The story opens with a kindly physician standing outside his home in “great perplexity”; his horse has died, and he has been summoned to see a critically-ill patient some ten miles away. The doctor’s maid has gone to try to borrow a horse, but he is sure she will be unsuccessful. The story is introduced in a series of tight, clipped sentence fragments, as if related in a state of great anxiety, but so far the events themselves make perfect sense. Suddenly, however, it transforms itself into nightmare.
The doctor kicks the door of an old abandoned pigsty, and two horses and a lecherous groom squeeze out of the tiny door as if the pigsty itself were giving birth to them. The doctor is soon borne away into the night, pulled by the huge horses, helplessly watching the groom trying to break into the house to rape the maid. Something dreadful and yet larger than life has been born out of the doctor’s complacency. The pigsty is significant in terms of Kafka’s Jewish background: pigs were considered unclean.
Hence anything to which they gave birth would be likewise unclean. We know immediately that these are no ordinary horses, and this is no ordinary groom. He is a demon, and those are demon steeds. They are rushing the country doctor to a confrontation, not with any ordinary patient, but with himself. When the doctor arrives at his patient’s house, he finds the patient to be a young boy who, at first glance, seems to be in perfectly good health — except that he pleads for the doctor to let him die.
The doctor is about to prescribe a placebo when the horses push open the bedroom window and begin neighing frantically, just as in Greek legend Achilles’ horse Xanthous similarly warned the young hero of his approaching death. The country doctor notices for the first time that the boy’s sister is waving a bloody towel (a little reminiscent of St. Veronica, wiping Christ’s face with her veil), and he decides to take another look at the patient.
Pulling back the bedclothes, he sees that the boy has a large and gaping wound in his side, already infested with living worms as big as the doctor’s little finger. He realizes there is nothing he can do for him. But the location of the wound is particularly significant; it is located below the boy’s hip, and would thus correspond to the wound that the Biblical patriarch Jacob receives in wrestling with the angel of God. It is significant also that the wound resembles a blown rose, with the worms serving as wriggling stamens.
The rose has always served as a symbol of sexuality — the doctor’s maid who is raped at the very beginning of the story is named Rose — and we note that as soon as the doctor has seen the wound (uncovered the patient’s private parts), the boy’s family strips the doctor of his clothes, sings a silly song, and tosses him into bed with the patient. Once in bed with the boy, the doctor, who can do nothing for the boy medically, is required to serve in the capacity of spiritual counselor, setting the boy’s mind at ease so he can die in peace. It is noteworthy to observe that traditional Judaism also regards contact with a corpse as unclean.
The doctor has helped the boy spiritually, but has sullied himself by doing so. Grabbing his clothes, the doctor leaves the dead boy and escapes into the night. But his horses which were so demoniacally fast in getting him to his patient are in no hurry to return him home. Gradually it comes to the doctor that they never will. The doctor cannot return home because the complacent life he had there, complete with the virtuous Rose, has been destroyed by a Rose of a different kind; and once having been through this life-altering experience, he can never again be the person he was.