The novel begins with a brief vignette about Martin Arrowsmith's great- grandmother—a pioneer who wanted to see the world. She is "going west" in her wagon, with her mother dead and her father ill but remaining steadfast, nevertheless.
After this brief, one-paragraph episode, Sinclair Lewis begins the story of Martin Arrowsmith. When the reader first meets him he is fourteen and sitting in Doc Vickerson's office reading Gray's Anatomy in the small town of Elk Mills, Winnemac. Martin's father heads the New York Clothing Bazaar, but Martin prefers to spend his time with the doctor, reading his books and looking at the specimens of Doc Vickerson's museum of medical oddities. And, in fact, Lewis informs the reader that Martin, at the young age of fourteen, has become the doctor's unofficial assistant.
Doc Vickerson is an old widower who is fond of the drink. His office is not very clean, and the doctor is portrayed as somewhat of a mess who calls himself a failure. Nevertheless, he encourages Martin in the direction of education, knowledge, and medicine. And, by the end of the chapter, Doc Vickerson has given Martin the gift of a magnifying glass.
It is 1904, and Martin is a junior in college, preparing for Medical school at the University of Winnemac, which is fifteen miles from the largest city in Winnemac (Zenith). He appears to be a fairly handsome though thin boy that the girls all call "romantic"; he is also quite shy.
Martin has forgotten Doc Vickerson and Elk Mills and is completely enthralled by his life at the university. His new idol is the head of the chemistry department named Edward Edwards, whom all the students call "Encore." Martin is impressed by his knowledge and, mid chapter, finds himself at one of Edwards's "At Homes," where students and faculty confer and discuss. During this meeting, the strange German, Jewish professor Max Gottlieb comes up in conversation. Gottlieb is known for his brilliant and difficult-to-understand research in Immunology and is shrouded with campus rumors and mystery that excites Martin. After the gathering, Martin goes to the medical school campus and sees Max Gottlieb leaving the lab late at night and is taken in a gust of admiration.
Soon after, Martin enters medical school feeling superior and yet, nervous. He goes to Gottlieb and tells the professor that he would like to take his bacteriology class, but Gottlieb tells him that he must come back the next year after he has taken physical chemistry. Martin is disappointed and thinks about his encounter with Gottlieb, and he begins to wonder if Edward Edwards was really as intelligent as he had once thought. Furthermore, Martin has begun to question "truth."
Lewis then begins his description of the world of the University of Winnemac Medical School. Ira Hinkley, for instance, is Martin's dissecting partner, a twenty-nine-year-old medic who wants to become a medical missionary and who preaches and attempts to convert everyone he meets. Martin is also a member of a fraternity—Digamma Pi, the chief medical fraternity—where the characters that will make up his life while in school emerge. The members of the fraternity include one Angus Duer, whom Martin both hates and envies for his determination and intelligence. Fatty Pfaff, another member of the fraternity is a gullible freshman who is not very smart. Then there are Clif Clawson and Irving Watters, who, along with Fatty Pfaff, room with Martin. Clif is the school's clown whom Martin quite likes, and Irving Watters is simply dull.
Martin's circle of friends (listed above) is constantly involved in discussions about what makes a good doctor. Martin arises as the cynic of the group who insults the way the medical school is run with all its mechanical memorization and striving for commercialism. He expresses his views often with his classmates and with Madeleine Fox, a girl he had gone to college with and has re- discovered in "medical school." Madeleine remained at the university in order to take up doctoral classes in literature. Martin believes that he loves her.
After exams, Martin looks forward to Gottlieb's bacteriology class after the summer and goes off to his summer job, installing telephones in Montana.
The introductory vignette about Martin Arrowsmith's great-grandmother sets the attempted scope of the novel. By going so far back in time, Lewis is telling us that his novel will be a kind of epic, while at the same time foreshadowing the life of Martin Arrowsmith himself. Martin's great-grandmother, "the pioneer," has suffered in that she has lost her mother at the age of fourteen and is driving a wagon across the Ohio wilderness. Yet, she is determined. When her sick father, who is lying limp in the back of the wagon, tells her she should slow down, she refuses to and says she is going to keep going west because there are "a whole lot of new things [she] aim[s] to be seeing!" This pioneer spirit will become evident within Martin Arrowsmith as the book progresses. And just as tragedy has befallen his great-grandmother, it will also befall Martin.
These beginning chapters also set the stage of Martin's background. He is a young, American boy living in the early 1900s who aspires to be a doctor. And, along with settings, characters are introduced—lively, yet archetypal characters. It becomes evident, early on, that Lewis is a caricaturist. Doc Vickerson is the epitome of the country doctor; Clif Clawson, with his practical jokes, is the class clown; Ira Hinkley is the religious one of the group and so on. Even the names are caricatures. For example: Angus Duer. Angus's last name "Duer" befits his personality because he is a "do-er," doing everything with utmost skill and determined to realize his goals in silence; not so much saying as "doing." Martin, on the other hand, talks and talks. He becomes a cynic and is constantly raving against "commercialism" and the mechanical teaching ways of the university.
This tendency toward archetype is very much a part of Lewis's style, which is a mix of realism and satire. From the beginning we realize that there are many things about the medical profession and American society in general, which Lewis is criticizing. He calls the university a mill, as if it were a machine that produces people like products, taught how to behave and speak and act within educated society.
It is important, however, to realize that another reason for the use of "types" in the novel is that this is not a novel about many characters; instead it is the journey of one man. It is a bildungsroman: the personal education and development of a single person (Martin Arrowsmith, in this case). Moreover, other characters are both a vehicle for satire and a way for Lewis to provide further create the character of Martin, either by placing these other characters in juxtaposition or through a connection to him.
Furthermore, as a side-note, Zenith, the largest city in Winnemac, is also the city in which the character of Babbitt from Lewis's earlier novel entitled Babbitt lives. This is a device that Lewis is using out of cleverness and also for the purpose of tying the themes of his novels together.
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