‘… all standardization is necessarily a standardization in impotence.’ (Sherwood Anderson).
The short stories that comprise Anton Chekhov’s ‘Medical Tales’ and William Carlos Williams’ (WCW) ‘The Doctor Stories’ offer up a body of work that demands a clinical level of scrutiny and attention even in the face of frequent irresolution, disarray, and obscurity. For both writers were professional physicians as well as literary greats and Chekhov is reported to have said ‘medicine is my lawful wife […] and literature is my mistress’. His ‘Medical Tales’ cover a diversity of material as well as formal changes over their period of production (1885-1900) and were to become the primary source of his income. ‘Ward No. 6’ (1982) and ‘The Grasshopper’ (1892) crystallise his inaugural stream of consciousness form, as well as a rejection of traditional moral narratives in favour of arguably confusing and irresolute story structures, considering himself the poser – not respondent – of questions. WCW was a successor both to Chekhov’s pioneering form of modernism and to his double devotion to medicine and literature. Williams’ iconic ‘Old Doc Rivers’, ‘The Use of Force’, and ‘Comedy Entombed: 1930’ embody the struggles he experienced in pioneering a new form of modernism, one centred on his orientation towards ‘locality’, as well as early leanings towards the Imagist movement. Just as Chekov had experienced first hand the realties of nineteenth-century middle and lower class life in both personal and professional circles, WCW occupied the world of turn of the century America. Influenced by their cultural and historical context, many of Chekhov and WCW’s characters live unsatisfactory lives, unable to help themselves in light of crisis or conscience.
Although not originally leveled at either Chekov or WCW’s literary output, Sherwood Anderson’s assertion invites a consideration of these stories against it as a baseline. The conclusive, universal lexicon of the statement (‘all’; ‘necessarily’) enacts a broad sweeping at the level of the language and, despite the potential value as a maxim, subsumes the critical details. Impotence is defined as ‘want of strength or power to perform anything; utter inability or weakness; helplessness’; or the pathological condition of ‘complete absence of sexual power: usually said of the male’. Meanwhile, the transitive verb ‘standardise’ not only signifies the activity of bringing to a uniform size, strength and form of construction but so too to test by a standard. This statement will be the standard to which these medical narratives are tried. Impotence will be considered in terms of relation to the novel form and to the modernist stance and an awareness that our writers worked during the fragmentation of sensibility, about 1880, to which the short story responded, being ‘the most appropriate medium for representing it’. Here, the following lines from Chekhov’s ‘The Cherry Orchard’ resonate: ‘if a great many remedies / are suggested for some disease, / it means the disease is incurable’.
It is common practice in the modern-day to seek a second opinion or for colleagues to collaborate on the treatment of an ill person, but, as this passage from ‘The Cherry Orchard’ reveals, impotence and the inability to cure and divert the onset of physiological and pathological destruction can sometimes persist. There are moments of professional impotence in the capacity of a doctor bound by the Hippocratic Oath – unable to divert many clinical afflictions. But there is also apparently self-conscious impotence on the part of the authors in their descriptions of literary doctors – at certain points the two worldviews and life commitments are not fully reconciled. Impotence itself is, importantly, a medical condition, referring to the inability to engage in sexual intercourse, with the ‘im’ prefix holding in tension the approximation of potency and impotency as a seemingly interchangeable binary. The lexicon of ‘standardisation’ is appropriate to the pathological condition of impotence, for it refers to the inability to participate in a primitive urge to pro-create and to provide a physical, as well as literary, legacy. Robert Coles uses the same field of discourse in claiming that ‘Chekhov knew too much about medicine to think that his doctors could actually heal many people, or make the world a better place. Thus, his medical men and women often appear impotent. Yet their impotence provides an arena in which a moral drama takes place. They define themselves as moral beings by the manner in which they respond to the overwhelming nature of their task’.
