The Doctor Stories

by William Carlos Williams

  Watch your head on these stairs, said the man ahead of me.

  Hello Doc, said a boy of about ten coming to my side at the moment. What you here for?

  Well, Sonny, why aren’t you in school?

  I got to stay home and take care of my mother.

  Isn’t your father here?

  Yeah, he’s here now. He kept woggling his head, looking down at the floor then up at me with a silly sly expression to his face, swinging his arms around the while as if it might be a clown imitating a monkey. I took up my satchel and leaving him started to climb the stairs, remembering just in time to bow my head so as not to hit the back of the opening above. All short people in this house, I could see that.

  At the top of the steep stairway, which merely went up from a corner of the kitchen through the ceiling and landed you in the middle of the bedroom above—I came out between two large iron double beds standing there as if they had been two boats floating in a small docking space, no carpet, no other furniture. Seeing no one I went through the only door to the other room, at the back. These two rooms comprised the whole upstairs.

  Here y’are, Doc.

  There she lay, in another double iron bed backed against a window. She seemed quite comfortable and rather amused at that. You could see her form, not unattractive, under the old quilt and above it on the pillow a blonde head with a somewhat scarred pointed face. A young woman, Polish in appearance, looking at me, half-smiling.

  Well, what’s going on?

  She’s having a lot of pain, Doc. She was five months along and scalded herself on Sunday pretty bad. The pains started yesterday morning.

  Here it comes again! she said as we men stood like a couple of goofs watching her while her face got red and she gritted her teeth and closed her eyes tight for a moment or two.

  How often do they come? I asked her after she had relaxed again.

  Oh, every few minutes. They’re not so bad. But he, indicating her husband, thought he’d better get somebody. We don’t know what it is.

  You know what it is, I said.

  Yeah, I suppose so. But what’s this I got here? She put her hand to her lower abdomen. I thought it might be a tumor or something.

  Let’s see. Why, that’s just the womb. You know, I said.

  I don’t know nothin’, she came back at me. Anyhow I wanted you to see it. Then she looked at me with a half smile on her face. You don’t recognize me, do you?

  No.

  You brought one of the children, the first one, ten years ago when we were living down at the Hill.

  You don’t mean it.

  Sure. Don’t you remember? Naw, you don’t remember. When do you think it’ll come, this one, I mean?

  I didn’t want to bother you, Doc, broke in the man. I’m used to these things but it began to look pretty bad.

  How many children you got?

  Four. All boys.

  This one was supposed to be a girl, said the woman smiling broadly.

  Then she began to have another pain and everything stopped for a moment. We watched her until her features gradually relaxed again. It didn’t last long but I could see now that she really meant business.

  Say, these are coming pretty fast, I said to them. Before we get stuck here let’s take a look at that burn.

  All right. She threw the covers carelessly down again exposing her thin, well-formed body almost to the knees.

  There was an oblong piece of folded cotton rag covering the length of the left thigh, held loosely in place by narrow adhesive strips above and below. I loosened one side of the lower strip and saw the burned area. It must have been a foot long with a big, half-shriveled blister in the center as big as the palm of your hand. I replaced the bandage. We’ll leave that alone. Does it hurt much?

  Nothing to it. She seemed completely at ease lying there, with none of the deformity apparent that you’d find in a maternity case at term, like a well woman who might be feigning—in all her soiled sheets. Her color was good. She didn’t seem greatly concerned about anything—and she was not unattractive! I remarked it again. It was odd to see that rather amused expression on her face. Whom did she remind me of? Oh yes, the woggle-headed kid downstairs. Clowns, the two of them.

  I guess it’s a good thing, she said. We got enough already.

  How much are you getting? said the man to me at that moment.

  Are you working?

  Yeah, I get eighteen dollars a week but I haven’t had more than three days recently.

  What do you do?

  I work for a house-wrecking company.

  Is that so! Well, that’s interesting. I thought of what Floss had said. I want to hear more about that later.

