The first thing I noticed about this piece was the diction. Williams does not use quotation marks to indicate dialogue, which gives his piece the feel of one person telling a story to another person or group of people. He also really doesn't need quotation marks as it's very clear who is talking when. He makes that clear by regularly reminding us of who is speaking.
The other thing that struck me about this piece was the use of dramatic irony. The three-year-old doesn't tell anyone that her throat is sore. That would be quite unusual for a three-year-old, especially one who is very sick. Three-year-olds aren't the best at keeping secrets or knowing what they should or shouldn't say. Somehow, this one knows that she doesn't want to have diphtheria. She has probably seen someone in her family die of diphtheria and knows that the way it begins is that they let a doctor look at their throat and then some time later, they die. This is a good example of dramatic irony because life and death is at stake and the little girl has it totally wrong. The doctor isn't the one who will cause her demise but the only one who can potentially save her, yet she is fighting him with everything she's got.
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