William Carlos Williams is considered one of the greatest American poets of the 20th Century. He was also a general medical practitioner. This is how one of his poems begins.
They call me and I go.
It is a frozen road
past midnight, a dust
of snow caught
in the rigid wheeltracks.
The door opens.
I smile, enter and
shake off the cold.
Here is a great woman
on her side in the bed.
She is sick,
to give birth to
a tenth child. Joy! Joy!
Each reader will have different responses to a poem, and our interest might be drawn to different details. Before you read my comments, I would ask you to read this poem opening again, slowly, out loud.
The poem is written in free form, without regular line length or rhyming patterns. It is a narrative poem, telling a story in a conversational tone. It is told from the point of view of the doctor, someone who is familiar with the unfolding of a patient’s history. Written almost a century ago, the poem doesn’t fit into the tight structural conventions of the time, but Williams had a huge influence on the shape of modern poetry.
The title he chose puzzles me. My initial response was to anticipate a patient making a complaint. I have had to deal with several patient complaints recently, in my role as a Complaints Officer. We tend to see in a poem, as in life, what we already know.
Decades ago, I was involved in providing GP obstetric care, including a total of eighty home-births. Being called out in the middle of a miserable night to participate in a wondrous event is familiar, but what strikes me here is that Williams has pared the drama down to two actors, his focus being only on the distressed woman and himself. Where were the husband, the other children? Was there a midwife? But a poet has the freedom to pay selective attention to the truth. This is not a documentary, it is creative art, however deeply it may be rooted in real experience. Like parables and mythology, poetry need not be ‘realistic’ to be a potent vehicle for truth.
But perhaps this woman is not in labour. She is sick, we are told, but the next two lines begin with the word ‘perhaps’, bringing a surprising degree of uncertainty into the poem. That may have been his first consideration as Dr Williams entered the room, but for this poem he was not concerned with sharing his diagnostic thinking to resolve uncertainty, instead he abruptly concludes with the following lines –
I pick the hair from her eyes
and watch her misery
Compassion is an abstract term which we are very familiar with in medicine, but for me the most powerful and moving line in this poem is, ‘I pick the hair from her eyes’. The description of that simple gesture conveys in so few words far more than a general lecture on showing compassion.
Williams’ great strength as a poet was his observation of the particular details on which the grand principles of life and medicine hinge. And this is also one of the defining features of general practice – to appreciate and attend to the singularities, the specifics which are of greatest concern for each patient we are with.
This essay was originally published in NZ Doctor, 2022.