  I can tell you anything you want to know. How much is it gonna be, Doc?

  Well, I said, I don’t know. Infection, hemorrhage. That sort of thing; she’ll need a little watching. How about ten dollars?

  O.K. I’ll get you some money. What else do you need?

  Nothing I won’t have with me.

  Don’t you want to examine her, Doc?

  I don’t think so.

  But suppose it’s coming.

  All right, I said. Let’s see where we’re at. I made a quick examination. The outlet was still contracted; it didn’t take me long. The man looked at me as I turned away in mild astonishment.

  Is that all?

  That’s enough for now. She’s all right. She’s going to have it. It’s too bad but it can’t be helped. Leave this basin just as it is. I’ll be back in about half an hour, just as soon as I can make it.

  All right, he answered. I got to walk down to the plant and get some money, it’ll take me about that time to get back here too. I’ll get the other things. But you’ll be back sure, Doc, won’t you? You won’t not come back, will you? I’ll have the money. I won’t have it all but I’ll have a couple of dollars.

  Yeah. And if anything happens while we’re gone, I turned to the woman, you just stay where you are, don’t get up, don’t touch anything. Just stay put. You understand.

  I know. All right.

  In half an hour I was back at the house again, as agreed. There was an old black-and-white cat lying in the sunny doorway who literally had to be lifted and pushed away before I could enter. As I shoved him off with my foot and kicked open the door—the boy came out from a sort of cubbyhole closet behind the stove, staring.

  Oh! he said with wide eyes. You here again? and he looked down at the two bags I was now carrying, one in either hand. You scared me! I thought it was some man pushed open the door to let the cat in. I noticed then that he was wearing a cowboy belt with a large-size snapper pistol in it. One can imagine what he must have been thinking.

  Two bags! he said with amazed emphasis. How many times you coming here?

  How’s your mother?

  Oh, she’s all right.

  Get that cat out. It had followed me into the room.

  Get out! he yelled and closed the door behind the slinking beast.

  I took my time to look around a bit as I stood there wondering. The whole place had a curious excitement about it for me, resembling in that the woman herself, I couldn’t precisely tell why. There was nothing properly recognizable, nothing straight, nothing in what ordinarily might have been called its predictable relationships. Complete disorder. Tables, chairs, worn-out shoes piled in one corner. A range that didn’t seem to be lighted. Every angle of the room jammed with something or other ill-assorted and of the rarest sort.

  I have seldom seen such disorder and brokenness—such a mass of unrelated parts of things lying about. That’s it! I concluded to myself. An unrecognizable order! Actually—the new! And so good-natured and calm. So definitely the thing! And so compact. Excellent. And with such patina of use. Everything definitely “painty.” Even the table, that way, pushed off from the center of the room.

  What you gonna do to my mother? the boy asked.

  Your father come back yet?

  No. What you gonna do?
/>   Just fix her up a bit, I said. I understand you got four boys in the family. No girls at all?

  No girls except my mother.

  That’s right.

  Upstairs again, through the bare bedroom. She looked just the same.

  Anything happen?

  Not yet. The pains seem to be getting worse, that’s all.

  I sat on the edge of the bed to wait. You haven’t had any chills have you?

  So quiet, so lovely, so peaceful in that room. So strangely comforting. I couldn’t make it out. Now the woman had another pain. I watched her.

  They been coming that way right along?

  About like that.

  I sat at the foot of the bed while we talked and waited.

  What’s all that fluffy stuff on the screen? I said turning to the window.

  Yeah, I was wondering about that too, said the woman.

  Oh, I see, it’s from the meadows, cat-tail down. That wind we had the other day must have blown it up here, quite a distance, isn’t it?

  When the husband came in with his supplies I removed my coat and took out my light rubber apron.

  Now the butcher work begins! she smiled.

  There wasn’t much change in the situation. So the husband gave me the four dollars he had for me and we fell to talking of the house-wrecking job.

