas’s house at the top end but otherwise the street was deserted.

  The two men and the dog moved quietly. In the pocket of his heavy overcoat, Denny had six sticks of dynamite especially stolen for him that afternoon from the powder shed at the quarry by Tom Seager, his landlady’s son. Andrew carried six cocoa tins each with a hole bored in the lid, an electric torch, and a length of fuse. Slouching along, coat-collar turned up, one eye directed apprehensively across his shoulder, his mind a whirl of conflicting emotions, he gave only the curtest answers to Denny’s brief remarks. He wondered grimly what Lamplough – bland professor of the orthodox – would think of him, involved in this outrageous nocturnal adventure.