The father tried his best, and he was a big man but the fact that she was his daughter, his shame at her behavior and his dread of hurting her made him release her just at the critical times when I had almost achieved success, till I wanted to kill him. But his dread also that she might have diphtheria made him tell me to go on, go on though he himself was almost fainting, while the mother moved back and forth behind us raising and lowering her hands in an agony of apprehension.

The contrast between the spareness of the story’s style and the drama of its conflict is apparent in these lines, which occur as the doctor makes undescribed attempts to approach and examine the child. The doctor thinks the father should be able to restrain his daughter. Later, the doctor will “order” the father to grip the child’s wrists, so readers can infer that she is using her hands and arms to push him away. In these lines, the doctor notes certain facts: the father is trying. He’s large enough to restrain the child, but fear gives him pause. He’s also ashamed of his failure. 

The doctor lists these facts almost clinically, yet rather than prompting his sympathy for the suffering father and child, the doctor feels a frustration so deep that he “wanted to kill him.” This dramatic confession, stated so strongly, bursts out of an otherwise matter-of-fact description of the scene. The doctor’s narrative also reveals the source of his irritation—at “critical” moments, the father flinches, and so the doctor fails. Yet by controlling the language, by keeping the style neat and controlled, the doctor can continue to tell himself that he is still in control of the situation, despite the occasional stray murderous thought. 

As I moved my chair a little nearer suddenly with one catlike movement both her hands clawed instinctively for my eyes and she almost reached them too. In fact she knocked my glasses flying and they fell, though unbroken, several feet away from me on the kitchen floor.

Both the mother and father almost turned themselves inside out in embarrassment and apology. You bad girl, said the mother, taking her and shaking her by one arm. Look what you’ve done. The nice man . . .

These lines occur when the doctor makes his first attempt to examine Mathilda. He uses his “best professional manner” and uses child-friendly language, holding his hands open to look safer. But even the modest action of moving his chair is enough to provoke the child’s “catlike” response. The doctor attributes Mathilda’s choice of target—his eyes—to instinct. An animal doesn’t need to be taught where its enemy’s weakness is; it knows and exploits the weakness without conscious thought. The “cold, steady” watchfulness with which Mathilda has constantly regarded the doctor since his arrival looks, in retrospect, like the way a wary animal observes its surroundings and potential predators. She attacks before he can make a move, defending herself out of terror. 

Though the figurative language compares her to a cat, it also points out that humans are indeed animals. “You bad girl,” the mother remonstrates, but Mathilda acts as a healthy animal would to fend off an attack before it begins. No other character in the story is described with figurative language that compares them to anything non-human, and her willingness to risk the attack startles the adults. It shames her parents, but it impresses the doctor and begins to draw out his own irrational emotions.

Perhaps I should have desisted and come back in an hour or more. No doubt it would have been better. But I have seen at least two children lying dead in bed of neglect in such cases, and feeling that I must get a diagnosis now or never I went at it again. 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.

The doctor has just told the mother to get a spoon that Mathilda can’t bite through. He intends to pry the child’s mouth open—clearly against his better judgment. These lines present the conflict that colors the entire struggle between him and the child. “No doubt” he should have stopped. The child could have been given time to rest, to calm down. The parents could have taken time to comfort her. The doctor does not have to have his diagnosis at this very moment. He knows all of this, but he is able to rationalize (he’s seen two children dead of diphtheria) and to catastrophize (this is a “now or never” situation). The first may be true, but it doesn’t dictate this moment. The second is irrational overstatement. Of course, the examination is not “now or never.” What decides the conflict in the doctor’s mind is entirely irrational. He is “beyond reason,” enjoying reflecting fury back at a restrained, terrified child as he holds all the power in the room. 

But his dread also that she might have diphtheria made him tell me to go on, go on though he himself was almost fainting, while the mother moved back and forth behind us raising and lowering her hands in an agony of apprehension.

Put her in front of you on your lap, I ordered, and hold both her wrists.

But as soon as he did the child let out a scream. Don’t, you’re hurting me. Let go of my hands. Let them go I tell you. Then she shrieked terrifyingly, hysterically. Stop it! Stop it! You’re killing me!

Do you think she can stand it, doctor! said the mother.

You get out, said the husband to his wife. Do you want her to die of diphtheria?

These lines occur as the doctor tries, and fails, to get close enough to Mathilda to begin the examination. They reveal the parents’ painfully conflicted emotions and fears as they try to help the doctor check the child’s throat. The father’s torment is seen in his insistence that the doctor “go on, go on” while he seems to be experiencing the child’s trauma in his own body. The mother’s inability to comfort Mathilda is evident, too. She can only witness the struggle, but when her daughter begins to scream, she tries to intervene. She appeals to the doctor, the professional in the room who should—and does—know better than to proceed. But the father’s focus on the threat of death silences the mother.

Both parents are stricken by their child’s suffering. The doctor perceives them as “abject, crushed, exhausted” but misses the source of their anguish—the love for their daughter. Their torment points out that the doctor, in contrast, is driven by contradictory personal and professional motivations, none of which spring from love.