  Can’t you give her something to ease the pain a little, Doc? said the man.

  Sure, if she wants it. These aren’t very strong but they may give her a little relief. Just leave everything else the same. I got to get some lunch now, then I have office hours. After that I’ll be back, around three o’clock, if you don’t call me sooner.

  How’s it going? said Floss a half hour later.

  Just a five months’ miss. She’s all right.

  What sort of people are they?

  You can imagine.

  Are they going to pay you.

  Yes, he gave me four dollars. Said he’d bring me some more when he had it. By the way, here’s something interesting, he’s a house-wrecker. What do you know about that?

  Well?

  It’s an idea, isn’t it?

  Didn’t I tell you something would come of it? What did he say?

  Oh, I didn’t get much chance to talk to him but he said they do go out of the state if it’s worth their while.

  Did you tell him about the stone construction?

  He said that don’t make no difference. They’ll level that off and even fill in the cellar if you have to have it that way. I’ll ask him more about it when I get back.

  When’s it coming off?

  I dunno.

  What a day! There was the old cat, as before, obstructing the doorway. I felt as though I lived in the place and had lived there always. Inside, the boy was lying on the floor playing with a half-busted mechanical engine and cars. He didn’t stir this time or even look up at me. I had to walk over his legs to get to the chair with my coat. Not a sound. Where’s your father?

  He’s upstairs.

  I ducked my head instinctively this time. As it came above the flooring into the bedroom above the man got up suddenly from where he had been sleeping on one of the children’s beds, rubbing his eyes to open them. He was halfdazed as I walked past him into the woman’s labor room. She too had been asleep, opened her eyes and smiled. Marvelous!

  I must have been asleep, she said stretching and smiling pleasantly at me.

  What’s happened to the pains? I said.

  It must have been those pills. I had to take them twice but after that the pains left me.

  I heard a commotion downstairs, then a grand stampede and clambering on the wooden stairway. Get out of here! I heard the father say loudly. Go on, the whole bunch of youse. Go downstairs. I had to go to look. There they were, all four of them, the three youngest fresh from school, standing around the stairhead like so many pegs, in amazement. I’m hungry, one of them said. Go on, get downstairs. I’ll get you something later. But he had to take them bodily, one at a time, and push them ahead of him before he could get them below.

  What do you say, Doc? She all right?

  Sure, leave her alone.

  Am I sleepy, he said. Up all night and doing the cooking and taking care of her. I’m dead. I sat down beside the woman and felt her pulse.

  Are you gonna examine me again? she said. No. That’s good. I’ll come back when it gets ready.

  Sure everything’s all right, Doc? Those must be good pills you gave her.

  Looks like it. Even put you to sleep without taking them, huh? Have you bled any? to the woman.

  No, nothing much. I feel good.

  All right. I guess then I’d better move on. I got work to do. Call me when you need me—and don’t make it four-thirty A.M.

  We don’t want to bother you, Doc. I’ll watch her and let you know when it’s coming.

  Say, about that wrecking business: How much does it cost to take a house down like I told you.

  They’ll give you a hundred dollars maybe or if somebody else is bidding maybe they’ll make it a hundred and a quarter. It won’t cost you nothin’. Have you got a card with you? I’ll have the boss see you in your office.

  We’ve got a house eating up seven hundred dollars a year taxes, and nothing coming in. Belongs to my mother-in-law.

  Yeah, you can’t keep that up.

  The kids were waiting for me with open mouths at the foot of the stairs. I rumpled the heavy blond head of hair of one of them and all smiled delightedly following me with their eyes as I said so-long to the father and disappeared from them through the door.

  It was four-thirty the next morning when the phone finally rang. Four-thirty! Of course. Aw right, aw right.

  It’s here, came the voice back at me. Take your time. She can wait till you come.

  These are the great neglected hours of the day, the only time when the world is relatively perfect and at peace. But terror guards them. Once I am up, however, and out it’s rather a delight, no matter what the weather, to be abroad in the thoughtful dawn.

