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Because of the intense first-person narration of “The Use of Force,” the story’s events and all the characters’ actions are filtered through the doctor’s perceptions and colored by his assumptions and biases. This focus makes him a compelling but sometimes disturbing narrator who reveals more than he intends. His comments on Mathilda’s behavior are particularly revealing. Because readers must infer what the child thinks—and, moreover, must sort out their inferences from the doctor’s comments—Mathilda becomes something of a mirror to the doctor and his conflicting professional and personal desires. The effect is that the story’s protagonist can also be thought of as its antagonist. The external conflict between doctor and patient reflects the internal conflict that the doctor fails to resolve in an ethical manner.
The doctor names the stakes of this conflict when he asks Mathilda whether she will open her mouth, “or shall we have to open it for you?” He uses we in this threat so that the child’s parents are complicit with his plan to force her mouth open, but he is the only character who can experience the conflict between what he knows is professional and ethical behavior and what he irrationally wants as a man being defied by a restrained child. She matches him, action for action. He approaches her; she repulses him. He orders the father to hold her hands; she screams, “You’re killing me!” He forces the tongue depressor into her mouth; she smashes it with her teeth. At this point, he admits that he “should have desisted,” yet he “goes on to the end.” His actions are a “social necessity,” he reasons, yet her persistent, furious emotional reaction reflects his better judgment. Her behavior reveals that he has violated professional ethics, driven by baser needs, regardless of what he tells himself.
