Trauma and "The Use of Force"

Daniel Moore

William Carlos Williams Review, Volume 29, Number 2, Fall 2009, pp. 161-175
(Article)

Published by Penn State University Press

DOI: https://doi.org/10.1353/wcw.2009.0028

For additional information about this article

https://muse.jhu.edu/article/516243

Access provided at 27 Nov 2019 03:27 GMT from Christ University

 Trauma and “The Use of Force”

Daniel Moore
Q U E E N ’ S U N I V E R S I T Y, C A N A D A

W
illiams ’ s two hats as an American modernist writer and

an on-call physician in Rutherford, New Jersey combine

strikingly in one of the most anthologized stories from
his 1938 collection, Life Along the Passaic River. With clinical attention to psy-
chological detail and Hemmingway-like terseness, “The Use of Force” follows the
house call of a rural doctor. A young girl, Mathilda Olson, is suspected to have
diphtheria, a contagious throat infection that may have already claimed the lives
of “at least two children” neglected before the doctor had seen them (FD 134). In
order to confirm his suspicions, which are shared by the girl’s parents, the doctor
needs to examine her throat, but his patient intractably refuses to allow him to
peer into her mouth. After failing to entice the young girl to open her mouth for
him, the doctor recruits the girl’s parents in an aggressive bid to pry her mouth
open. During the struggle the girl destroys the doctor’s wooden tongue depressor,
cutting her tongue in the process. The story ends with the doctor’s use of force
seemingly vindicated by his positive diagnosis. However, the child’s visible tor-
ment during the examination, as well as the doctor’s analysis of his motivations
for proceeding despite her obvious distress, seem to undercut any obvious utilitar-
ian justification for his actions.
Over the years, criticism has gradually bifurcated Williams the modernist and
Williams the physician by reading the story mainly in terms of one or the other of
his two vocations. The representation of the narrator’s implied sexual desire for his
patient and the perilous confluence of sex and violence in his forced ingress into
his patient’s mouth occupied the attention of most interpretations until about
1990. R. F. Dietrich’s 1966 essay “Connotations of Rape in ‘The Use of Force’”

161
William Carlos Williams Review, vol. 29 no. 2, Fall 2009 © Texas Tech University Press
 162 William Carlos Williams Review

offered perhaps the first interpretation of the violent eroticism that Williams
weaves into the doctor’s examination of the young girl. Subsequent readings have
enriched Dietrich’s central argument that the story offers a window into a thinly
sublimated desire, like Marjorie Perloff’s suggestion that similar illicit sexual ap-
pear in several of the other male narrators in Life Along the Passaic River.1 These
readings set Williams’s story within a tradition of early-twentieth-century creative
texts that draw—however tacitly—on the emerging discourse of psychoanalysis.
As such, they reveal a story keenly interested in how inner life takes on linguistic
form in written texts, and how written texts, much like the writings of a Venetian-
born scientist, can enrich our notions about inner life. More recently, scholars
have shifted attention to the story’s treatment of Williams’s workaday vocation.
These later readers explore some of the more pragmatic, but equally important
questions, raised by the text around a specific set professional and ethical dilem-
mas. In general, these scholars—in some cases writing from within the medical
field—consider how the doctor retrospectively narrates his examination of his
patient in order to evaluate the appropriateness of his actions, namely to decide
whether or not, or to what degree, he violates his Hippocratic Oath. In this light,
the emphasis falls on Williams’s presentation of the doctor’s social self; his values,
behaviour, and understanding of these things are seen as extensions of his profes-
sional culture and his participation within it.
I want to consider how these two perspectives—roughly, the historical psycho-
analytic and the contemporary medical—are compatible with one another de-
spite remaining almost wholly disparate in scholarship on the story. Although
these readings posit different sets of questions about Williams’s text, the treatment
of bodily and psychical wounding in the story as well as the doctor’s attempt to
work through his memory of the experience overlap in the notion of trauma.
Drawing on scholarship already linking “The Use of Force” with Freud’s founda-
tional text on trauma, Beyond the Pleasure Principle (1920), and offering new evi-
dence to further bring these two texts into comparison, I propose that the common
tongue-depressor exam supplies an analogy for trauma in the writings of each
modernist doctor and writer. From Freud, Williams obtains an analogy for explor-
ing the power dynamics that characterize the relationship between physician and
patient, and for diagnosing multiple forms of wounding produced or concealed
by medical treatment. Williams also takes Freud’s analogy further. The hindsight
perspective from which Williams’s doctor goes over the sequence of events in the
Olson’s house suggests an effort to ethically respond to a traumatic event, as
Cathy Caruth puts it, whose “violence has not yet been fully known” (Caruth 6).
The unique collision of violence, repetition, and retrospection in trauma offers a
useful framework for exploring both the doctor’s narration of his examination—
 moore — Trauma and “The Use of Force” 163

