{"id":497,"date":"2017-10-26T07:30:01","date_gmt":"2017-10-26T06:30:01","guid":{"rendered":"http:\/\/www.scottishmedicalhumanities.org\/human\/?p=497"},"modified":"2018-04-22T22:31:43","modified_gmt":"2018-04-22T21:31:43","slug":"the-secret-in-the-throat","status":"publish","type":"post","link":"https:\/\/www.scottishmedicalhumanities.org\/human\/the-secret-in-the-throat\/","title":{"rendered":"The secret in the throat"},"content":{"rendered":"<p><strong>The use of force. William Carlos Williams.\u00a0<\/strong><\/p>\n<blockquote><p>The child was fairly eating me up with her cold, steady eyes and no expression to her face whatever.\u00a0 But her face was flushed, she was breathing rapidly, and I realized that she had a high fever. She had magnificent blonde hair, in profusion. One of those picture children often reproduced in advertising leaflets and the photogravure sections of the Sunday papers.<\/p>\n<p>Does your throat hurt you?<\/p>\n<p>Aw come on, I coaxed, just open your mouth wide and let me take a look.<\/p>\n<p>As I moved my chair a little nearer suddenly with one cat-like movement both her hands clawed instinctively for my eyes and she almost reached them too. In fact she knocked my glasses flying and they fell, though unbroken, several feet away from me on the kitchen floor.<\/p>\n<p>Both the mother and the father almost turned themselves inside out in embarrassment and apology.<\/p>\n<p>If you don\u2019t do what the doctor says you\u2019ll have to go to the hospital, the mother admonished her severely.<\/p>\n<p>Oh yeah? I had to smile to myself. After all, I had already fallen in love with the savage brat, the parents were contemptible to me. In the ensuing struggle they grew more and more abject, crushed, exhausted while she surely rose to magnificent heights of insane fury of effort bred of her terror of me.<\/p>\n<p>We\u2019re going through with this. The child\u2019s mouth was already bleeding. Her tongue was cut and she was screaming in wild hysterical shrieks. But I have seen at least two children lying dead in bed of neglect in such cases, and feeling that I must get a diagnosis now or never I went at it again. But the worst of it was that I too had got beyond reason. I could have torn the child apart in my own fury and enjoyed it.<\/p>\n<p>I forced the heavy silver spoon back of her teeth and down her throat till she gagged. And there it was \u2013 both tonsils covered with membrane. She had fought valiantly to keep me from knowing her secret. She had been hiding that sore throat for three days at least and lying to her parents in order to escape just such an outcome as this.<\/p>\n<p>Now truly she was furious. She had been on the defensive before but now she attacked. Tried to get off her father\u2019s lap and fly at me while tears of defeat blinded her eyes.<\/p><\/blockquote>\n<p>Extracted from <em>The Doctor Stories<\/em> by William Carlos Williams.<\/p>\n<h3>Commentary<\/h3>\n<p>Williams conveys contrasting, at times frightening emotions in himself and in his patients in his short stories. This one centres on a single interaction with a child whose determination inspires his admiration. He wins this engagement, and feels guilty elation that he can write of, but not speak of. Diphtheria remained a feared, life-threatening childhood illness.<\/p>\n<p>Williams spent his professional life as a doctor in the poor, industrial, high-immigrant northern New Jersey city of Paterson. He started as a general practitioner, later narrowed his practice down to mostly paediatrics, and was a school physician. In amongst records of his school visits, he wrote in his notebook in 1914:<\/p>\n<blockquote><p>I bless the muscles<br \/>\nof their legs, their<br \/>\nnecks that are<br \/>\nlimber, their hair<br \/>\nthat is like new<br \/>\ngrass, their eyes<br \/>\nthat are not<br \/>\nalways dancing<br \/>\ntheir postures<br \/>\nso naive and<br \/>\ngraceful, their<br \/>\nvoices that are<br \/>\nfull of fright &amp;<br \/>\nother passions<br \/>\ntheir transparent<br \/>\nshams &amp; their<br \/>\nmimicry of adults<br \/>\n\u2013 the softness of<br \/>\ntheir bodies \u2013<\/p><\/blockquote>\n<h3>Further info<\/h3>\n<ul>\n<li>There is more about Williams and the background to the <em>Doctor Stories<\/em> beneath <a href=\"http:\/\/www.scottishmedicalhumanities.org\/human\/the-heart-attack\/\">The Heart Attack<\/a> and <a href=\"http:\/\/www.scottishmedicalhumanities.org\/human\/dance-pseudomacabre\/\">Dance Pseudomacabre<\/a>.<\/li>\n<li>Read The<\/li>\n<li>Image: &#8216;<a href=\"http:\/\/resource.nlm.nih.gov\/101448710\" target=\"_blank\" rel=\"noopener\">A doctor is examining the throat of a young girl&#8217;<\/a> from the National Library of Medicine (USA)<\/li>\n<li><a href=\"http:\/\/www.scottishmedicalhumanities.org\/human\/the-steel-windpipe\/\">The Steel Windpipe<\/a> describes undertaking a tracheostomy in a child with diphtheria.<\/li>\n<li>A <a href=\"http:\/\/peir.path.uab.edu\/wiki\/IPLab:Lab_9:Diphtheria\" target=\"_blank\" rel=\"noopener\">diphtheria autopsy<\/a> (Univ Alabama at Birmingham Pathology Dept). Nice.<\/li>\n<li>Immunization has saved thousands of lives from diphtheria, but in the early days there were mishaps too. <a href=\"http:\/\/www.scottishmedicalhumanities.org\/human\/a-devastating-prescribing-error-in-1930\/\">A dispensing error at Medellin<\/a>.<\/li>\n<\/ul>\n<h3>Contributed by<\/h3>\n<p>Neil Turner<\/p>\n<h3>Rate this post<\/h3>\n\n<p>&nbsp;<\/p>\n<h3>More like this<\/h3>\n","protected":false},"excerpt":{"rendered":"<p>The use of force. William Carlos Williams.\u00a0 The child was fairly eating me up with her cold, steady eyes and no expression to her face whatever.\u00a0 But her face was flushed, she was breathing rapidly, and I realized that she had a high fever. She had magnificent blonde hair, in profusion. One of those picture <a class=\"more-link\" href=\"https:\/\/www.scottishmedicalhumanities.org\/human\/the-secret-in-the-throat\/\">Read More &#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":966,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"wpupg_custom_link":[],"wpupg_custom_link_behaviour":[],"wpupg_custom_link_nofollow":[],"wpupg_custom_image":[],"wpupg_custom_image_id":[],"yasr_overall_rating":0,"yasr_post_is_review":"","yasr_auto_insert_disabled":"","yasr_review_type":"","footnotes":""},"categories":[29,50,5,52],"tags":[11,13],"class_list":["post-497","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general-practice","category-infectious-diseases","category-medicine","category-paediatrics","tag-doctor-experience","tag-prose"],"yasr_visitor_votes":{"stars_attributes":{"read_only":false,"span_bottom":false},"number_of_votes":1,"sum_votes":4},"_links":{"self":[{"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/posts\/497","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/comments?post=497"}],"version-history":[{"count":12,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/posts\/497\/revisions"}],"predecessor-version":[{"id":969,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/posts\/497\/revisions\/969"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/media\/966"}],"wp:attachment":[{"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/media?parent=497"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/categories?post=497"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.scottishmedicalhumanities.org\/human\/wp-json\/wp\/v2\/tags?post=497"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}