The Doctor Stories Read online

  THE DOCTOR STORIES

  Compiled with an introduction by Robert Coles, M.D.

  Afterword by William Eric Williams, M.D.

  William Carlos Williams

  A NEW DIRECTIONS BOOK

  Contents

  INTRODUCTION by Robert Coles

  Mind and Body

  Old Doc Rivers

  The Girl with a Pimply Face

  The Use of Force

  A Night in June

  Jean Beicke

  A Face of Stone

  Danse Pseudomacabre

  The Paid Nurse

  Ancient Gentility

  Verbal Transcription: 6 A.M.

  The Insane

  Comedy Entombed: 1930

  The Practice (from The Autobiography)

  POEMS

  The Birth

  Le Médecin Malgré Lui

  Dead Baby

  A Cold Front

  The Poor

  To Close

  AFTERWORD: MY FATHER, THE DOCTOR

  by William Eric Williams

  Introduction

  A GREAT PRIVILEGE (and actually, turn of fate) befell me in the early 1950s, when I was encouraged by a fine professor-friend of mine, under whose supervision I’d written my undergraduate thesis, to send a note to William Carlos Williams and ask him whether he’d mind reading a college student’s effort to understand his poetry, especially the first book of Paterson. This inquiry was not thoroughly gratuitous or self-serving, Professor Perry Miller kept insisting—a response to my fearful hesitancy, an attitude which surely (I now realize) protected me from realizing how much of my pride, if not (as today’s psychiatrists call it) narcissism had been put into that research and writing effort. This particular poet, Mr. Miller reminded me several times, was hardly a favorite of many college professors, and might well enjoy reading what a student writing in an ivy-covered dormitory library managed to say about Paterson, wherein no huge flowering of ivy is recorded.

  Soon enough, I’d dispatched my essay, and received a warm, friendly and lively response to it, coupled with an invitation to drop by; and soon enough I did. For me, to know Dr. Williams, to hear him talk about his writing and his life of medical work among the poor and working people of northern New Jersey, was to change direction markedly. Once headed for teaching, I set my sights for medical school. The result was a fairly rough time with both the pre-medical courses, not easy for me, and medical school itself, where I had a lot of trouble figuring out what kind of doctoring I’d be able to do with a modest amount of competence. During those years, ailing though Dr. Williams was, he found the time and energy to give me several much needed boosts—as in this comment: “Look, you’re not out on a four-year picnic at that medical school, so stop talking like a disappointed lover. You signed up for a spell of training and they’re dishing it out to you, and all you can do is take everything they’ve got, everything they hand to you, and tell yourself how lucky you are to be on the receiving end—so you can be a doctor, and that’s no bad price to pay for the worry, the exhaustion.”

  Anyone who knew him would recognize the familiar way of putting things, of approaching both another person and this life’s hurdles: kind and understanding underneath, but bluntly practical and unsentimental. Not that Williams didn’t have in him (and in his writing) a wonderful romanticism, an ardently subjective willingness to take big risks with his mind and heart. His greatest achievement, Paterson, is a lyrical examination of a given city’s social history, from the early days of this country to the middle of the twentieth century—and the poet whose eyes and ears become the reader’s is mar-vellously vibrant, daring. But there is also in that poem, and in other aspects of Williams’ work a sensible and skeptical voice—the side of Williams these stories reveal to us: a hard working doctor whose flights of fancy are always being curbed by a sharp awareness of exactly what life demands as well as offers.