what Brian A. Bremen calls the story’s “‘diagnostic treatment’ of an act of diagno-
sis” (100)—as well as the hurt experienced by his patient. That readers consider
both doctor and patient under the same heuristic framework seems desirable.
Given the chance, our interpretive lens may blunder by recognizing the suffering
that the doctor’s patient experiences while, with the other hand, rationalizing her
suffering as a necessary means for the narrator’s new self-knowledge—the brutal-
ity of which he is capable. Indeed, the doctor occupies an ambiguous role in the
sense that he participates in a traumatic event as its perpetrator and assumes the
position of a traumatic, perhaps traumatized witness who gives testimony about
that event. These multiple roles challenge any easy distinction in the text between
victim and perpetrator, and the relationship between these positions and trauma’s
third category of witness. What I hope to demonstrate is how the doctor’s reflec-
tions on his own actions remain implicated in his affective ambivalence toward
his young patient, suggesting the text positions him, too, as a traumatized subject.
Trauma carries a host of theoretical traditions and associations in contempo-
rary culture, which is one reason to focus on a particular tradition, in addition to
Williams’s likely familiarity with it. Beyond the Pleasure Principle was published
roughly a decade before Williams wrote “The Use of Force” and still serves as a
point of departure for contemporary trauma scholars working at the crossroads of
literature and clinical therapy. According to Bryce Conrad, Williams was familiar
with Freud’s text shortly after it was published. Although Williams’s knowledge of
German was limited, he makes pains to refer to Freud’s text by its original German
title in Voyage to Pagany (151). Moreover, some years ago Robert Gorham Davis
noticed striking parallels between Williams’s story and Freud’s first dream analysis
in The Interpretation of Dreams, the “Dream of July, 23rd-24th, 1895,” or simply
Freud’s “Irma Dream.” In each narrative, a physician encounters resistance while
attempting to examine a young woman’s throat, but with perseverance he eventu-
ally obtains a positive diagnosis. The little girl in Williams’s story virtually shares
the same name as one of the real-life young women who Freud believes the in-
fected girl represents: Freud’s daughter Matilda, who nearly died of diphtheria like
Williams’s fictional Mathilda (Davis 9).
It seems difficult to contest that the similarities Davis observes in Freud’s and
Williams’s texts are coincidental; but even if they were, Williams could have been
inspired to write a story about an aggressive throat inspection from another text by
Freud. Beyond the Pleasure Principle’s primary aim is to identify the limit of the
pleasure principle in the functioning of the ego. The ego’s seemingly rare compul-
sion to relive painful experiences is actually common enough, upon closer in-
spection by Freud, to warrant a competing operative principle: the death drive.
Freud handles this change from anomaly to normality by substituting violent ex-
 164 William Carlos Williams Review

