Dorothea invites Lydgate to Lowick Manor. She has become very excited about the idea of helping him. When he arrives, the signs of prolonged misery are clear on his face, and she is shocked at how terrible he looks. When Dorothea mentions the New Hospital, Lydgate says that he is not in a position to give advice about whether she should continue supporting it, as he may soon have to leave Middlemarch. She immediately declares that she doesn’t believe the rumors about him; feeling deeply moved, Lydgate thanks her. She asks that he tell her the full truth.
Here Dorothea emerges as a kind of saintly figure (the significance of this is revealed in light of the discussion of St. Theresa of Avila in the “Prelude”). Not only is she willing to support the New Hospital, but she is convinced of Lydgate’s innocence and prepared to stand by him even if this means facing public ostracization.
Lydgate says that he doesn’t want to “bear hard on Bulstrode,” because despite everything he is still grateful to him for the £1000. Dorothea promises that she won’t repeat his words to anyone, although she says that if she did, many people in Middlemarch would believe her. Although this may be naïve, Lydgate chooses to trust her, and tells her everything.
Lydgate’s desire not to seem as if he is shifting all the blame to Bulstrode certainly emerges from loyalty, but is also strategic. Appearing as though he is trying to evade guilt by sacrificing Bulstrode will likely only increase the suspicion people have of him.
Lydgate finishes by saying that it has since emerged that Raffles was given more opium than Lydgate prescribed (plus brandy, which he forbade). He doesn’t know how or why his instructions for Raffles’s care were not followed (and therefore does not know if Bulstrode is guilty of helping to kill Raffles). Either way, Lydgate is condemned by association—“the business is done and can’t be undone.” Moved, Dorothea says she can’t bear the idea of Lydgate’s ambitions coming to this end.
Dorothea’s comment shows that her admiration for Lydgate does come from their shared commitment to social reform. Perhaps she sees some of herself in Lydgate, not only on the basis of their shared passions but also because she, like Lydgate, has experienced the bitter disappointment of failed ambitions.
Dorothea suggests that Lydgate stay and keep up his work at the New Hospital while waiting for the rumors to die down. She says he might even one day still become a famous medical innovator. Lydgate says he can’t do that because he has lost faith in himself. Dorothea insists that she has too much money and wants to give it away, especially after Sir James and Mr. Brooke persuaded heƒr that her idea of building a colony was “too risky.” Hearing about Dorothea’s ardent desire to help others, Lydgate cannot help but smile. However, he then repeats that he cannot stay, because it would make Rosamond too unhappy.
After everything Lydgate has been through in his mission to bring medical reform to Middlemarch, the final impediment to his attempting to realize some of his ambitions is Rosamond. This proves that his initial fears about how getting married would affect his career were all too prescient. While Lydgate arguably has a duty to make Rosamond happy, there is no doubt that marrying her was fatal to his career.
Dorothea asks if she can go and try to persuade Rosamond to stay. Lydgate agrees that she should visit her, saying that it would please Rosamond to hear that Dorothea still holds him in high esteem. However, he also says that the New Hospital should be merged with the Old Infirmary, and thus handed over to someone else. He has decided to go to London, but thanks Dorothea again for going to see Rosamond. As he rides away, he is overcome with admiration for Dorothea’s selflessness. Back at Lowick, meanwhile, Dorothea writes a note and a check for £1000 to Bulstrode, in order to relieve Lydgate’s debt to him.
Lydgate’s decision to move to London is somewhat painful to witness, as it means that all of his efforts in Middlemarch have come to nothing (and therefore that the standard of medical care in the area will not improve). However, it is perhaps the more honorable thing to choose Rosamond’s happiness (and, to a lesser extent, his own dignity) over remaining in Middlemarch and battling in vain to force reforms in a community that does not want them.