Book Review

Modernism, Medicine, and Williams

N Engl J Med 1994; 330:722March 10, 1994

Article

Modernism, Medicine, and Williams
By T. Hugh Crawford. 195 pp., illustrated. Norman, Okla., University of Oklahoma Press, 1993. $27.95. ISBN: 0-8061-2550-0

In recent decades William Carlos Williams, physician-poet, has straddled disciplines in university settings. Literature students compare his Pulitzer Prize-winning works with writings by his modernist colleagues Wallace Stevens, T.S. Eliot, and Ezra Pound. Medical students, on the other side of campus, typically focus on Williams's medical themes, compiled by Robert Coles in The Doctor Stories/William Carlos Williams (New York: New Directions, 1984). Both sets of readers find a voice struggling to articulate cultural upheaval, to portray the “new world naked.”

In Modernism, Medicine, and Williams, T. Hugh Crawford suggests that Williams's training as a scientist emphasized the modern concepts of clarity and cleanliness, which were transposed into his way of seeing and describing. With his unswerving dedication to “clean words” and his ideology of clarity, Williams serves as a bridge between the forces of post-Flexnerian scientific standards and the current reaction to standards, as characterized by cultural diversity, global connections, and of course, health care reform.

His poems look different on the page; “cut there by the teeth of the typewriter,” they exhibit “aggressive geometries,” just as his medical stories present jarringly vivid portrayals of physician-patient encounters. For Williams, trained as a scientist in the “theatre of proof,” it is essential to objectify, “to suppress any noise in the communication channel” so as to achieve absolute clarity. New words in strange constructions are required, and in terms of substance, Williams's physician-narrators arrest readers with stark accounts of their own impressions during encounters between physicians and patients. Just as the appearance of Williams's poetry may be as confounding as the world in which we live, an examining physician's confession of lust and the desire to transgress (in his short story “The Use of Force”) can be breathtaking.

Whether or not the reader is familiar with Williams's writings, Crawford makes clear how science and technology fostered patterns of perceiving and organizing that would eventually lead to the breakdown of patriarchal standards and systems and the troubling ambiguities of postmodernism. Using his sharp eyes and ears to observe and conclude, Williams recognized tensions between the “knowable, objective world and one where truths are uncertain.” Never abandoning scientific scrutiny, he anticipated current dilemmas by voicing “with certainty his own uncertainty.” As his long poems Paterson (New York: New Directions, 1946-1958) and “Asphodel” show, he continued to encompass facts but “surrendered to love and passivity.”

Though centering on Williams, Crawford's study provides insight into the profound changes that have occurred during this century. Medical professionals who are frustrated with the transformations in medicine will find this book particularly useful. Crawford demonstrates how the tools of science led inevitably to shifts away from that discipline's supremacy and authority when the “promises of enlightened science” failed to be fulfilled.

Crawford's work shows that, with the breakdown of traditional barriers and the move toward interdisciplinary study in academia and primary care in medicine, Williams's writings form a valuable connection between the two sides of the campus. The resistance to postmodernism and the problems associated with diversity require, perhaps, the lens used by Williams in his interpretation of the world around him, the double lens of science and art.

Trained in a patriarchal setting and vested with professional authority, Williams was unrelenting in his pursuit of truth and compelled to name what he saw. “Don't think,” he wrote, “that because I say this / in a poem / it can be treated lightly / or that the facts will not uphold it.” After all, he asked, “are facts not flowers and flowers facts?” When he declared in a well-known poem that “so much depends upon” not science itself but the observation of ordinary “things,” such as chickens and wheelbarrows, we have an almost perfect representation of cultural metamorphosis and an emblem of the imperfect world inhabited by scientists and artists.

Lois LaCivita Nixon, Ph.D.
University of South Florida College of Medicine, Tampa, FL 33612-4799