1The Hippocratic Oath binds doctors to practice ethically and, above all, to “do no harm.” The doctor narrating William Carlos Williams’s short story “The Use of Force” comes dangerously close to breaking that oath, yet ironically is able to justify his actions by invoking his professional image and the pretense of preserving his patient’s well-being. As an account of a professional doing harm under the pretense of healing, the story uncovers how a doctor can take advantage of the intimate nature of his work and his professional status to overstep common forms of conduct, to the extent that his actions actually hurt rather than help a patient. In this way, the doctor-narrator actually performs a valuable service by warning readers, indirectly through his story, that blindly trusting members of his profession can have negative consequences.

2In the way the story and its characters introduce us to the narrator, we see how people automatically grant a doctor status and privilege based on his profession alone, creating an odd sort of intimacy that is uncommon in ordinary social relations. At the story’s beginning, the narrator identifies the family he visits as “new patients” (501), and he establishes that they are virtual strangers to him—“all [he] had was the name, Olson” (501). After the mother confirms that he is the doctor, however, she immediately invites him into the most intimate part of her home, the kitchen, where her husband and sick daughter are waiting (501). Later, the mother reassures the child that the doctor is a “nice man” and “won’t hurt you,” though she can base those assertions only on what little she knows of him: his occupation (502). At the same time, the narrator senses that the family is “very nervous, eyeing me up and down distrustfully” (501). The parents’ eagerness in offering their home and hospitality, coupled with the betrayal of their nervousness, hints at the dubious nature of the intimacy between a doctor and his patient. Although the doctor’s profession gives him privilege to overstep certain boundaries, the basis of real trust is lacking, thus casting the doctor-patient relationship as something strange and artificial.

3The narrator communicates to readers that he perceives both sides of the interaction and also admits to intentionally using the weight of his professional status against the family’s natural distrust of outsiders. The young girl, who is not yet “adult” enough to follow social conventions (503), might be read as representing the family’s instinct for self-protection. In the face of the child’s resistance, the narrator “smiled in [his] best professional manner” (502), trying to invoke the special form of trust that doctors typically assume. The phrase “professional manner” shows that the narrator acknowledges he is using the power of his occupation, while also admitting that his reassuring smile is only part of his professional performance. As the doctor’s struggle to examine the little girl’s throat becomes more heated, he repeatedly brings up his expert concern to justify his rough actions. He tells readers, “I had to do it . . . for her own protection” (502). Later, he reminds readers (and himself) that “I have seen at least two children lying dead in bed of neglect in such cases, and [feel] that I must get a diagnosis now or never” (503). He also notes that “others must be protected” against the sick child before him (503). The narrator repeatedly brings up his duty as a doctor and the privilege that comes with it to defend his use of force. Yet at other points, he admits to having “grown furious” (503), to being unable to “hold [himself] down” (503), and to have “got beyond reason” (503). In acknowledging the loss of his capacity for reason and self-control, he essentially admits that his “professional manner” and attempts to be gentle in getting the girl to follow his commands are empty artifice (502). When these attempts fail, emotion alone drives his actions. In effect, he uses the medical art as a pretense to justify otherwise unacceptable interventions.

4Beyond admitting his personal motivations in his treatment of the girl, the narrator sketches a more disturbing and potentially incriminating image of himself in his use of militaristic diction, for it aligns his character more with harming than healing—the perfect contradiction of a doctor. Examples of militaristic diction include calling his struggle with the girl a “battle” (502), the tongue depressor a “wooden blade” (503), his bodily effort an “assault” (503). She too is a party in this war, moving from fighting “on the defensive” to surging forward in an attack (503). Such metaphors of fighting and warfare, especially those associated with the doctor and his actions, figuratively convey that his character crosses a crucial boundary. They present the argument that, despite his honorable pretentions, his actions—at least during the height of his conflict with the girl—align more with violence than with healing. The doctor’s thoughts even turn more obviously (and more consciously) violent at times, such as when, in a bout of frustration, he wants “to kill” the girl’s father (502), or when he says, “I could have torn the child apart in my own fury and enjoyed it” (503). Although these statements are arguably exaggerated or hyperbolic, they, like the metaphors of war, imply a tendency to do harm that goes directly against the narrator’s duty as a doctor. While the story’s opening introduces him as a person whose occupation is enough to overcome the parents’ distrust, by the end of the story he leaves his readers thoroughly horrified by his forceful handling of the little girl. By investigating the calculated artifice and military metaphors, we might conclude that the narrater is conscious both of his deceptive rhetoric and of the harm it allows him to inflict upon his patient.

5Curiously, the narrator readily pleads guilty on both counts, which leads one to wonder why any person would willingly paint such a damning picture of himself—one that would surely destroy his livelihood. I would argue that the doctor of this story does not take ownership of his despicable actions but uses them to blame the parents and more generally to warn against blindly trusting those in positions of authority. Looking back to the story’s opening, we note that the narrator presents himself generically. He does not name or describe himself or provide any information beyond the fact that he is a doctor. The lack of specification renders him the “every doctor” and expands the possible reference points for the pronoun “I” as it is used in this story. That is to say, although the story is told in the first person, attaching the actions and events to the singular narrator, that narrator turns himself into a placeholder for every doctor by leaving out all identifying features. I would argue, furthermore, that speaking in the first person, as he must to make his story credible, the narrator offers a cautionary tale about a doctor who exploits the privileges of his profession. The warning implied in the story of a doctor’s exploitation of professional privilege is for patients to protect themselves. Thus, through his cautionary tale, the doctor-as-narrator does the opposite of the doctor-as-actor in the story: he performs a doctor’s duty to his readers of preventing harm.

6For readers who distinguish between the different layers of Williams’s first-person narrator, the story is ultimately both a damning and a flattering depiction of the doctor figure. The doctor-as-actor in the story becomes a despicable specimen of professionalism corrupted, someone capable of brutality and rhetorical manipulation. Above him stands another—the doctor-as-narrator—who counteracts these crimes through his art. The way he tells the story conveys a powerful story and serious message.

Work Cited

Williams, William Carlos. “The Use of Force.” The St. Martin’s Guide to Writing. Ed. Rise B. Axelrod and Charles R. Cooper. 10th ed. Boston: Bedford/St. Martin’s, 2013. 501–03. Print.