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.