Ivan Dmitrich of Chekhov’s ‘Ward No. 6’ suffers a lack of self-knowledge, as does the medical protagonist, Ragin. As a young professional, Ragin committed himself to a noble cause and ideals but the narrative of the tale parallels his life progression and the increasing self-deception and ultimate disillusionment which ensue. ‘”Aha! so they have put you in here, too, old fellow?” he said in a voice husky from sleepiness, screwing up one eye. “Very glad to see you. You sucked the blood of others, and now they will such yours. Excellent!”” introduces the troubled, and contextually charged notion of a Dracula figure, surely the antonym to a doctor. In this characterisation, Chekhov reminds his readers that doctors are also subject to human afflictions, desires and impulses, and in the case of Ragin, his emotional numbness is only broken when he becomes labelled in the only way he recognises – as a mentally unwell patient under which condition he could, and did, suffer. The irony in the empty rhetorical question is carefully exacted as it is apparent that Ragin is no longer a professional visitor to the psychiatric clinic, but is a patient. Chekhov probes the status of Ragin as a doctor who becomes admitted under clinical direction – at no point is there the suggestion that this physician is no longer a professional, despite the fact that he has been institutionalised alongside his former charges.
So too, the physician’s identity is questioned in WCW’s ‘Old Doc Rivers’: ‘But what could he do? What did he do? What kind of doctor was he, really?’. This tricolon, loaded with the negative trigger of ‘but’ positions itself within a field of doubt and rhetorically constructed inadequacy. Meanwhile, ‘as he had not the means to live at home and be nursed, Ivan Dmitrich was soon sent to the hospital, and was there put into the ward for venereal patients’ offers a bitter commentary on the limitations of a medical system at a pragmatic level. Not least is there no economically viable option for home care, but so too, a mentally ill patient is received into a clinic for those with venereal diseases. Aside from the doubts surrounding the value of institutionalisation, Chekhov satirises the label of ‘impotence’. By being admitted to a venereal ward, these patients are surely sexually sound, but this capacity has made them physically impotent, just as the administrative medical system shows weak governance in inappropriate admissions.
WCW also exploits the grotesque to comic effect, as in the alarmingly titled ‘The Use of Force’: ‘as doctors often do I took a trial shot at it as a point of departure. Has she had a sore throat?’. Importantly, the doctor addresses the girl’s parents despite the fact that she has demonstrated a maturity and competency in being able to vocalise her wish not to be treated, which warrants a direct address to her as an individual and wilful charge. So too, ‘a trial shot’ is metaphorically skewed, recalling the intravenous injection that could be administered as a result of the girl’s diphtheria, but the obvious lack of specificity in the space of the consultation highlights the difficulty of assessing physical conditions in communicative modes. This shortcoming in language and assessment is distilled in WCW’s ‘Comedy Entombed: 1930’ with a register of hypothesis and provisionality: ‘I want to know if it’s a girl. / I looked. / Yes, it would have been a girl’.
The stories under consideration variously employ a narrator who sets up the framework of a story-telling narrative, or who positions themselves as the spokesperson of the historical figures of Chekov and Williams. However, much as their two life couplings of medicine and literature have no clear boundaries in the crossovers of analytical thinking, patient history-taking and letters home from Sakhalin, the authorial role can never be clearly or finitely identified. Reader and writer are mutually aware of the impotency experienced by the author at moments of irreconcilability between medical and written experience. This impotence functions in a similar manner to the professional deficiencies from the standard previously identified, as well as in terms of natures and conditions that will never unite.
The convoluted lexicon of this passage in ‘Ward No. 6’ struggles with the very obscurity Chekhov tries to make sense of in his fictional patient: ‘when he talks you recognize in him the lunatic and the man. It is difficult to reproduce on paper his insane talk. He speaks of the baseness of mankind, of violence trampling on justice, of the glorious life, which will one day be upon earth, of the window-gratings, which remind him every minute of the stupidity and cruelty of oppressors. It makes a disorderly, incoherent potpourri of themes old but not yet out of date’. ‘It is difficult to reproduce on paper his insane talk’ directly aligns the difficulties encountered by the literary doctor, while the reference to ‘reproduction’ invites an allegorical interpretation in which the writer is impotent and incapable of producing the desired offspring from his literary engagements and activity.
