The day after losing at billiards, Lydgate feels repulsed by his own actions. He has learned that Rosamond has already asked Mr. Vincy for financial help twice and been refused. His only remaining option is to go to Bulstrode. Before he can approach Bulstrode, however, he receives a note from him asking to meet him at the bank. Bulstrode has lately been suffering from insomnia, which has seriously jeopardized both his mental and physical health. Lydgate explains that anxiety can have terrible bodily repercussions, as he himself knows all too well at the moment.
Lydgate and Bulstrode encounter one another in moments of absolute desperation. Although the problems they are facing are different, both are significantly rooted in the need to preserve one’s reputation at all costs. If Lydgate didn’t face so much pressure from Rosamond to keep up appearances, then he would have been able to curb their spending.
Bulstrode says that in order to relieve some stress, he is planning to step back from several aspects of his business and to move to the coast. Given this, he plans to withdraw from the New Hospital, which leads Lydgate to believe that Bulstrode must have lost a lot of money. Bulstrode says that Dorothea would be the only person who might reasonably be expected to finance the hospital in the future. He has approached Dorothea about it and she has asked for some time to consider the proposal.
Lydgate and Bulstrode’s ambitious plans to bring medical reform to Middlemarch are coming crashing down. Neither man is equipped to bring his dreams into reality, and as a wealthy widow Dorothea is the last hope for the hospital. Without money, even hard work is not enough to make ambitions succeed.
Lydgate suggests that he can go and talk to Dorothea and Bulstrode agrees, although he adds that at the moment she is in Yorkshire with Sir James and Celia. Lydgate says that his association with the New Hospital has made him unpopular as a doctor, and most of his patients can’t pay him for his services. He explains that he is £1000 in debt and, full of shame, asks for a loan. Bulstrode says that he unfortunately can’t help and advises Lydgate to declare bankruptcy. Lydgate says that this would be unbearable and wouldn’t help him anyway. He says goodbye and leaves.
We do not know why Bulstrode refuses Lydgate’s request. After all, he has the money, as evidenced by his attempt to give it to Will Ladislaw. He may be trying to save money in order to pay off Raffles, or perhaps he wants to avoid putting Lydgate in the position that Will refused of accepting “ill-gotten money.”