The story takes place in a rural setting during winter. The doctor lives on a remote farm, suggestive of both physical and existential isolation. The bitter cold and snow introduce physical obstacles for the protagonist. The snow and cold also present physical conflicts for the doctor to get to his patient and perform his duty, something he takes seriously and is preoccupied with. Additionally, the reader is informed early that the doctor’s horse died from exposure to the cold the day before, emphasizing the mortal danger of the cold and foreshadowing the doctor’s situation at the end of the story in which he too finds himself unprotected in the bitter cold and facing his own death.

On a symbolic level, the winter serves as a physical representation of the doctor’s age and stage in life. Throughout the story, the doctor is concerned about his status in the community due to his age. That the story takes place in winter is a reminder of the doctor’s age and impending death. Additionally, the snow contributes to the dreaminess of the story and the presence of illogical and implausible elements. The snow serves to obscure the landscape, covering everything with a monochromatic whiteness that creates a sense of disorientation for both the doctor and the reader.