  I will never forget an exchange I had with Williams when I was in my last year of medical school. He had been sick rather a lot by then, but his feisty spirit was still in evidence, and as well, his canny ability to appraise a situation—anyone or anything—quickly and accurately. I told him I wanted to take a residency in pediatrics. He said “fine,” then looked right into my eyes and addressed me this way: “I know you’ll like the kids. They’ll keep your spirits high. But can you go after them—grab them and hold them down and stick needles in them and be deaf to their noise?” Oh yes, I could do that. Well, he wasn’t so sure. Mind you, he wasn’t being rudely personal with me. He was just talking as the old man he was, who had seen a lot of patients, and yes, a lot of doctors, too. “Give yourself more time,” he urged me, in conclusion. Then he regaled me with some (literally speaking) “doctor stories”—accounts of various colleagues of his: how they did their various jobs; the joys some of them constantly experienced, or alas, the serious troubles a number of them had struggled to overcome; the satisfactions of x, y, z specialties, and conversely, the limitations of those same specialties. It was a discourse, a grand tour of sorts, and I remember to this day the contours of that lively exchange. I told my advisor at medical school about the meeting, and I can still recall those words, too: “You’re lucky to know him.”

  We are all lucky to know him, to have him in our continuing midst. Only in those last years of his life was William Carlos Williams, finally, obtaining the recognition he’d failed to receive for many decades of a brilliantly original, productive literary life. But during that early spell of relative critical neglect (or outright dismissal, or patronizing half-notice) this particular writer could rely upon other sources of approval. Every day of a long medical life (and often enough, in the middle of the night, too) he was called by the men, women and children of northern New Jersey, ordinary people, plain people who considered themselves lucky to hold a job, lucky to be able to get by, barely, or not so lucky, because jobless—families who had one very important loyalty in common, no matter their backgrounds, and they were ethnically diverse: a willingness, an eagerness, a downright determination to consider one Rutherford doctor their doctor, W. C. Williams, M.D. We who think of poets often look wide and far for their spiritual roots, their cultural moorings. William Carlos Williams was one poet who made quite clear who his teachers were, where they lived, how they affected him, helped shape his particular sensibility: “Yet there is/ no return: rolling up out of chaos,/ a nine months’ wonder, the city/ the man, an identity—it can’t be/ otherwise—an/ interpenetration, both ways.”

  The city was, of course, Paterson, the Paterson of Paterson, the Paterson of industrial strife, of smokestacks and foundries and assembly lines, the Paterson of foreign languages still native tongues, of Italians and Jews and Poles and the Irish and the Blacks, the Paterson of desperately poor people in the 1930s, part of that enormous nation within a nation characterized by Franklin Delano Roosevelt in 1933 as “ill-fed, ill-housed and ill-clothed.” As the poet of Paterson declared, he had struggled himself in that city of hard-pressed souls, and so doing, had become very much part of a given human scene—not only the lyric observer or prophet, as in Paterson of five epic volumes, but also the obstetrician and gynecologist, the school doctor, the pediatrician, the general practitioner: the young doc and the middle-aged doc and the old doc who drove all over and walked all over and climbed steps all over Paterson (and Rutherford and other New Jersey towns), a family legend to hundreds and hundreds rather than a literary giant (eventually) to hundreds and hundreds of thousands.

  “Outside/ outside myself/ there is a world,” the poet of Paterson declares himself to have “rumbled,” and then notes that such a world was “subject” to
his “incursions,” and was one he made it his business to “approach concretely.” No question he did, with all the directness, earthiness, and urgent immediacy of a doctor who knows life itself to be at stake—someone else’s, and in a way (professional, moral) his own as well. I remember the doctor describing his work, telling stories that were real events, wondering in retrospect how he did it, kept going at such a pace, hauled himself so many miles a day, got himself up so many stairs, persisted so long and hard with families who had trouble, often enough, using English, never mind paying their bills. And as he knew, and sometimes had to say out loud, even mention in his writing, it wasn’t as if he was loaded with money, or a writer who took in big royalties.

