Why is Dr Monygham, who won't figure in the story until much later, introduced here? In the blur of faces, names and shifting points of view it may seem random, but in fact it's very significant that we meet Dr Monygham, particularly in his relationship to Mrs Gould, before we meet Charles Gould. The three of them form a triangle based on Mrs Gould's altruism. Her altruism is the desire to help downtrodden people. Charles supplies the actual help, which has to appeal to her, but the cynical Monygham supplies something more essentially compatible: a doctrine of downtrodden people. When Charles finally brings prosperity to Sulaco, Mrs Gould resents it and distrusts it and loses her relationship with him (a loss that is partly, but not entirely, his fault), while her affection for Dr Monygham survives. The placement of the doctor's introduction is thus very deliberate.