Hektoen International

A Journal of Medical Humanities

Franz Kafka, A Country Doctor, (and Bob Dylan)

Howard Fischer
Uppsala, Sweden


Two horses in the snow, much like those in A Country Doctor
Elk Viewing Sleigh Ride – Thunder Bay Resort, Hillman MI. Photo by Joe Ross. Via Flickr. CC BY-SA 2.0

“Certainly doctors are stupid, or rather, they’re not more stupid than other people but their pretensions are ridiculous; [but] you have to reckon with the fact that they become more and more stupid the moment you come into their clutches . . .”
— Franz Kafka1


Franz Kafka (1883–1924), a German speaking Czech, was an important author of the twentieth century. His work influenced later writers and philosophers such as Camus, Ionesco, Sartre, and Salinger. W. H. Auden called him “a modern Dante.”2 He was the first of four children and the only boy in a bourgeois, barely observant Jewish family in Prague. His father was a domineering bully who constantly humiliated his son, which may account for Kafka’s lifelong feelings of inferiority, weakness, and helplessness.3 He became a lawyer, but worked as a low-paid government insurance company bureaucrat, which produced still more criticism from his father.

Kafka published his first short stories in 1908. His productivity increased in the years just before and after the Great War. “A Country Doctor” (“Ein Landarzt”) was written in 1916–1917, and published in 1919. There was, in fact, a country doctor in Kafka’s family: his favorite uncle, Siegfried Löwy (1867–1942), a country doctor who practiced in a small Moravian village.4 As a child and adolescent, Kafka loved to spend summers with his uncle.5

Kafka was diagnosed as having pulmonary tuberculosis in 1917. The disease progressed to his larynx and in 1924 to the epiglottis. It made unable him to eat or drink, and he died that year.

“A Country Doctor” has nothing in common with the book A Country Doctor’s Notebook,6 by Mikhail Bulgakov (1891–1940), a collection of the author’s real-life experiences as a newly graduated doctor in a rural Russian village, written in the 1920s.

Kafka’s short story is filled with dreamlike, supernatural, unreal events, and is more of a nightmare than a peaceful dream. It was published in a volume of stories also called A Country Doctor (1919). The original title of the story was “Responsibility.”7

In the story,8 a bachelor country doctor is called to see a patient, ten miles away, on a snowy night. His horse is dead from exhaustion. His maid cannot get the neighbors to lend another one. A groom emerges from the supposedly empty pigsty with two strong horses. While harnessing the horses, the groom embraces the maid, whose name is Rosa, and bites her on the cheek. The doctor wants the groom to come with him on the house call, so as not to leave Rosa alone with the groom, who clearly has every intention of raping her. The groom says he is staying, yells “giddap” and the carriage with the doctor takes off. After “a moment” the doctor arrives at the patient’s house.

The doctor takes a casual, negligent glance at the boy who is the patient and pronounces him “quite sound.” The boy says he wants to die. The doctor sees the patient’s sister waving a bloody cloth and decides to take a better look at the boy and discovers a wound filled with worms on the patient’s side. During all of this, the doctor is constantly thinking of Rosa. The patient asks the doctor to save him, and the doctor offers some false reassurance. The family and the village elders then undress the doctor and put him in bed with the patient. A choir of schoolchildren sing some songs proclaiming the uselessness of doctors. The patient complains, “Instead of helping me, you’re crowding my deathbed. What I’d love best is to scratch your eyes out.”

The patient dies and the naked doctor makes his escape from the house. His fur coat is caught in the carriage, and cannot be worn home. “The horses now crawl[ed] slowly,” and he thinks that he will never reach home, that he’ll lose his thriving practice, and that Rosa has been raped. He wails, “Betrayed, betrayed. A false ring of the night bell [which called him to see the patient], once answered—it can never be made right.”

What does A Country Doctor mean? The story has been interpreted in several ways, and from varied points of view. Remembering that the original name of the story was, “Responsibility,” it is clear that a conflict of responsibilities is presented early on. The doctor has a duty to attend to his patient, but also feels a duty to stay and protect Rosa from the groom. The decision seems to be made for him with the groom’s “giddap” that sends the horses on their way.

When writing this story, Kafka was in a state of great anxiety: He was about to be engaged to a young woman, Felice Bauer, and his health was declining.

Sandoval10 suggests that the patient’s first statement to the doctor, “. . . let me die,” is the doctor’s own wish to die because Rosa has been victimized and “lost to him.”

The doctor is “wounded” as well as the patient. He cannot help himself, nor can he help the patient.

The wound he discovers when he finally examines the patient has been discussed at length in literary analyses. It is described as “rose-red” in English, but rosa (pink) in German. The worms inside it are also “rose-red” (rosig). Thus, Rosa is always a significant part of the story. In addition, she is the only person in the story who has a name. Possibilities for the nature of the wound range from the physical: syphilis, tuberculosis, or self-inflicted11—to the more symbolic: a vagina, a circumcision,12 or the wound on the right side of Christ.13 The presence of worms in the wound might be a representation of intercourse.14

The doctor remarks that the patient had asked “Will you save me?” although a doctor might expect the question to be, “Will you heal me?” He wonders if patients have allowed medicine and doctors to replace religion and the clergy.15 This question remains pertinent one hundred years later. The doctor is undressed by the people present. Does this resemble the stripping, mocking, and taunting of Christ, which is further suggested when the doctor is placed near the wounded right side of the patient?16

A school choir sings “All you patients rejoice/a doctor’s laid in bed beside you!” “Rejoice” in German is Freuet euch. This may be a pun on Freud’s name.17,18 Kafka did not trust psychology or psychoanalysis (“No psychology ever again!”19). Stockholder20 states that the patient wanting to “scratch [the doctor’s] . . . eyes out” represents the doctor thinking of the boy as a version of himself, “inflicting on him the punishment of Oedipus.” Finally, the inability of the doctor to get back into his fur coat may be a way of saying that he has lost the emblem of his status and authority.21 What conclusions may be drawn from this mixed bag of symbols and interpretations?

