The Iatroversalia (Doctor Poems) of William Carlos Williams
This column explores the links and synergies between medicine and literature. What roles can literature play in reflecting and influencing good practice, and what sorts of images of doctoring are to be found in drama, poetry, fiction, biography, electoronic fora and film? The editors would be pleased to receive short papers between 500 and 1,000 words on relevant topics. Those interested in contributing should email brian.hurwitz{at}kcl.ac.uk or neil.vickers{at}kcl.ac.uk
To the frequently asked question ‘How was he able to manage two full-time careers so well and for so long?’, the physician–writer, William Carlos Williams (Rutherford, New Jersey, 1883–1963), used to reply that it was no strain since:
‘they are two parts of a whole, that it is not two jobs at all, that one rests the man when the other fatigues him’.1
Williams was indeed an extremely busy obstetrician and paediatrician practising in his hometown during and after the time of the Great Depression. He also became a well known American storyteller and one of the greatest American poets.
His classic The doctor stories is a compilation of writings gathered by Robert Coles, his junior colleague in both medicine and literature, who had met Williams at a stage where the acclaimed author of the epic poem Paterson and of Pictures from Brueghel had been forced into retirement following a series of strokes. The doctor stories Coles collected combine invaluable autobiographical accounts and insights into Williams' medical practice, stories of quality unparalleled since those of Anton Chekhov, such as The use of force, The insane, and Old doc rivers, as well as some of the best poems written by a doctor, including Dead baby, A cold front or Le Médecin Malgré Lui.2
Under the early influence of Whitman and especially Keats, his first book, Poems, was published in 1909 at his own expense, a volume that in revisions of his oeuvre he would later exclude, considering it an immature and poor replica of Keats's Endymion. Along with Ezra Pound and Hilda Doolitle, both of whom he met at Pennsylvania State University, Williams briefly embraced the modernist, anti-romantic movements Imagism and Vorticism, only to distance himself soon after from his fellow (and otherwise fulltime) writers, in order to focus on the everyday life of people dying or giving birth, working or unemployed in the industrial landscapes of the Passaic River, from where his poetry emanates.
Unlike other contemporary American poets such as TS Elliot and Ezra Pound, who flew to Europe in search of inspiration at the time, Williams settled down in Rutherford. Having travelled and lived in Europe during some of his high school and postgraduate years, Williams was to remain in his birthplace and boyhood town for the remainder of his life, believing that the universal is the particular without boundaries and that ‘anywhere is everywhere’.3 His abrupt resignation from the New York nursery and children's hospital, as he blew the whistle on corrupted managerial practices, also played a significant part in his return to New Jersey.4
For Williams, medicine and poetry worked in symbiosis. Thanks to poetry, he was able to transform medical jargon into a more comprehensible narrative. On the other hand, medicine helped him set his priorities straight and prevented a detachment from reality, thus making concision and objectivity the hallmarks of a personal poetic style, epitomised in his most famous recurrent line: ‘no ideas but in things’,3,5 a style reflected in his doctor poems The mental hospital garden and in Between walls:
‘The back wings/ of the// hospital where/ nothing// will grow lie/ cinders// in which shine/ the broken// pieces of a green/ bottle’.5
The poem Histology is another example of his use of an American idiom and the variable foot as two essential ways of poetic expression: ‘There is/ the/ microscopic/ anatomy// of/ the whale/ this is/ reassuring.’6
Medicine also left behind Williams's creative ego by putting things into perspective: ‘there's nothing like a difficult patient to show us ourselves’.1
In The yellow flower he asks:
‘What shall I say, because talk I must?/ That I have found a cure/ for the sick?/ I have found no cure/ for the sick/ but this crooked flower/ which only to look upon/ all men/ are cured.’6
In his roles as paediatrician and obstetrician, Williams was dedicated to the healthcare of his neighbours and helped to deliver as many babies as poems (The birth among them). As John Berryman once wrote in his elegy:
‘At dawn you rose and wrote—the books poured forth—/ you delivered infinite babies, in one great birth—/ and your generosity/ to juniors made you deeply loved, deeply:/ if envy was a Henry trademark, he would envy you,/ especially the being through.’7
In his autobiographical The practice, Williams explained:
‘My business, aside from the mere physical diagnosis, is to make a different sort of diagnosis concerning–patients–as individuals’.1
Narrative-based medicine finds a mine of references in this great doctor–narrator who regarded ‘medicine’ as ‘the very thing that made it possible for me to write’,1 who left little out of his writings concerning a physician's ‘being through’ after a lifetime of careful listening:
‘Forget writing, it's a trivial matter. But day in day out, when the inarticulate patient struggles to lay himself bare for you, or with nothing more than a boil on his back is so caught off balance that he reveals some secret twist of a whole community's pathetic way of thought, a man is suddenly seized again with a desire to speak of the underground stream which for a moment has come up just under the surface.’1
Williams was only awarded the Pulitzer posthumously for Pictures from Brueghel. Perhaps if he would have lived, then, he might have responded by paraphrasing his The last words of my English grandmother (Emily Dickinsonb of Chichester) about recognition that comes too little too late:
‘we passed a long row/ of elms. She looked at them/ awhile out of/ the ambulance window and said,// What are all those/ fuzzy-looking things out there?/ Trees? Well, I'm tired/ of them and rolled her head away’.5
Footnotes
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↵a The team ‘iatroversalia’ was coined by the spanish physician-poet Pascual Iniesta (1908–1999) meaning poetry inspired by or related to medical practice.
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↵b Her original name was Emily Dickenson Wellcome, but Williams probably renamed it after the great 19th century American poet Emily Dickinson (1830–86).
- © 2012 Royal College of Physicians
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