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The Privilege of Agency
In “The Use of Force,” four characters want certain outcomes. The outcomes themselves, at least as the story begins, are positive. The adults need to know what is wrong with the child so that they can help her get well, and the doctor needs to control the current diphtheria outbreak—all good outcomes. The child is sick and in pain but is so terrified of the doctor that she has only one goal: to keep him away from her. Self-preservation in the face of a threat is also a positive outcome. Unfortunately, unlike the adults, Mathilda does not have the privilege of agency. To a point, this makes sense. As the doctor notes, the child can’t grasp the danger she might be in. She can’t pay for the treatment or diagnose and carry it out. She’s a child in a social structure that affords children scant autonomy or its associated agency. She can’t advocate for her needs or even articulate why she is so terrified of the doctor, whom she observes carefully with “cold, steady eyes” as he enters the kitchen.
Mathilda depends on her parents to advocate for her, but they fail her because of their fear for her life, which the doctor uses to get them to comply. He knows that the parents will be cooperative partners in deciding how to proceed, while the child is his adversary. He needs to get the parents on his side right away. As adults in their society, they do have the privilege of agency, especially the father, who makes the decision to restrain his daughter even as she becomes more panicked. They could use it to put a stop to the examination their daughter screams is “killing” her, but instead they cede their decision-making power to the doctor, even after he uses enough force to cause Mathilda to bleed and gag.
The Human Tendency to Justify and Excuse
The protagonist of “The Use of Force” is a trained professional who assesses the situation rationally when he enters the Olsons’ kitchen. Readers can almost hear him starting case notes about the home visit in the story’s opening lines: new patients, mother is “very clean,” child being kept warm. The opening paragraphs suggest a checklist approach appropriate to a medical examination, and the doctor reveals himself to be thoughtful, conscientious, and observant. This is likely how he perceives himself, which makes the gradual unraveling of his rational approach riveting to watch. The doctor does what humans tend to do when plans go awry: he justifies, rationalizes, and excuses irrational decisions.
The doctor begins in his “best professional manner” to persuade Mathilda to open her mouth, but when the mother interjects with “He won’t hurt you,” his disgust flares. He finds himself increasingly irritated by the “contemptible” parents and aggravated by the defiant child. He feels his emotions rising but fails to “hold [himself] down.” In this overexcited state, he rationalizes decisions made in frustration. He knows “how to expose a throat for inspection” and intends on going through with it despite Mathilda’s shrieks and bleeding mouth. He “had to,” because he’s seen “two children lying dead in bed of neglect.” He “had to,” because the “brat” requires protection against “idiocy” and the community requires protection against her. He “had to,” because “One goes on to the end,” regardless. When the doctor sees the membrane, he has the final justification for the force of the “unreasoning assault” that defeats Mathilda. Yet he knows, and her rage underscores, that no one “had to” proceed in this way. He could and “[n]o doubt" should have stopped the examination and tried another approach. His rationalizations allow him to justify and excuse unwise choices and harmful actions.
Power and the Potential for Abuse
A subtle subtext in “The Use of Force” is the nearly sexual language that tinges some interactions between the doctor and the child. The doctor sets up these descriptions when, early in the story, he describes Mathilda as “an unusually attractive little thing,” a blonde child pretty enough to model for ads. He admires her spirit and, after she tries to strike him, confesses to having “fallen in love with the savage brat” as she ascends to “magnificent heights of insane fury” to defend herself. That the doctor’s descriptions of Mathilda become increasingly hyperbolic also prepares readers for the story’s escalation of violence.
After the doctor’s first attempt to force the tongue depressor into the child’s mouth, she becomes “hysterical.” Mathilda is being forcefully restrained in a man’s lap. She can’t get away from him, and she can’t use her hands to push away another man, whom she fears so much that she screams, sobs, and struggles. After she crushes the tongue depressor, a common medical gadget whose destruction may symbolize her temporary victory over the doctor, the mother brings a heavy silver spoon at the doctor’s request. The next event is described as an “assault,” a word with sexual connotations. The restrained child’s neck is “overpowered” and her jaws are forced open by unwanted penetration.
No wonder, when her throat is finally “exposed,” the child feels violated and wants to attack the man who held the spoon. Given when the story was first published (1933), this subtext, suggestive of rape, must remain implied. And it is notable that the doctor seems shocked by the child’s extreme reaction to what has been done to her. The story’s final sentence is the only one from which the subject is omitted, suggesting the doctor’s alarm at the child’s fury: “Tried to get off her father’s lap and fly at me. . . .”
