The story begins with the first-person protagonist, known only as “the doctor,” facing the challenge of getting to a patient. There is a snowstorm, and the doctor must travel ten miles to get to a sick man. To make matters worse, his horse died from exposure in the cold the night before, so he has no way to get to his new patient. His servant girl, Rosa, has left to go try to borrow a horse from neighbors in the village, but the doctor has little hope of her success. She confirms that fear when she returns without a horse. The doctor is so frustrated that he kicks the broken door of the pigsty that’s been vacant and unused for a long time. To his shock, a man emerges from the sty, crawling on all fours, asking the doctor if he’s ready to have his horses hitched up to his carriage so he can leave.

The mysterious man, referred to as “the groom,” is described as having an honest face and blue eyes. As he comes out of the pigsty, the doctor and Rosa peer into the stall in amazement. Rosa laughs and jokes that no one really knows what’s actually in their own home. The groom goes on to call forth two huge, powerful horses from the sty. The doctor doesn’t question the appearance of the horses but directs Rosa to help the groom who promptly grabs the girl and bites her on the face, leaving teeth marks. The doctor yells at the groom but then realizes he doesn’t know anything about the man and that he needs his help. The groom continues to prepare the horses and tells the doctor to climb into the carriage, and the doctor does so but insists on taking the reins. 

The groom says he’s staying behind with Rosa, and the girl screams and runs into the house to lock herself inside. The doctor states that he can inexplicably see Rosa as she runs and hides inside the house even though she’s behind the closed and locked outer door. He tells the groom he’s not leaving him behind with his servant girl because he’s certain the man will attack her again. The groom, however, tells the horses to giddy up, and the doctor is pulled away, the journey seemingly out of his control. As he departs, the doctor hears the sound of the door being broken down, but before he can think about what is happening to Rosa, he magically arrives at his destination in moments. The sick man’s parents and sister rush out to meet him and take him into a room that is thick with smoke from a cooking stove.

The doctor goes to examine his patient who, although thin and with a vacant expression, does not appear sick. The man whispers a request that the doctor let him die. The parents and sister don’t seem to have heard, and the doctor is flustered. He opens his bag, pulls out tweezers, puts them back, thinks about the providence of the horses being available just when he needed them, and suddenly worries about what Rosa is likely going through at the hands of the groom. He feels guilty that he left her behind without any protection. Just as he thinks about how he’s not sure if he can control the horses and get them to pull the carriage back home to Rosa, the horses put their heads through the windows of the house and observe the sick man. The sister takes the doctor’s coat, and the father gives him a glass of rum which the doctor does not drink even though he understands it is a valuable offering. Instead, the doctor puts his head on his patient’s chest and confirms that the man is healthy and should simply be made to get out of bed.

The doctor concludes, however, that he has to do his job even though he’s worried about Rosa and has the thought that he wants to die too. He reflects on his job and how he gets pulled out of bed regularly by people who need him, yet he can’t help his own servant girl who’s probably being raped at that moment by the groom. He thinks of Rosa as a sacrifice he has had to make in order to do his job, and he calls for his coat and moves to leave. The sister, however, shows him a bloody rag, so the doctor goes back to the patient and examines him again as the horses neigh from the windows. The doctor discovers a large, bloody wound on the patient’s hip. When he looks closer, the doctor sees large worms burrowing in and out of the wound, and he tells the man there is no way to help him. He’s going to die from the gruesome wound.

The parents and sister are happy, however, because it looks like the doctor is accomplishing something. Other people arrive to the house as the patient asks the doctor if he’ll save him. The doctor feels frustrated by the demands of his job and reflects that more is expected of him than priests. His thoughts also return to Rosa and how he can’t help her. More people arrive, and they strip the doctor naked while a choir of children sing about how he needs to be nude in order to heal the patient, but if he can’t save the man, they will kill the doctor because he’s unimportant. The doctor is dragged to the bed and made to lie beside the patient, next to the wound. The family and townspeople leave. The patient whispers that he has no confidence in the doctor’s abilities and that all he’s doing is taking up room in his deathbed. The doctor tries to reassure the man, who seems to believe the doctor and is peaceful.

While the patient is still and quiet, the doctor plans his escape. He gets out of the bed, gathers up his coat, bag, and clothes, and climbs out a window without taking time to get dressed. He mounts one of the horses and leaves, still naked, the carriage rattling empty behind him with his fur coat dragged behind in the snow. He can hear the children still singing as he leaves. The trip home is nothing like the supernaturally speedy journey there, and the doctor realizes he’s going to die out in the cold. He imagines how someone will replace him in his medical practice and how Rosa is being brutalized by the groom with no one to protect her. As the horses continue moving slowly, the doctor feels betrayed that of all the patients he’s helped over the years, there’s no one to help him as he freezes to death.

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