Country Doctor

A man stands with a somewhat slumped posture in a kitchen, leaning against the hob. In his right hand he holds an unsipped cup of dark coffee, the tin spoon delicately balanced in the saucer. In his left he pinches between thumb and forefinger the remains of a cigarette. The ash looks as if it might fall, but he’s indifferent to that. He wears a white smock and a cap flecked with dark stains, we presume blood, and his face mask hangs beneath his chin, the ties dangling desultorily. The doctor stares downward at nothing, his forehead creased, his lips tight. We have all been where he is. His gaze is the gaze of failure.

Ernest Ceriani was a general practitioner in rural Colorado in 1948, and the photojournalist W Eugene Smith accompanied him on his rounds for a groundbreaking photo essay that appeared in Life magazine later that year. Elsewhere the photographer captures the doctor’s face creased with worry as he walks under a threateningly black sky borrowed from a Goya painting. He carries his bag to an abode, a loner out of a Western, a Gary Cooper figure about to battle with the Fates. We see him vaccinate cheery kids, clean wounds, and hang on the phone with an expression of infinite patience. His features are held in a rictus of absorption throughout the essay. Smith had an eye for capturing Vermeer like moments of intense concentration. There’s nothing obviously staged here, no hint of what the critic Michael Fried diagnosed as the merely theatrical.

But it’s that shot in the kitchen that we return to: the image of medical failure. The picture was taken after a home birth, and the mother and child have died. It’s a reminder of times when maternal mortality rates were ludicrously high. We empathise with Ceriani’s frozen state because we have known it in our own working lives. His gaze is specifically not that of Don McCullin’s shell shocked soldier in Vietnam, the famed thousand yard stare. McCullin captured an abyss of despair with no exit route. Smith on the other hand shows us an exhausted man in deep contemplation of the inescapable facts of life and death. Ceriani, as with Samuel Beckett, feels that he can’t go on but knows that he must. Doctors have to try again—and again. In Beckettian parlance from Worstward Ho (1983): “Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.” The famed writer also claimed that, “to be an artist is to fail as no other dare fail.” Eh? Shuffling words in Montparnasse bears no comparison with the duties of a country doctor.