I think we can see an author anxious about many things, such as sex and sexual activity. According to Kafka biographer Ernst Pawel (1920–1994) quoted in Marson,22 Kafka had a “morbid aversion to sex,” and had great self-loathing after coitus.

He also had, perhaps with good reason, little confidence in the medical profession. The doctor in this story is helpless and completely superficial in his first evaluation of the patient. He offers false reassurance when he realizes the boy is “past helping.” He is a failure—he did not help Rosa, he did not help his patient, and he is barely able to help himself. He may never get home again.

Now, a coda. Bob Dylan23 used some of the words and images from A Country Doctor in his 1965 song “Love Minus Zero/No Limit.”24,25 Here are some selected pairings of song and story, with elaboration as needed:

1. “. . . A country doctor rambles . . .” [Stanza 4 line 2]

2. “People carry roses . . .” [S 1 line 1]

3. “Failure’s no success at all.” [S 2 line 8]

4. “My love she laughs like the flowers” [S 1 line 7] Compare with Kafka: “The bloom on your side is destroying you.”

5. “My love she’s like some raven/At my window with a broken wing” [S 4 lines 7- 8], Kafka (usually spelled “kavka”) is a “raven” in Czech.

6. “In ceremonies of the horsemen/Even the pawn must hold a grudge” [S 3 lines 3- 4].

The groom, in setting the horses in motion, deprives the doctor of the ability to make a decision, thus making a “pawn” of him.

7. “The cloak and dagger dangles . . .” [S 3 line 1].

The doctor’s cloak (his fur coat), caught on the carriage, drags behind it in the snow.

Thus it seems that Franz Kafka’s nightmare also contributed to Bob Dylan’s love song decades later.



  1. Iain Bamforth, “Kafka’s Uncle: Scenes from a World of Trust Infected by Suspicion,” Medical Humanities, 26 (2000):85-91.
  2. Jeremy Adler, Franz Kafka. London: Penguin Books, 2001.
  3. Albert Van Alphen. “A Study of the Effects of Inferiority Feelings on the Life and Works of Franz Kafka, LSU Historical Dissertations and Theses, 1969. https://digital commons./lsu.edu/gradschool_disstheses/1626
  4. Bamforth, “Kafka’s Uncle.”
  5. Adler, “Franz Kafka.”
  6. Mikhail Bulgakov, A Country Doctor’s Notebook. London: The Harville Press, 1995.
  7. Eric Marson and Keith Leopold, “Kafka, Freud, and Ein Landarzt,” The German Quarterly, 37, no. 2 (1964): 146-160.
  8. Franz Kafka, A Country Doctor In The Metamorphosis and Other Stories. New York: Barnes and Noble, 1996.
  9. Van Alphen, “A Study.”
  10. Jim Sandoval, “The Myth of the Mortally Wounded Rose in Franz Kafka’s A Country Doctor,” Cognitive Typology, ND.
  11. Bamforth, “Kafka’s Uncle.”
  12. Marson, “Kafka, Freud.”
  13. Herman Salinger, “More Light on Kafka’s Landarzt,” Monatshefte, 53, no.3 (1961): 97-104.
  14. Etti Golomb-Bregman,” No Rose Without Thorns: Ambivalence in Kafka’s A Country Doctor,” American Imago, 46, no. 1 (1989):77-84.
  15. Marson, “Kafka, Freud.”
  16. Richard Lawson, “Kafka’s Der Landarzt,” Monatshefte, 49, no. 5 (1957): 265-271.
  17. Salinger, “More Light.”
  18. Marson, “Kafka, Freud.”
  19. Franz Kafka, The Zürau Aphorisms. London: Harville-Secker, 2006.
  20. Katherine Stockholder, “A Country Doctor: The Narrator as Dreamer,” American Imago, 35, no. 4 (1978): 331-346.
  21. Salinger,”More Light.”
  22. Marson, “Kafka, Freud.”
  23. Bob Dylan, Lyrics 1962-2001. New York: Simon & Schuster, 2004, p 145.
  24. John Herdman, Voice Without Restraint: Bob Dylan’s Lyrics and Their Background. New York: Delilah Books, 1981.
  25. Howard Fischer,”Dylan and the Doctors: A Brief Overview with Occasional Comments, Montague Street, the Art of Bob Dylan, 2 (2010):66-70



HOWARD FISCHER, MD, was a professor of pediatrics at Wayne State University School of Medicine, Detroit, Michigan. He has always been interested in the connections between literature and medicine, and the connections between Bob Dylan and life on earth.


Spring 2021  |   Sections  |  Literary Essays

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