amples of traumas for increasingly trivial scenarios. After alluding to the “terrible
war” that “gave rise to a great number of illnesses of this kind” (18: 12), he shifts
to the domestic sphere of children who encounter traumas almost on a daily basis
when their mothers leave the house. It is here readers find the well-known case of
Freud’s grandson who copes with his mother’s absence by inventing his fort/da, or
gone/found, charade (18: 15–16). Seemingly in order to avoid misleading his
reader by relying too heavily on an illustration of trauma that also involves loss
and absence, Freud gives one more example of a traumatic situation. Significantly,
it is presented to sound even more mundane than the previous one: “If the doctor
looks down a child’s throat or carries out some small operation on him, we may
be quite sure that these frightening experiences will be the subject of the next
game” (18: 16). Freud here gives a distinctly therapeutic value to later repetitions
following a traumatic occurrence, again with reference to children’s play. In re-
staging the doctor’s unfamiliar operation, the child presumably learns how to do-
mesticate the new experience and so relive it in a safe, self-controlled environment.
It seems quite appropriate, then, to use Beyond the Pleasure Principle while
exploring Williams’s engagement with a similar traumatic episode in “The Use of
Force.” Remaining with Freud’s scenario of a throat inspection, however, it is im-
portant to underscore the weight that he places on this example in the context of
his overall argument. The doctor’s examination is not traumatic simply because it
is “frightening,” but rather because it represents an invasion from the standpoint
of the ego. As Freud continues: “We describe as ‘traumatic’ any excitations from
outside which are powerful enough to break through the [ego’s] protective shield.
It seems to be that the concept of trauma necessarily implies a connection of this
kind with a breach in an otherwise efficacious barrier against stimuli” (18: 29).
This is the first stage in Freud’s model of trauma, which provides perhaps another
way of considering the forced ingress of Williams’s doctor into his patient’s mouth.
Invasion and penetration carry double meanings, not only suggesting sexual pen-
etration but already enacting a psychological assault with harmful consequences.
The main point is that Williams had reason to associate penetration or bodily in-
vasion with the notion of trauma, in addition to whatever else he had surmised
from Freud’s reputation.
We might consider, then, the doctor’s house call in the story as the making of
a trauma whose later repetitions in the young girl’s imagination are not available
to readers, as Williams limits the narrative perspective to the doctor—the initial
trauma’s perpetrator. We can thus frame the relationship between the doctor and
his patient under a broad thematic of invasion, which is at play on a number of
levels in the text, above and beyond the obvious forced entrance into Mathilda’s
 moore — Trauma and “The Use of Force” 165

mouth. References to the doctor’s foreign presence and the protective measures of
Mathilda and her parents are as plentiful as references to the erotic overtones of
the operation. The dynamic between the doctor and the Olson family is repre-
sented as a kind of compromised entry from the outset. The young girl’s mother
admits the doctor into the house with minimum encouragement—“When I ar-
rived I was met by the mother . . . who merely said, Is this the doctor? and let me
in” (FD 131)—and solely on the grounds of his professional title. The mother’s
possible wariness is understandable in light of the narrator’s comment in the
opening paragraph that they are all strangers to one another (131). Since the child
is ill, her parents keep her in the “back” of the house “in the kitchen where it is
warm” (131); the mother carefully explains all of these details and apologizes for
the circumstances, as if to account for the unusual intimacy. Once in the kitchen,
the doctor’s remarks on the family’s caginess around him: “I could see that they
were all very nervous, eyeing me up and down distrustfully. As often, in such
cases, they weren’t telling me more than they had to, it was up to me to tell them;
that’s why they were spending three dollars on me” (131). The narrator character-
izes the doctor-patient relationship as an unavoidable apposition of wills; he in-
troduces (foresees?) potential conflict between the family’s resistance to voluntary
disclosure and his professional obligation to interrogate further—in this case, to
see more.
Terence Diggory rightly observes how much of the conflict in the story re-
volves around sight. “The ensuing battle between patient and doctor unfolds as a
battle over the eyes,” he writes (57). Diggory accounts for the doctor’s response to
Mathilda’s gaze (“The child was fairly eating me up with her cold, steady eyes”
[FD 131]) and his subsequent frustration with the operation in terms of psycho-
sexual male anxieties about the phallic mother, which Diggory finds elsewhere in
Williams (Diggory 53, 57–58). The “Beautiful thing!” in Paterson, Book III, who
represents “defiance of authority” similarly challenges the male speaker’s power
over his female patient (P 119). Unclothed, she exposes his “desire” rather than
his “medical knowledge” (Diggory 53). At the same time, the doctor in “The Use
of Force” irks too under the eyes of the parents, and his own looks are portrayed
as a form of violence in the story’s syntax. During the dialogue between the doc-
tor and the parents, look becomes the redundant operative. It appears eight times
in the course of the discussion and always in reference to the doctor’s task of ex-
amining Mathilda’s throat, until the doctor becomes enraged by her opposition
(after she “claw[s] instinctively for [his] eyes” [132]) and uses the word in its last
appearance as an invective: “Look here, I said to the child, we’re going to look at
your throat” (133). Looking at, and into, another becomes synonymous with ag-
 166 William Carlos Williams Review

