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Tertius Lydgate is the male protagonist of the novel, and in a way, a male counterpart of Dorothea. He is twenty-seven years old, talented and good looking. He comes of "good" family, being the nephew of a baronet, but has been orphaned early and has not family fortune. Developing an early fascination for biology, he asks to be trained in medicine, a cheap alternative to the university.
When the novel opens, he has decided to settle in Middlemarch to improve provincial medical facilities; work free in a new fever hospital; and to investigate the "primary tissue" of living matter his passion in life. He is confident, even arrogant about his abilities and intentions, "I should never have been happy in any profession that did not call forth the highest intellectual strain, and yet keep me in good warm contact with my neighbors." Unlike Dorothea, he has had a less secure life, traveled and worked in Europe, and having a noble profession, is more focussed in his commitment.
Yet like her, he has his self-absorbed blindness. He makes no effort to understand the structure of provincial society, taking it for granted he can overcome all difficulties with his dynamism. He has also the fatal "spots of commonness" - the unthinking belief that he can live very comfortably, yet work with dedication on meager earnings; the belief that he can marry the extravagant town beauty and turn her into a docile helpmate. Thus he, like Dorothea, but with no excuse of inexperience, marries Rosamond Vincy, "the best girl" in the town, to the envy of all the young men. The novelist reveals his early love affair with Laure, a temperamental French actress. Laure has killed her husband and co-actor on stage in an apparent accident. Lydgate, full of faith in her innocence, is horrified on finding she had intentionally killed a man she had tired of! Learning nothing from this past episode, he turns to Rosamond, believing she is Laure’s complete opposite. In the struggle between Rosamond’s petty scheming to rise upward, and his efforts to preserve his Dorothea, he lacks the ruthlessness to push aside opposition when it comes with emotional attachment. He gets embroiled in increasing debt. Professionally, the conservative public and medical vested interests combine to harm his practice.
The Finale informs the reader of Lydgate’s leaving Middlemarch to settle in the city. This too, is a surrender to Rosamond’s ambition.