From altar to autopsy table: ecological imaginaries, medical violence and parareligious affect in William Carlos Williams’s ‘The Use of Force’ and Tess Gerritsen’s The Surgeon

This article compares William Carlos Williams’s short story ‘The Use of Force’ (1938) and Tess Gerritsen’s novel The Surgeon (2001) to explore how biomedical care can slide into coercion and how clinical spaces oscillate between sanctuary and sacrilege. Building on Michel Foucault’s formulation of clinical vision, together with Julia Kristeva’s account of abjection and René Girard’s sacrificial theory, I propose a three-strand analytic—power/knowledge, Gothic embodiment and parareligious affect—supplemented by an ecoGothic perspective that scales clinical violence from flesh to environment. Through close reading, the essay shows how Williams’s intimate house call converts beneficent intention into brute force, while Gerritsen’s medical thriller grotesquely weaponises medical expertise: the gaze that sees also dominates, and instruments of cure—tongue depressor, spoon, scalpel—become ritual implements that breach bodily borders. Attending to gendered vulnerability and trauma poetics, the analysis situates Gerritsen’s femicidal surgeries within patriarchal control and foregrounds the counter-agency of Jane Rizzoli and Catherine Cordell. Placing a modernist vignette beside a 21st century medical thriller, the article maps both continuities and ruptures in the ontological, epistemic and ethical stakes of clinical authority, tracing how sacrificial logic, secular priesthood and toxic ecologies persist across periods. The contribution is twofold: to Gothic studies, by clarifying medicine’s parasacral volatility and its ecological imaginaries; and to bioethics and the medical humanities, by articulating a normative claim that only practices disciplined by consent, narrative reciprocity and institutional accountability can sustain the secular covenant of care. Otherwise, curative ritual hardens into authorised brutality, and knowledge is purchased through a sacrificial economy in which cura collapses into cruelty. Such findings refine debates on clinical paternalism, narrative ethics and trauma representation in literature.