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BMJ. 2007 March 31; 334(7595): 699.
PMCID: PMC1839234
Medical Classics

The Doctor Stories

Iain McClure, consultant child and adolescent psychiatrist, Vale of Leven Hospital, Alexandria, Scotland

William Carlos Williams (1883-1963) made his living as a doctor and his reputation as a writer. After initial training in New York he worked as a family practitioner in his home town of Rutherford, New Jersey, for 40 years, seeing—in his own estimation—a million and a half patients. His formative working life was spent during the Depression, his patients being mainly blue-collar workers and the unemployed underclass. Many were immigrants who spoke little or no English, and a chronic feature of his consultations was their struggle to pay him even a meagre fee. He worked hard, seeing patients every day and regularly attending calls through the night.

In view of this punishing workload, it seems astounding that Williams produced a canon of writing that leaves him regarded as one of America's foremost poets. In addition, he was a prolific prose writer, and The Doctor Stories, a compilation of short stories and autobiographical essays written between 1932 and 1962, is a compelling testament to his originality and skill, both as writer and doctor.

His subject is his patients and, to a lesser extent, his colleagues and domestic life. So, there are stories about mothers who lose their babies, about a girl with suspected diphtheria who won't let him look down her throat, and about a badly burned workman who needs a sick line to placate his unforgiving boss. The key feature of Williams's prose is its absolute, sometimes brutal, honesty. If he finds his patients (even children) physically attractive, he tells us; if he doesn't like his patients, he explains why. Williams holds nothing back about them, nor little about himself, in his desire, as he puts it, to “penetrate to some moving detail of a life.” These days, the GMC might take issue with a doctor reporting his clinical experience so freely, but a key issue for Williams seems to be deciding which is the over-riding responsibility: of the doctor to his patient, or the artist to his subject? As he states, in an autobiographical chapter: “My business, aside from the mere physical diagnosis, is to make a different sort of diagnosis concerning them as individuals.”

In his prose style, Williams is a modernist, and at first reading his stories seem almost draft in form. On reflection, however, the style is a crucial part of the honesty and testifies to the pressured reality of his life as a doctor-writer. He worked fast. Thus, he writes like an impressionist paints, quickly capturing the essence of a clinical moment. As a result, The Doctor Stories leave images of patients that last forever.


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