  America’s Depression was a disaster for Dr. Williams’ patients, and many of them never paid him much, if indeed, anything at all. America’s Depression was also a time when a marvelously versatile, knowing, and gifted writer who happened to be a full-time doctor was not having any great success with critics, especially the powerful ones who claimed for themselves the imprimatur of the academy. No wonder this writing doctor was glad to go “outside” himself, greet and try to comprehend a world other than that of literary people. No wonder, too, he shunned the possibility of a relatively plush Manhattan practice—the doctor to well-known cultural figures. His patients may have been obscure, down and out, even illiterate by the formal testing standards of one or another school system, but they were, he had figured out early on, a splendidly vital people—full of important experiences to tell, memories to recall, ideas to try on their most respected of visitors, the busy doc who yet could be spellbound by what he chanced to hear, and knew to keep in mind at night when the typewriter replaced the stethoscope as his major professional instrument.

  I remember asking Williams the usual, dreary question—one I hadn’t stopped to realize he’d been asked a million or so times before: how did he do it, manage two full-time careers so well and for so long? His answer was quickly forthcoming, and rendered with remarkable tact and patience, given the provocation: “It’s no strain. In fact, the one [medicine] nourishes the other [writing], even if at times I’ve groaned to the contrary.” If he had sometimes complained that he felt drained, overworked, denied the writing time he craved, needed, he would not forget for long all the sustaining, healing, inspiring moments a profession—a calling, maybe, it was in his life—had given him: moment upon moment in the course of more than four decades of medical work.

  Such moments are the stuff of these “doctor stories”—the best of their kind since Dr. Anton Chekhov did his (late nineteenth-century) storytelling. As one goes through Williams’ evocation of a twentieth-century American medical practice, the sheer daring of the literary effort soon enough comes to mind—the nerve he had to say what he says. These are brief talks, or accounts meant to register disappointment, frustration, confusion, perplexity; or, of course, enchantment, pleasure, excitement, strange or surprising or simple and not at all surprising satisfaction. These are stories that tell of mistakes, of errors of judgment; and as well, of one modest breakthrough, then another—not in research efforts of major clinical projects, but in that most important of all situations, the would-be healer face-to-face with the sufferer who half desires, half dreads the stranger’s medical help. As I heard Dr. Williams once say: “Even when the patients knew me well, and trusted me a lot, I could sense their fear, their skepticism. And why not? I could sense my own worries, my own doubts!”

  He has the courage to share in these stories such raw and usually unacknowledged turmoil with his readers—even as he took after himself in an almost Augustinian kind of self-scrutiny toward the end of the second book of Paterson. In almost every story the doctor is challenged not only by his old, familiar antagonist, disease, but that other foe whose continuing power is a given for all of us—pride in all its forms, disguises, assertions. It is this “unreflecting egoism,” as George Eliot called it, which the doctor-narrator of these stories allows us to see, and so doing, naturally, we are nudged closer to ourselves. Narcissism, as we of this era have learned to call the sin of pride, knows no barriers of race or class—of occupation or profession, either. But as ministers and doctors occasionally realize, there is a sad, inevitable irony at work in their lives—the preacher flawed in precisely the respect he denounces during his sermons, the doctor ailing even as he tries to heal others.

  Williams knew the special weakness we all have for those who have a moral hold on us, for those who attend us in our life-and-death times. Williams knew, too, that such a vulnerability prompts gullibility, an abject surrender of one’s personal authority—and the result is not only the jeopardy of the parishioner or the patient, but the priest or the physician. Arrogance is the other side of eager acquiescence. Presumptuousness and self-importance are the wounds this life imposes upon those privy to the wounds of others. The busy, capable doctor, well aware of all the burdens he must carry, and not in the least inclined to shirk his duties, may stumble badly in those small moral moments that constantly press upon him or her—the nature of a hello or good-bye, the tone of voice as a question is asked or answered, the private thoughts one has, and the effect they have on our face, our hands as they do their work, our posture, our gait. “There’s nothing like a difficult patient to show us ourselves,” Williams once said to a medical student, and then he expanded the observation further: “I would learn so much on my rounds, or making home visits. At times I felt like a thief because I heard words, lines, saw people and places—and used it all in my writing. I guess I’ve told people that, and no one’s so surprised! There was something deeper going on, though—the force of all those encounters. I was put off guard again and again, and the result was—well, a descent into myself.”