gression, and tellingly so at the pivotal moment in the doctor’s exam. As he goes
on to report, this is when “the battle began” (133) to force rather than coax his
entry into the young girl’s mouth.
Until the doctor arrives, Mathilda has successfully managed to keep her par-
ents from inspecting her diphtheritic tonsils, even though they too suspect the
cause of her complaint (132). In effect, they summon the doctor in order to per-
form an operation that they are unable to carry out. The doctor’s status as a
stranger to Mathilda does not seem conducive to his task, but her parents hope
otherwise. In this light, the doctor’s presence in itself represents a breach or entry,
namely the doctor’s breach into Mathilda’s domestic space and thus her entry into
a social world beyond her parents. The converse of the doctor’s opening remark—
“[t]hey were new patients to me” (131) —is that he is a new adult to the young
girl; unlike her parents who will “release her just at the critical moment” out of
their “dread of hurting her” (133), the doctor restrains himself less for such consid-
erations. His unfamiliarity is why he is required. In addition, the doctor interprets
his presence as an unwanted insertion of himself between the young girl and her
parents on an affective level. “I had already fallen in love with the savage brat, the
parents were contemptible to me,” he tells us while standing between Mathilda
and her mother (133). His disruption of the parent-child triangle seems to consti-
tute a structural trauma within the Olson family. The doctor’s visit carries the over-
tones of a trauma for Mathilda not only in terms of how he performs the diagnosis,
but as his intervention breaches her until now safe, domestic sphere. To put it
baldly, the whole thing is traumatic for her.
The above is not to submit a defence of the doctor, even though the story does
hint at his mere representative function; it suggests how Mathilda’s socialization,
and health, necessitate, in a very Foucauldian manner, her subjection to an agent
of the medical profession. Recent discussions of the story have focused much on
either defending or critiquing the doctor-narrator. They measure his exercise of
force alongside medical codes of preventing harm during the provision of care,
questioning to what degree and on what grounds his actions are condemnable or
defendable. John Woodcock evaluates the doctor poorly: he exceeds the neces-
sary means to obtaining his diagnosis and fails to walk away (“Perhaps I should
have desisted and come back in an hour or more. No doubt it would have been
better” [134]) in order to allow himself and his patient to calm (158). Alterna-
tively, Brian Bremen offers a defence of the doctor on the grounds that he success-
fully establishes an empathetic relationship with his patient despite as well as
through their conflict (89–101). I wish to broaden the terminology used to discuss
and engage with Mathilda’s victimhood. Moving beyond the professional-ethical
debate means taking into account what exactly is invested in both the doctor’s
 moore — Trauma and “The Use of Force” 167

and Mathilda’s experiences. These questions are complicated by the fact that the
entire sequence of events is available to readers exclusively through the doctor’s
hindsight perspective.
Before considering the text’s narrative organization and its representation of
traumatic memory, I want to consider an important thematic in trauma studies
that also arises in “The Use of Force.” As Cathy Caruth explains in reference to the
story of Tancred and Clorinda in Jerusalem Delivered, to which Freud also refers
in Beyond the Pleasure Principle (18: 22), the “infliction of the injury and its inad-
vertent and unwished-for repetition” does not alone signify trauma; rather, it is
“the moving and sorrowful voice that cries out, a voice that is paradoxically re-
leased through the wound” (2, original emphasis). Caruth’s point is that the
wound of a traumatic event remains unknown when it first occurs. Trauma survi-
vors and witnesses only come to know and grapple with it through acts of remem-
bering, a process often figured through the voice of the injured. This trope of
trauma witnessing is what leads Shoshana Felman to write: “the event [of trauma]
is witnessed insofar as it is not experienced, insofar as it is literally missed” (168,
original emphasis). It is not surprising of course that the young girl in Williams’s
story rarely speaks, anxious as she is to bar the doctor’s tongue depressor. There is
only one exception to her silence. When the doctor begins to exercise more force,
and just when he tells Mathilda’s father to place her just so and “hold both her
wrists” (FD 133), Mathilda risks opening her mouth so as to voice her protest:

But as soon as he did the child let out a scream. Don’t, you’re hurt-
ing me. Let go of my hands. Let them go I tell you. Then she shrieked
terrifyingly, hysterically. Stop it! Stop it! You’re killing me!
Do you think she can stand it, doctor! said the mother.
You get out, said the husband to his wife. Do you want her to die of
diphtheria?
Come on now, hold her, I said. (134)

Mathilda’s protests are unsuccessful; her voice effectively goes unheard as

none of the adults respond to her cries. The drama of the situation not only in-
volves injury and an unheard voice, coinciding with some observations of trauma
theory. The predicament that the Olson parents and the doctor encounter is the
predicament Caruth and Felman see as central to trauma’s genesis: during a hurt-
ful act, the voice of the injured party goes unheard and so can only be responded
to after the fact—through repetition and re-telling.
I now wish to explore the narrator’s re-telling of the house call as a narrative in
the mode of traumatic witnessing. Of all the elements in the story, the narrative
 168 William Carlos Williams Review

perspective is least accounted for in criticism. It rarely emerges in either the early
psychoanalytic or later medical readings as integral to the story’s proper action, or
to a complete characterization of the doctor. Dietrich briefly draws attention near
the end of his essay to the doctor-narrator’s hindsight “ironic eye” (450), and Bre-
men shows how the perspective in this short story is best understood in terms of
Williams’s practice as physician—as a “‘diagnostic treatment’ of an act of diagno-
sis” (100). To return again to Bremen’s comment, it elegantly captures the self-
analysis at play in the doctor’s narration. It alerts readers to the intricate manner in
which the story turns the act of diagnosis on its head and places the physician, as
it were, on the examining table. Certainly, the doctor’s re-telling of the visit brings
a microscope to bear upon his own affective impulses, much more so than on
those of his “hysterical” patient. “The damned little brat must be protected against
her own idiocy, one says to one’s self at such times,” he says, bringing his motiva-
tions to the forefront of the reader’s attention: “all these things are true. But a blind
fury, a feeling of adult shame, bred of a longing for muscular release are the op-
eratives” (FD 134–35). The doctor’s assessment of his diagnosis seems a little more
searching than Bremen’s comment suggests. Bremen’s précis of the doctor’s self-
analysis arrives at a rather tautological explanation that leaves the “operatives”
that the doctor so fervently tries to name unstated. These operatives are central to
the doctor’s self-examination in retrospect and counter attempts to read the story
as a confessional narrative. The strange nature of the doctor’s motivations, he
notes, is their proclivity to be overlooked in the moment. They become conscious
material only through the narrative process, thus complicating the opposition be-
tween veiling and revealing in confessional discourse.
In this sense, the doctor’s affective experience occupies a central place in the
traumatic memory shaping the narrative. The affective “operatives” named by the
doctor—fury, shame, and “a longing for muscular release” —become known as
such only after the fact. Dori Laub describes such retrospective “cognizance” as
the process whereby victims and witnesses come to understand, and so begin to
work through, traumatic events:

The trauma—as a known event and not simply an overwhelming

shock—has not been truly witnessed yet, not been taken cognizance of.
The emergence of the narrative which is being listened to—and heard—
is, therefore, the process and the place wherein the cognizance, the
‘knowing’ of the event is given birth to. (57)

Like Caruth, Laub develops her notion of trauma’s retrospective epistemology

from Freud’s emphasis on rehearsal and repetition. After he postulates that the vi-
 moore — Trauma and “The Use of Force” 169