Further to the points of troubled articulation, we are alerted to the presence of artistic license and the doubt with which these purportedly authoritative, genuine narratives are read. This warning is captured in the title of ‘The Head Gardener’s Story’ when it is disclosed that there are no under gardeners so this appellation of ‘head’ is troubled. This tension reappears later with ‘”it’s incredible! It can’t be so! Take care that a mistake is not made; it does happen, you know, that evidence tells a false tale”’. Understatement, inconsequentiality and ambiguity stud this tale and ‘Ionitch’ not least in the strikingly short sentence: ‘that is all that can be said about him’. The resultant questions demand whether this is an authorial failure to flesh out the characterisation, or whether the figure themselves is impotent in not calling up the standard level of written description. While Chekhov was the model for and of ‘free fiction’ Williams claims not to have wanted to be a surgeon in practice, but in his stories, he is both a surgeon and a cameraman. He was afforded these roles through his fascination with the latest technology, not least the modern instrument of the motorcar – progressive traits which became unified in his written output.
In his Autobiography, WCW describes the state of being between two professions of author and physician: ‘I had my typewriter in my office desk. All I needed to do was to pull up the leaf to which it was fastened and I was ready to go. I worked at top speed. If a patient came in at the door while I was in the middle of a sentence, bang would go the machine – I was a physician. When the patient left, up would go the machine’. It is noteworthy that WCW wrote his poems and stories on a machine – a typewriter, with the idea of composing ‘at top speed’ being a productive one when exploring William’s characteristic rapid shifts of attention. He tried to get movement out of stasis much as did his contemporary T.S. Eliot whose elusive mythical method of The Waste Land conceives the whole of time (which makes large-scale change hard to notice). WCW was in line with the modernism of the 1920s that was happening the other side of the Atlantic, a school of thought and mode that is best evidenced in ‘Mind and Body’. The protagonist, his namesake, Dr. Williams, illustrates the difficulties a doctor encounters when he is untrained in psychiatric medicine and is presented with a patient suffering from such a disorder. Like Chekhov and Williams as writers, their audience and literary circle were in constant flux during their literary career, which is at times exposed in their expressions or unwitting disclosures of literary impotence.
In considering the medical practitioners of these tales, and their variant degrees of competency on a personal level and within the contexts of contemporary scientific and medical knowledge, emotional, social and relational impotencies are exposed. As has been suggested, ‘impotence’ exists on a spectrum of competency, and the boundaries between complete helplessness and burgeoning possibility are not clearly distinguished. Similarly, emotional standards are less quantifiable than those measured against professional benchmarks of the Hippocratic Oath or survival record, (as with the ‘cure’ record in the legend of the in-house logbook of WCW’s ‘Old Doc Rivers’). As a result, both Chekhov and WCW struggle to compare the degrees of emotional impotence in a variety of spheres, from that of matrimony, doctor-patient, lover and beloved, husband and mistress, and more. ‘He always spoke with passion and enthusiasm of women and of love, but he had never been in love’ identifies the disjunction between voiced emotions and experience, and harks back to the metatextual anxiety over the authenticity of the subject matter of these doctor stories.
Coles has commented that ‘Dr. Ragin, the protagonist of “Ward No. 6”, lives in a world of emotional numbness’, which articulates an impotency of feeling and a parallel universe in which he cannot experience what some others can. Chekhov is deeply concerned with this sense of applying, and approximation to, a standard, as articulated in ‘The Grasshopper’. ‘”Look at him; isn’t it true that there is something in him?” she said to her friends, with a nod towards her husband, as though she wanted to explain why she was marrying a simple, very ordinary, and in no way remarkable man’. The narratorial remark of ‘as though she wanted to explain why she was marrying a simple, very ordinary, and in no way remarkable man’ sounds at odds with the wife’s interrogation that engages us in a question of differentiation. In this manner, Chekhov corrupts the thoughts of narrator and wife, and pre-figures the closing realisation that Dymov is a hero – above standard – and that his potency can only be recognised posthumously, when it is too late.
WCW similarly explores possible extremities and insufficiencies in emotional and socio-relationships. The syntactical order and rigour of ‘by this time, we were all sweating and mad – at the patient, each other, and ourselves’ almost, but not quite, disguises the melting-pot of sanity and insanity, patient and physician, individual and collective in ‘Old Doc Rivers’. Such extremity and disorder of emotion is similarly captured in ‘The Use of Force’: ‘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. It was a pleasure to attack her. My face was burning with it’. Perhaps surprisingly, this is a rare use of psychosomatic description for WCW, in which the visual image of the protagonist is inflamed, becoming an icon for the schadenfreude and passion that corrupts the view of the clinical, white-clad physician of the early 1900s propaganda and Red Cross advertisements.
