The Use of Force Summary

"The Use of Force" is a short story by William Carlos Williams in which a doctor is called to examine Mathilda Olson, who resists his efforts to obtain a throat culture.

  • A doctor is called to the Olson house to examine their young daughter, Mathilda.
  • There has been a diphtheria outbreak at Mathilda's school, and the doctor suspects that Mathilda has contracted the disease.

  • Mathilda refuses to open her mouth for a throat swab. When the doctor's cajoling and stern rebukes fail, he resorts to using force. Mathilda does indeed have diphtheria.

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Last Updated September 5, 2023.


American writer and poet William Carlos Williams’s “The Use of Force” was first published in his 1938 short story collection Life Along the Passaic River. It was later anthologized alongside his other medical fiction in the 1984 collection The Doctor Stories. Williams was a modernist writer who prioritized clear, concise imagery and economy of language. He was strongly influenced by the imagist movement, a literary philosophy that developed in the early twentieth century. Imagists rejected the sentimental, existential approach of the Romantics and instead preferred more straightforward, tangible images and themes. Williams drew inspiration from everyday events and believed that grounding fiction in the realities of life had greater resonance than fantastical inventions. His literary efforts also frequently drew from his experiences as a family physician and pediatrician, leading some to speculate that “The Use of Force” may have autobiographical elements.

Plot Summary

The story begins as the narrator, an unnamed doctor, arrives at the Olson residence for a house call. The Olsons’ young daughter, Mathilda, has a high fever, and her parents want the doctor to examine her. Diphtheria, an infection of the nose and throat, has been making the rounds at Mathilda’s school, and more than one child has died from it. Though the parents have called for the doctor, his presence clearly makes them nervous; they seem to distrust him and are not especially forthcoming.

The doctor finds Mathilda sitting on her father’s lap. Though she’s flushed with a fever and breathing shallowly, the doctor can’t help but take note of her beauty and her “magnificent blonde hair.” He thinks to himself that she’s just the sort of photogenic child who might appear in an advertising leaflet. The parents explain that Mathilda has been running a fever for three days, and nothing they’ve tried has improved her condition. All the while, Mathilda stares at the doctor with “cold, steady eyes,” her face devoid of all expression. 

The doctor begins by asking if Mathilda has a sore throat. The parents say Mathilda denies her throat is sore but admit that they haven’t been able to physically examine inside her mouth to confirm that nothing is wrong. The doctor asks Mathilda to open her mouth so he may examine her throat, but Mathilda continues to stare at him resolutely. The mother insists that the doctor is a “nice man” who won’t “hurt” Mathilda, but this appears to have no effect on her daughter. The doctor is privately annoyed by the mother’s attempt to persuade Mathilda, believing that merely mentioning the word “hurt” is counterproductive in a situation like this. 

As the doctor scoots closer, Mathilda strikes out unexpectedly, knocking his glasses off his face as she tries to claw his eyes. Embarrassed by her wild behavior, the parents apologize profusely, but Mathilda remains uncooperative. The doctor feels strangely drawn in by Mathilda’s stubborn and savage behavior. Feeling that the situation has morphed into a personal battle between him and the child, he resents the parents’ attempts to intercede by cajoling, persuading and even threatening their daughter into compliance. The doctor observes that while Mathilda’s power seems only to increase as her “insane fury” and fear grows, her parents become more feeble and, in his mind, contemptible. 

Determined to make Mathilda surrender, he orders her father to pin her arms while he forces a wooden tongue depressor between her teeth. Mathilda screams that they are hurting her and, wild with rage at being restrained, bites down so hard that she breaks the tongue depressor, causing her mouth to bleed. At this point, the doctor acknowledges that it would probably be best for him to leave and return at a later time when Mathilda has had a chance to calm down. However, fueled by a mixture of frustration and fear for the child’s health—as well his private enjoyment of the struggle—he decides to continue the exam.

As a final measure, he uses a heavy silver spoon to force Mathilda’s jaws open. Finally successful, he triumphantly notes that her tonsils are, indeed, covered with membrane, a clear sign of diphtheria. The doctor reasons that he resorted to using force in order to protect the child and others against the disease. However, he also admits that he “had got beyond reason.” He says, “I could have torn the child apart in my own fury and enjoyed it. It was a pleasure to attack her.” Once her “secret” illness is exposed, Mathilda launches herself at the doctor in a blind fury, enraged at having been defeated in their battle of wills.

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