olence of a trauma for the ego involves a breach of some kind, Freud suggests that
the impetus behind the tendency to revisit such unpleasant experiences is essen-
tially therapeutic: “These dreams [and therapy sessions] are endeavouring to mas-
ter the stimulus retrospectively, by developing the anxiety whose omission was
the cause of the traumatic neurosis” (18: 32). Anxiety designates the state of ap-
prehension, the subject’s experience of coming under assault from without, de-
spite the fact that the cause of anxiety is “unknown” (18: 12). The object that
instigated the trauma, Freud goes on to propose, is re-inserted or reconstructed
through the process of remembering (18: 32).
Freud’s portrait of the traumatized subject as attempting to re-master the expe-
rience after it occurred suits the doctor’s fraught place within the traumatic se-
quence of events well, perhaps better than Laub’s notion of retrospective general
knowing. The doctor’s loss of control over his patient, his diagnosis, and his pro-
fessional demeanour continues to haunt him long after the experience. He now
goes over it again, step-by-step. The act of lending his affective experience order
and causality through narrative suggests an attempt to regain control over his
“blind fury” in the moment. In this light, a crucial element of the traumatic experi-
ence that the doctor’s narrative tries to comprehend and come to terms with is his
own loss of control.
Reading the doctor as in some sense a traumatic victim of his use of force, too,
allows us to notice how his affective responses during the house call comprise
much of the material that he tries to work through by narrating the event. The
opening sentence of the story, “[t]hey were new patients to me, all I had was the
name, Olson” (131), suggests a fracture located in the effort of remembering. Wil-
liam Baker points out how the punctuation is slightly distorted here, unlike the
narrator’s voice elsewhere (7). Indeed, the narration is structurally fragmented
throughout the story. At times the narrator recounts the sequence of events chron-
ologically (“When I arrived I was met by the mother . . .”) while at others intruding
from the narrative present to address his implied reader (“Perhaps I should have
desisted and come back in an hour . . .”). In his initial description of the young
girl, the two perspectives are difficult to distinguish:

She did not move and seemed, inwardly, quiet; an usually attractive lit-
tle thing, and as strong as a heifer in appearance. But her face was
flushed, she was breathing rapidly, and I realized that she had a high
fever. She had magnificent blonde hair, in profusion. One of those pic-
ture children often reproduced in advertising leaflets and the photogra-
vure sections of the Sunday papers. (131)
 170 William Carlos Williams Review

Interestingly, the narrator gives his main attention to the girl’s appearance apart
from her illness. His recognition of her symptoms interrupts his admiring descrip-
tion, and then continues. Dietrich underscores the sexual overtones of the narra-
tor’s language here, the young girl’s “flushed” face and quickened “breathing”
(449), even though these details seem the least evocative; the narrator is momen-
tarily reminded of the gravity of the girl’s condition. That his portrayal of the young
girl is once-removed from the original encounter, a reconstruction from his mem-
ory, is suggested by the reference to “reproduced” images.
The doctor-narrator deploys a range of comparisons for his patient during his
mnemonic rehearsal of the disturbing house call. He thus recalls the speaker in
William’s poem “The Young Housewife” who submits his own gaze at a woman to
critique, inviting readers to question the metaphors he would apply to her body.
This self-reflexive objectification crafts the doctor’s portrayal of the young girl too,
alerting us to how his images of her are inseparable from his affective responses:
when he sees her sitting quietly on her father’s lap, he says that she is “as strong as
a heifer” (131); when she knocks off his glasses, he calls her “cat-like” in the way
she “claw[s] instinctively” for his eyes (132); when she continues to resist him and
fails to heed her parents, she becomes a “savage brat” (133). The vicissitudes of
the doctor’s feelings toward, and for, his patient shape his changing representa-
tions of her. Indeed, when he completes his exam by confirming the presence of
a diphtheria infection, he drops analogy altogether, de-investing himself from his
patient, and simply states: “Now truly she was furious” (135, original emphasis).
The doctor’s affectively inscribed language and his factual pronouncement at the
end convey the same distinction in traumatic witnessing that Slavoj Zizek makes
between truth and truthfulness. An account of a traumatic event, he writes, is of-
ten perceived as truthful due to “its very factual unreliability, its confusion, its in-
consistency” (4). He continues: “the very factual deficiencies of the traumatized
subject’s report on her experience bear witness to the truthfulness of her report,
since they signal that the reported content ‘contaminated’ the manner of reporting
it” (4). In general, the doctor’s movement from figurative to concrete description
suggests a working-through process. He moves from an experiential “truthfulness”
about his experiences, the ways that they craft his affective responses, toward a
more objectively reliable reportage.
However, one of the narrator’s least reliable statements suggests how his expe-
rience in the Olson’s house perhaps remains incompletely worked through, even
in his re-telling. When the narrator catches his first glimpse of Mathilda, sitting
between her parents, he says that she “was fairly eating me up with her cold,
steady eyes” (131). As the paragraph read in its entirety makes plain (cited above),
the doctor obviously sees his patient through the lens of projection. His own ad-
 moore — Trauma and “The Use of Force” 171