At a syntactical level, this disorder and disparity between expected modes of contact and repertoire of emotional experience is expressed through short, staccato style sentences. For instance, this passage from ‘Comedy Entombed: 1930’ conflates the standard ‘straight lines’ of a narrative with deviations from this: ‘I took my time to look around a bit as I stood there wondering. The whole place had a curious excitement about it for me, resembling in that the woman herself, I couldn’t precisely tell why. There was nothing properly recognizable, nothing straight, nothing in what ordinarily might have been called its predictable relationships. Complete disorder. Tables, chairs, worn-out shoes piled in one corner. A range that didn’t seem to be lighted. Every angle of the room jammed with something or other ill-assorted and of the rarest sort’. WCW shares this moment of epiphany with us, and challenges the moments and point at which standardisation and impotence revert to disorder and excessive energy.
At their core, these tales are grounded in the functionings of the mind and body, with the denouement subject to forensic investigation and almost corporeal functioning at the levels of grammar, register, syntax and tone. Indeed, sexual impotence and proneness punctuate these stories. This sexual frustration is most commonly evidenced at the moments of narratorial flair, flirtation and erotic attraction to one of the fictional characters, which become complicated when some of these stories are supposedly semi-autobiographical renderings of Chekhov and William’s own experiences. Proneness is witnessed at the level of language as well as meaning, and acts as a metonym for the flaccid male sex organ as in: ‘at home he always read lying down’. It is noteworthy that the act of reading and of receiving these tales is described as a performance of helplessness, incomprehension, and below standard, which challenges our own role as recipient of these works.
Chekhov asks us to engage with the self-contortion and desire of ‘Ionitch’: ‘“we all have our oddities,” he thought. “Kitten is odd, too; and – who knows? – perhaps she is not joking, perhaps she will come”; and he abandoned himself to this faint, vain hope, and it intoxicated him’. So too, through the changing speaker, shifts in perspective, and register of ‘Old Doc Rivers’, WCW invites us to consider the restlessness of his stories. Perhaps we conclude, like Old Doc Rivers, that ‘the mansion was relaxation to him, but he couldn’t live there and his restlessness would in the end pass beyond it’. Doctor, narrator, reader and writer are invariably left in an impotent state of interpretation by the close of these stories, still questioning how they relate to the norm of the short story production of their time, as well as the service, or disservice, they effect on the realities of the contemporary medical profession.
 Green, Fiona, American TRIPOS Paper 16 Poetry Lecture Circus: William Carlos Williams lecture [21 January 2015]
 Stevenson, Lionel, ‘The Short Story in Embryo’ in English Literature in Translation, 1880-1920, Volume 15, 4 (1972), pp. 261-268 (p. 268)
 Chekhov, Anton, The Cherry Orchard: and other plays, from the Russian by Constance Garnett (Chatto and Windus: London, 1935), frontispiece
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. xx
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. 130, ‘Ward No. 6’
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 16
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 97, ‘Ward No. 6’
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 57
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 118
 In 1890, Chekhov journeyed to the far east of Russia and the penal colony on Sakhalin Island (north of Japan). He spent three months interviewing convicts and settlers for a census, and the letters he wrote during this two-and-a-half month journey are among his best.
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. 93
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. 158
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. 173
 Green, Fiona, American TRIPOS Paper 16 Poetry Lecture Circus: William Carlos Williams lecture [21 January 2015]
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 94, ‘Ward No. 6’
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 190
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. 135
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 10
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 59
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 113
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 95, ‘Ward No. 6’
 Chekhov, Anton, Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales, Jake Coulehan (ed.), Foreword by Robert Coles (The Kent State University Press: Ohio, 2003), p. 164
 Williams, William Carlos, The Doctor Stories, compiled by Robert Coles (New Directions Books: New York, 1984), p. 26
Image Credit: Felix E. Guerrero, Flickr