Middlemarch: A Study of Provincial Life first appeared as an eight-part serial novel in 1871-72. Meanwhile, personal problems intervened and when she took up the project again, it was with a renewed sense of creativity. While Bulstrode, Lydgate, and Dorothea have great hopes for the hospital, most of the characters are still too attached to the old way of doing things to see the advantages a new institution could bring.George Eliot's seventh and perhaps most famous novel almost didn't get written! It took birth as a short novella titled Miss Brooke but she was unhappy with its progress and finally in despair, she decided to put it aside for a couple of years. It symbolizes the difficulty of progress in an area where most people are skeptical of reform. Even without the scandal, however, it is unclear whether the New Hospital would have been able to survive. Ultimately the financial scandal that drives both Bulstrode and Lydgate from Middlemarch dooms the hospital to failure, and after this point it is attached to the Old Infirmary. The resistance of the local people makes it difficult for the New Hospital to flourish none of the Middlemarch doctors will work there, and Lydgate thus has to employ people from outside the area. The New Hospital is thus designed to be a cutting-edge institution in the midst of a largely backwards, provincial area that tends to be resistant to technological progress and reform.
They plan to conduct research there and even hope to open an affiliated medical school one day. The New Hospital is established by Nicholas Bulstrode (who finances and manages it) and Tertius Lydgate (who serves as the medical director) as a way to raise the standard of medical care in Middlemarch.
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