  He laughed as he said that, and worried about a comparison he nevertheless proceeded to make—with the achievement of “insight” in psychoanalysis. I say “worried” because he knew rather well that he had in mind a moral as well as psychological or emotional confrontation, and he’d been hearing a lot in those last years of his life (to his amazement and chagrin) about a supposedly “value-free” psychoanalysis or social science. Not that he couldn’t put aside his anger and disgust and simply laugh at his own pretensions and spells of blindness, at those of others. These stories abound with such self-mocking gestures—parody turned on the parodist, words used to take the stern (but also compassionate) measure of the doctor who dispensed (among other things) words, and then went home to dish them out—well, “in the American grain.” It is important to emphasize the humorous and tolerant side of this storytelling self-arraignment of a singular New Jersey doctor: even the terribly hurt, driven, melancholy “Old Doc Rivers” is not without his spirited decency—a dizzying mix of selfless honor, passionate concern, and alas, the unrestrained demonic constantly at work.

  These stories are, really, frank confidences extended to the rest of us by one especially knowing, dedicated physician who was willing to use his magical gifts of storytelling in a gesture of—what? We all require forgiveness, and we all hope to redeem our own missteps—hope, through whatever grace is granted us, to make every possible reparation. Words were the instrument of grace given to this one doctor, and words are the instrument of grace, also, for the rest of us, the readers who have and will come upon these marvelously provocative tales. As Dr. Williams’ beloved wife Flossie (she appears now and then in these medical fictions) once said to me: “There’s little in a doctor’s life Bill didn’t get at when he wrote.” She’d been there with him, of course, all along, and she knew: the periods of irritability and impatience; the flashes of annoyance and resentment; the instance of greed, or just plain bitterness that “they” can’t, don’t, won’t pay up; the surge of affection—even desire, lust; the assertion of power—a fierce wish to control, to tell in no uncertain terms, to win at all costs; the tiredness, the exhaustion, the despondency. The rush of it all, the fast-paced struggle, again and again, with all sorts of illnesses—and the vict
ories over them, the defeats at their hands, and not least, the realization (postmortem) of one’s limitations, one’s mistakes.

  For years I have been teaching these doctor stories to medical students, and during each class we all seem newly awakened—encouraged to ask the important whys, consider the perplexing ifs. The stories offer medical students and their teachers an opportunity to discuss the big things, so to speak, of the physician’s life—the great unmentionables that are, yet, everyday aspects of doctoring: the prejudices we feel (and feel ashamed of), the moments of spite or malice we try to overlook, the ever loaded question of money, a matter few of us like to discuss, yet one constantly stirring us to pleasure, to bedeviling disappointment in others, in ourselves. What, in fact, that is really important has Williams left out? Nothing, it seems. He gives us a chance to discuss the alcoholic doctor, the suicidal doctor. He prompts us to examine our ambitions, our motives, our aspirations, our purposes, our worrying lapses, our grave errors, our overall worth. He gives us permission to bare our souls, to be candidly introspective, but not least, to smile at ourselves, to be grateful for the continuing opportunity we have to make recompense for our failures of omission or commission.

  He extends to us, really, moments of a doctor’s self-recognition—rendered in such a way that the particular becomes the universal, and the instantly recognizable: the function, the great advantage of all first-rate art. And not to be forgotten in this age of glib, overwrought formulations, of theories and more theories, of conceptualizations meant to explain (and explain away) anything and everything, he brings to us ironies, paradoxes, inconsistencies, contradictions—the small vignette which opens up a world of pleasurable, startling, or forbidden mystery. Doc Williams becomes William Carlos Williams the accomplished fabulist, anecdotist—and as well, the medical and social historian who takes the risks of autobiography. There were poems similarly harnessed, intended, and even journal entries, as in this wonderful statement found in the “little red notebook” Williams the Rutherford School Physician kept in 1914: