The doctor who narrates “The Use of Force” knows that the Olsons, a working-class couple, must fear that their young daughter is quite ill if they are willing to pay the three-dollar fee for his visit. Mathilda Olson is an unusually attractive child who clearly has a high fever, and the doctor sets out in his best professional manner to discover the cause. The unspoken possibility on his mind and on her parents’ is that she might have diphtheria, several cases having been reported at the school the child attends.
The story is based on the simple premise that the doctor must examine Mathilda’s throat and get a throat culture for her own protection and for the protection of others around her. It promises to be an easy enough task. A simple throat examination, however, becomes instead a battle between doctor and child, and William Carlos Williams traces the first-person narrator’s shifting attitude toward the child and the task as the doctor moves well beyond reasoned professionalism to delight in the use of force.
The doctor first tries kindness: “Awe, come on, I coaxed, just open your mouth wide and let me take a look.” In a single catlike movement, the child claws at his eyes and sends his glasses flying. Next, he tries firmness: “Look here, I said to the child, we’re going to look at your throat. You’re old enough to understand what I’m saying. Will you open it by yourself or shall we have to open it for you?” The child refuses, and the battle is on. The doctor has fallen in love with the spirited child by this point and sees her as magnificent in her terror of him. With the father’s help, he manages to get a tongue depressor into Mathilda’s mouth, but she splinters it with her teeth. The doctor sees that it would be best to stop and come back later, but he is beyond reason, and in his fury he asks for a makeshift tongue depressor that she cannot destroy: a spoon. In spite of Mathilda’s bleeding mouth and hysterical shrieks, he persists and finally manages to reveal the secret that she has been hiding for three days: Her tonsils are covered with the membrane that indicates diphtheria.