miring gaze follows this statement, where he remarks on her “magnificent blonde
hair” and how she looked like such an “attractive little thing.” Certainly he is
“fairly eating” her up with his gaze. At this stage, the narrative places the young
girl in the position of the object of anxiety around which the doctor-narrator’s
trauma testimony revolves. Indeed, his suggestive phrasing only seems to make
sense applied to the prepubescent patient in terms of Diggory’s reading of the
doctor’s castration anxieties, whereby he casts his patient in the menacing role of
phallic mother. This reading gains strength near the climax of the forceful exam
when Mathilda crushes the doctor’s tongue depressor in her mouth: “she reduced
it to splinters before I could get it out again” (134). Interestingly, Diggory does not
pick up on the most transparent symbolic cue in the text for his Freudian interpre-
tation: the destruction of the doctor’s phallic instrument. This violent act imbri-
cates the doctor and his patient in a shared traumatic experience. It represents a
wound (the original meaning of trauma) for both patient and physician: a harm to
the doctor’s symbolized professional self and to the young girl, whose tongue
bleeds as a result of the splintered wood.
The reciprocal fashion of the traumatic wounding ties the doctor to his patient
in ways that complicate placing either under clearly defined ethical positions of
perpetrator or victim. Even as the doctor mobilizes the full force of his profes-
sional obligation and authority (and then some), his young patient capably resists
him (for a while). She defiantly challenges his attempts to exercise force over her
and disrupts his professional resolve, and identity. Mark Faust notes how some
students respond to the young girl in the story not as a victim but as an empower-
ing symbol of resistance against multiple forms of authority embodied by a “grop-
ing doctor” (48). The doctor’s testimony supports such a response in the admiration
he shows his feisty young patient in retrospect. The story thus offers another ex-
ample of how certain modernist texts, according to Julie Taylor, refuse to endorse
a “gendered dichotomy between victim and perpetrator(s)” even while giving tes-
timony to gendered violence and sexual abuse (130). Taylor’s point is quite salient
in the case of Williams’s story. While testifying to a young girl’s traumatic experi-
ence of abusive power, “The Use of Force” anticipates Foucauldian analyses of
how power is wielded rather than possessed. The doctor faces the brunt of his
patient’s force too and loses his control over himself—a form of power that his
status as a medical professional supposedly lends him.
Again, this is not to excuse the doctor so much as point out how the text rep-
resents his sudden loss of self-control as an affective experience that resists full,
adequate account. It is this ambivalence in the doctor’s self-analysis that tends to
get downplayed in recent medical readings of the story. Critics like Fred Griffin
and John Woodcock frame the text as essentially an ethical dilemma that the
 172 William Carlos Williams Review

physician-in-training would do well to work through. Woodcock for instance ti-

tles his essay, “Does Williams’s Doctor Do the Right Thing?” The doctor’s progres-
sion from tentative coaxing to “hot-blooded assault” (161) certainly demonstrates
how healthcare providers will develop affective responses to their patients, which
will shape the nature of the assistance they provide. Feelings toward a patient or a
situation will get ‘in the way.’ The processes underwriting these feelings may place
doctors, and nurses, in positions akin to psychoanalysts, who must diagnose pa-
tients while themselves working through affective complications of transference.
To be sure, such nuances to providing care seem worth exploring as part of a
“medical humanities” training (157). Medical students and young professionals
are obvious candidates—and experts—for considering how the doctor attempts to
balance the medical emergency of the situation with his reaction to his patient’s
resistance. Yet, at least in Woodcock’s case, this pedagogical lens places the em-
phasis on measuring the doctor’s culpability, as opposed to recognizing perhaps
the inescapability of patient-doctor transference. Woodcock encourages students
to notice how the doctor’s “motives” are deeply suspect, “subethical and quasi-
sexual,” and so “obviously inappropriate for a professional” (158). Articulating
these ethical boundaries are useful, for, as Woodcock reports, the majority of his
students read the doctor’s behaviour as completely defensible despite the doctor’s
statements otherwise. (Interestingly, all the male students in Woodcock’s class de-
fended the doctor while the women in the class agreed with Woodcock’s critical
assessment.) Still, it seems equally useful to consider how healthcare providers
cope with challenging situations, even failures in professionalism, after their oc-
currence.
Williams’s story explores the meaning, and potential value as a sort of thera-
peutic exercise, of the doctor’s memory of a diagnosis gone wrong. It suggests
how a medical professional who proceeds with giving treatment despite his pa-
tient’s manifest distress might experience his patient’s alarm, and his own actions,
in the manner of a traumatic event. It thus necessitates working through by delib-
erate re-telling. By remembering, and in a sense ‘restaging’ the event—including
the actions of those around him as well as his own behavior and affective re-
sponse—it becomes material for further exploration and interrogation. Williams’s
doctor overlaps past and present in the narrative apparently for just this reason: to
consciously account for and reclaim (borrowing Caruth’s expression) his trau-
matic experience. His final verdict on his behaviour is delivered in two discrete
accounts, one from his perspective then and one from the narrative present:

The damned little brat must be protected against her own idiocy, one
says to one’s self at such times. Others must be protected against her. It
 moore — Trauma and “The Use of Force” 173

is social necessity. And all these things are true. But a blind fury, a feel-
ing of adult shame, bred of a longing for muscular release are the opera-
tives. One goes on to the end. (134–5)

In the first half of the passage, the narrator presents his rationale in the mo-
ment, ventriloquizing his initial chain of thoughts. The second half offers a re-
vised, still more accurate, account of his actions and affect; he recognizes their
rootedness in affect and bodily experience. In hindsight, the greater “social neces-
sity” of obtaining a diagnosis so as to treat his patient and protect others from her
only supplies the factual truth of the event. Its traumatic truthfulness arises after-
wards by staging the event through narrative.
“The Use of Force” thus undermines the implied insistence of its narrator on
definite categories of illness and health, patient and physician. It submits the pro-
vider of healthcare to “diagnosis” in ways that expose his own subjection to forms
of power inseparable from the delivery of medical treatment. Still, we do well to
keep in mind how the doctor’s position—his responsibilities and knowledge,
along with his authority—is not the same as his patient’s. He concludes by recall-
ing the young girl’s desperate fury after his overpowering use of force: she lashes
out at him while “tears of defeat blind . . . her eyes” (135). Her ire at him prevents
her, too, from fully recognizing what has happened, namely, how her temporary
subjection will lead to her recovery. Of course, in its narrative re-staging of the
doctor’s affective ambivalences, the story interrogates what recovery entails, and
how it might occur. Williams elsewhere makes the distinction between the hy-
pothesis of a perfect, immediate cure and the gradual, maybe less perfect, process
of recovering: “Any worth-his-salt physician knows that no one is ‘cured’. We re-
cover . . . ” (A 286). “The Use of Force” bears out Williams’s belief, for neither
patient nor physician arrive at any obvious cure. Mathilda’s treatment has just
begun, and the conclusion the doctor arrives at generalizes his affective impulses.
It offers a diagnosis (“a longing for muscular release”) but with little certainty that
this provides a concrete preventative strategy for the future. “One goes on to the
end,” he says, anticipating Samuel Beckett’s famous affirmation of modernism’s
surrender to ambiguous closure at the end of The Unnameable.
Trauma is uniquely poised to help readers unpack instances of deferred clo-
sure, recovery, and self-mastery, as I hope to have shown in the case of Williams’s
text. It allows us to bring the confessional guise of the doctor’s narrative into ques-
tion and consider how the story offers, not just a history of the house call, but a
still active engagement with those events in the fashion of traumatic memory.
Further, the plurality of traumas that the doctor’s narrative gives witness to, points
in the direction of observing how literary texts explore the collective nature of
 174 William Carlos Williams Review

traumatic experiences. These may even include remembered experiences that

place a trauma’s perpetrator at the centre of traumatic events in ways that require
serious attention. Doing so enriches the way acts of witnessing and giving testi-
mony can be deployed, and interpreted, for various purposes.

Notes
1. See also Bremen (100) and Crawford (79–80).
2. See Woodcock’s and Griffin’s short essays. Brian A. Bremen notes how Williams’s
story “has become a near-standard text in the field of literature and medicine” (87), appear-
ing in medical pedagogy texts such as Conflict in the Classroom: The Education of Emotion-
ally Disturbed Children (1975) and Textbook of Pediatric Emergency Procedures (1997).

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