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Academic Medicine:
doi: 10.1097/ACM.0b013e3181c88768
Medicine and the Arts

The Practice: [Excerpt]

Williams, William Carlos

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Excerpt from “The Practice,” by William Carlos Williams from The Doctor Stories, copyright © 1951 by William Carlos Williams. Reprinted by permission of New Directors Publishing Corp.

William Carlos Williams was born in Rutherford, New Jersey in 1883 and died there in 1963. A graduate of the University of Pennsylvania School of Medicine, Williams is said to have delivered over 2,000 babies in and around Rutherford between 1910 and 1951. Williams claimed to do all his writing at night, and his output was prodigious, including poems, short stories, novels, plays, and his autobiography, as well as numerous essays. He received a posthumous Pulitzer Prize for Pictures From Brueghel and Other Poems and the Gold Medal for Poetry of the National Institute for Arts and Letters. For physicians, the most accessible introduction to his work is The Doctor Stories, edited by Robert Coles.

The physician enjoys a wonderful opportunity actually to witness the words being born. Their actual colors and shapes are laid before him carrying their tiny burdens which he is privileged to take into his care with their unspoiled newness. He may see the difficulty with which they have been born and what they are destined to do. No one else is present but the speaker and ourselves, and we have been the words' very parents. Nothing is more moving.

But after we have run the gamut of the simple meanings that come to one over the years, a change gradually occurs. We have grown used to the range of communication which is likely to reach us. The girl who comes to me breathless, staggering into my office, in her underwear a still breathing infant, asking me to lock her mother out of the room; the man whose mind is gone—all of them finally say the same thing. And then a new meaning begins to intervene. For under that language to which we have been listening all our lives a new, a more profound language, underlying all the dialectics offers itself. It is what they call poetry. That is the final phase.

It is that, we realize, which beyond all they have been saying is what they have been trying to say. They laugh (For are they not laughable?); they can think of nothing more useless (What else are they but the same?); something made of words (Have they not been trying to use words all their lives?). We begin to see that the underlying meaning of all they want to tell us and have always failed to communicate is the poem, the poem which their lives are being lived to realize. No one will believe it. And it is the actual words, as we hear them spoken under all circumstances, which contain it. It is actually there, in the life before us, every minute that we are listening, a rarest element—not in our imaginations but there, there in fact. It is that essence which is hidden in the very words which are going in at our ears and from which we must recover underlying meaning as realistically as we recover metal out of ore.

© 2010 Association of American Medical Colleges

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