In Sherwood Anderson's short story collection Winesburg, Ohio, the story "Paper Pills" focuses on the character of Doctor Reefy and the devastating effects of his ill-fated marriage. The "paper pills" of the title are the small pieces of paper upon which the doctor writes his thoughts, and reads to his wife up until her death. Her death ruptures Doctor Reefy's life so that it, just like his pieces of paper, turns inwards, eventually transforming into a gnarled, isolated little shell of a life. By examining the role of the "paper pills" in the story of the same name and the narrator's description of Doctor Reefy's physical appearance, it will be possible to see how these balled-up scraps of paper represent Doctor Reefy himself (both literally and figuratively), and show how he has turned in upon himself following his wife's death. The paper pills represent the doctor because are literally transcriptions of his thoughts, but they also serve as a visual metaphor for the emotional changes the doctor goes through and serve as a companion image to the narrator's descriptions of the doctor's weathered, gnarled hands.
Before addressing how the paper pills and Doctor Reefy's physical appearance inform each other, it will be useful to briefly examine previous study of the paper pills themselves, as these features of the story have been the locus of much scholarly work and require an accurate interpretation. In the essay "Expressionist contours in Sherwood Anderson's fiction," Fred Madden (1997) argues that "Doc Reefy believes himself unable to express his thoughts verbally; so he writes them on" the pieces of paper which he then reads to his wife (Madden, p. 366). Madden makes this claim as part of a larger argument surrounding repression and miscommunication in Anderson's work, but it oversimplifies Doctor Reefy's character and thus misses the true role of the bits of paper. Nowhere in the story does Doctor Reefy demonstrate an inability to express himself, and in indeed, when the tall dark girl who would marry Doctor Reefy first meets him, "for hours she sat in silence listening as he talked to her" (Anderson, 1919, p. 21). This demonstrates a nuance to Doctor Reefy's expressive ability that Madden overlooks, a nuance that is important to acknowledge in order to understand how the paper pills function as a metaphor for Doctor Reefy's own life. The doctor is perfectly able to express his thoughts; it is only the partial, ephemeral ideas which he does not speak aloud, at least until he is able to read them to his wife. Thus, Madden's interpretation of the paper pills is shown to be incorrect, or at least inaccurate.
Arnold Weinstein (1997), in his essay "The Unruly Text and the Rule of Literature," provides an analysis of the paper pills which remains misguided but which nonetheless begins to address them more accurately than Madden. Taking his cue from the tooth-pulling scene, Weinstein performs a psychosexual reading of the story and suggests that the "paper balls are irresistible aborts," with Doctor Reefy's incomplete thoughts taking the place of half-formed fetuses (Weinstein, p. 3). While the overall accuracy of Weinstein's claims are dubious, because he relies so heavily on a supposed "displaced narrative" which allows him to connect previously unrelated scenes, his identification of the paper balls as somehow stunted, abbreviated, or unwanted points toward a more accurate analysis of their role in the story. In order to fully describe this role, it will be necessary to examine one additional piece of scholarly work, because it provides the final piece necessary to understand how the paper balls serve to highlight the tragedy of Doctor Reefy's position, acting as a visible metaphor for his isolation. Weinstein focuses too much on his prescribed reading to the point that he ignores the most salient details of the paper pills, so his critique can only approximate the ingrown nature of the paper balls.
The proper way of understanding the paper balls in relation to Doctor Reefy is demonstrated in Bill Solomon's essay "The Novel in Distress: a Forum on Fiction" (2010). As part of a larger analysis of Winesburg, Ohio, Solomon notes that Doctor Reefy is one "in a succession of marginalized would-be storytellers," who, "deprived of a listener after the untimely death of his young bride, […] has no one to read the 'odds and ends of thoughts' he has scribbled on bits of paper," which Solomon sums up by stating that "his medicinal prescriptions will thus alleviate the emotional pain of no patients" (Solomon, p. 125-126). Refining the sentiment expressed by Weinstein by combining it with Solomon's argument, one can see that the paper balls represent the unformed, audience-less expression, turned and twisted in upon themselves so that it becomes hard and alone, just like Doctor Reefy. Of the three critiques discussed here, Solomon's is the only that fully understands the paper pills role in the story. The text itself offers ample evidence to support this interpretation, because the paper pills reoccur throughout, popping up to remind the reader of their importance.
The paper pills are first mentioned when the narrator describes Doctor Reefy's "linen duster with huge pockets into which he continually stuffed scraps of paper," which "after some weeks […] became little hard round balls, and when the pockets were filled he dumped them out on the floor" (Anderson, p. 19). "On the papers were written thoughts, ends of thoughts, beginnings of thoughts," and Doctor Reefy has begun this habit by the time he meets his wife (Anderson, p. 20). After their marriage, the role of the paper pills changes, because no longer are they simply stuffed into a pocket and thrown away, but instead Reefy reads "to her all of the odds and ends of thoughts he had scribbled on pieces the bits of paper" (Anderson, p. 23). Even then however, Doctor Reefy only ever "laughed and stuffed them away in his pockets to become round hard balls" after reading them to his wife.
Doctor Reefy's habit of writing partial thoughts on paper and then stuffing them into his pockets to become little balls predates his marriage, and it continues after his wife's death. What changes, however, is the ritual, because the arrival of Reefy's wife adds an audience to the whole process. Doctor Reefy's thoughts are no longer Weinstein's "irresistible aborts," because they are given meaning, however brief, in the time that he reads them to his wife. Like a performance without an audience, Doctor Reefy's spare thoughts can never truly exist, only ever embodied in condensed, unintelligible little balls. Following his wife's death, Doctor Reefy turns his thoughts inward again, and he hardens alongside them.
The paper pills undoubtedly represent Doctor Reefy himself, as they remain hardened and isolated except for when given momentary life in the act of reading them to Reefy's wife. In order to see just how much the two elements are tied together, one only need look as far as the narrator's description of Doctor Reefy's physical appearance. When his "hands were closed they looked like clusters of unpainted wooden balls," and the "gnarled apples that the pickers have rejected [….] look like the knuckles of Doctor Reefy's hands" (Anderson, p. 18-20). If that were not enough, the narrator recalls when "one runs from tree to tree over the frosted ground picking the gnarled, twisted apples and filling his pockets with them" (Anderson, p. 20). By comparing Doctor Reefy to the gnarled, compacted apples people stuff into their pockets, the narrator is making a subtle comparison between the doctor and the gnarled, compacted bits of paper he stuffs into his own pocket. The narrator notes that "only the few know the sweetness of the twisted apples," just as only Doctor Reefy's wife knows the secrets of the paper pills.