The doctor-narrator orders a number of medical procedures, including a lumbar puncture due to the infant’s inflamed ear drums and high fever.
A sense of dread takes hold of the caregivers, including the doctors, who watch the child as she struggles to survive.
The story closes with the doctor-narrator and the ear specialist acknowledging that, had they properly diagnosed the ailment, they could have saved the girl.
[7][8][9] “The whole story is an elegy for Jean, for her condition (physical and social), and an apology by the physician for his mistaken diagnosis and the fallibility of science, of doctors, of humanity.
Williams underscores all this with a tremendously prominent narrative voice…with descriptions that are both grotesque and beautiful.”—Biographer Robert F. Gish in William Carlos Williams: A Study of the Short Fiction (1973),[10] Literary critic Nasrullah Mambrol remarks on Williams’ use of story structure to convey his theme: The story’s careful structure takes us from external details—Jean’s misshapen body, tiny face, and pale blue eyes—to internal ones—in the postmortem—and so suggests that beneath society’s superficial ills lie fundamental, perhaps incurable, troubles...the author’s main achievement is to individualize yet not sentimentalize Jean and to dramatize her life-and-death struggle so that it matters to him—and to the reader.”[11]Literary critic George Monteiro notes that Williams’ account of the autopsy contrasts the humane impulses that motivate the medical professionals involved while the patient still lived, and with a detachment that allows the doctors to reassert a measure of control after the death of the patient: “[T]he doctor, who had been so solicitous…was now cooly clinical.”[12] The autopsy, though exposing failures in the podiatrists diagnosis, is rewarded by “discovering the logic of the disease…Satisfaction has come with post-mortem knowledge.
The physician’s faith in science and his craft is intact.”[13] Monteiro adds: “What gives this story its power is that the wisecracking and the running diagnosis cum (italics) treatment cannot eradicate the narrator’s affections.