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Hello! Both 'The Use of Force' (by William Carlos Williams) and 'The Steel Windpipe' (by Mikhail Bulgakov) are short doctor stories about the trials of dealing with young patients and their anxious relatives.
In the stories, both doctors are faced with a very sick, young child. The little girl in 'The Use Of Force' has had a sore throat for three days, but she hides this fact from her parents because she is afraid of the doctor. In this story, the doctor starts out by coaxing the little girl to open her mouth so that he can examine her throat for evidence of diphteria. She is uncooperative. The doctor tries a wooden tongue depressor to get her to open her mouth, but this method fails when she fiercely bites down on the depressor, wounding herself in the process. In the end, he uses a spoon to pry her mouth open forcefully. He is ashamed of having to use brute force, but rationalizes that he has seen 'at least two children lying dead in bed of neglect in such cases...' and that he is just doing what he needs to, for her own good. He is embarrassed at his loss of control, but tells himself that
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 is a social necessity.
His experience illustrates how easily the stress of a situation can devolve into chaos and anxiety if not properly handled. The doctor did not put his patient at ease. Instead, he expected her to comply with his instructions without first establishing a necessary rapport.
In 'The Steel Windpipe,' the doctor has to contend with an anxious mother and a meddling grandmother. He warns that the child will die from diphteria if he is not allowed to operate on the child. He is calm, but firm, and he will brook no hysterics. Sometimes he tells the grandmother to be quiet, and is merciless in his response to her needling, but he never uses brute force. One of the midwives firmly pushes the grandmother out of the operating room. The doctor despairs of ever finding the girl's windpipe as he performs the operation, and he wonders why he ever chose to study medicine. However, he stays calm and receives a fresh wave of courage when he remembers the pleading eyes of the mother. Despite his personal fears regarding his adequacy as a newly practicing doctor, he betrays none of his anxieties to his staff, the patient, and the patient's relatives. In this way, he increases the trust of his staff and his patients in his skills. His level of professionalism is contrasted with that of the first doctor in 'The Use Of Force.' Diligent and prompt action combined with professional composure is essential to excellent patient care.
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