  He was waiting for me in the semi-dark, in his shirtsleeves, at the curb, and we went in together.

  Upstairs the four kids were asleep in the big beds. Two were lying across the one at the right, their heads all but hanging over the edge nearest me, side by side. The older boys were on the other bed, the head of one near the feet of the other. There was no cover on any of them and all were only partially undressed, as if sleep had overtaken them in the act of removing their clothes.

  Good for you, I said to the woman. Did you have strong pains?

  Yeah, all night but as long as I knew it was all right I could stand it.

  It’s still in the sack, he said. It all came together.

  He was right, the whole mass was intact. Through the thin walls of the membranes the fetus could be plainly made out. About five months.

  Is it alive? he asked me.

  No.

  It was alive when it was born though, she said. I looked and I could see it open its mouth like it wanted to breathe. What is it, Doc, she continued, a boy or a girl?

  Oh, boy! said the husband, have I got a bellyache tonight. She laughed. Guess he’s having a baby. He’s worse than I am.

  I feel like it, he said.

  Maybe you are, I told him as we started to work over the woman to make her comfortable.

  You’d be more famous than the Dionne quintuplets, she smiled. You’d get your pictures in the papers and talk over the radio and everything. Say, Doc, she continued, you haven’t told me. What was it?

  What do you want to know for?

  I want to know if it’s a girl.

  I looked. Yes, it would have been a girl.

  There, she said, you see! Now you’ve got your girl. I hope you’re satisfied.

  I haven’t got any girl, he answered her quietly.

  I’m hungry, yelled a sleepy voice from the other room.

  Shut up! said the father.

  The Practice (from The Autobiography)


  IT’S THE HUMDRUM, day-in, day-out, everyday work that is the real satisfaction of the practice of medicine; the million and a half patients a man has seen on his daily visits over a forty-year period of weekdays and Sundays that make up his life. I have never had a money practice; it would have been impossible for me. But the actual calling on people, at all times and under all conditions, the coming to grips with the intimate conditions of their lives, when they were being born, when they were dying, watching them die, watching them get well when they were ill, has always absorbed me.

  I lost myself in the very properties of their minds: for the moment at least I actually became them, whoever they should be, so that when I detached myself from them at the end of a half-hour of intense concentration over some illness which was affecting them, it was as though I were reawakening from a sleep. For the moment I myself did not exist, nothing of myself affected me. As a consequence I came back to myself, as from any other sleep, rested.

  Time after time I have gone out into my office in the evening feeling as if I couldn’t keep my eyes open a moment longer. I would start out on my morning calls after only a few hours’ sleep, sit in front of some house waiting to get the courage to climb the steps and push the front-door bell. But once I saw the patient all that would disappear. In a flash the details of the case would begin to formulate themselves into a recognizable outline, the diagnosis would unravel itself, or would refuse to make itself plain, and the hunt was on. Along with that the patient himself would shape up into something that called for attention, his peculiarities, her reticences or candors. And though I might be attracted or repelled, the professional attitude which every physician must call on would steady me, dictate the terms on which I was to proceed. Many a time a man must watch the patient’s mind as it watches him, distrusting him, ready to fly off at a tangent at the first opportunity; sees himself distrusted, sees the patient turn to someone else, rejecting him.

  More than once we have all seen ourselves rejected, seen some hard-pressed mother or husband go to some other adviser when we know that the advice we have given him has been correct. That too is part of the game. But in general it is the rest, the peace of mind that comes from adopting the patient’s condition as one’s own to be struggled with toward a solution during those few minutes or that hour or those trying days when we are searching for causes, trying to relate this to that to build a reasonable basis for action which really gives us our peace. As I say, often after I have gone into my office harassed by personal perplexities of whatever sort, fatigued physically and mentally, after two hours of intense application to the work, I came out at the finish completely rested (and I mean rested) ready to smile and to laugh as if the day were just starting.