Among Franz Kafka’s stories, which have been subjected to many interpretations, there is one entitled A Country Doctor, an unsettling rush of events with the vertiginous inevitability of a bad dream. The tale, at the same time mundane and unearthly, describes a succession of dilemmas and challenges which, if only in the imagination, will be familiar to many doctors, albeit in a heightened, vivid and feverish form.

To start with, an urgent night visit through the snow to a family home some miles distant (I am not sure how many doctors still do this, but some psychiatrists certainly do). The visit made more complicated because of problems with transport – here it is the lack of a horse, but it could be a car that will not start. The unknown consequences that might flow from a hastily improvised arrangement to solve such a difficulty.

The anxious and caring family. The patient who asks to be allowed to die. The nagging awareness of the tension between our duty to them and our responsibility to those we have abandoned at home. An initial finding that nothing is wrong with the patient and that they might be better for getting out of bed. The sense of being poorly paid but still being eager to help the poor people: ‘It is easy to write prescriptions, but beyond that it is difficult to come to an understanding with people … once again I have been troubled for no good reason, I am used to that, the whole district makes me a martyr to my nightbell.’

The disappointed family who urge you to reconsider, and the reluctant admission that yes, there is more to this case. An awful discovery. A terminal diagnosis. The patient who asks, can you save me? ‘This is how people are in my part of the world. Always asking the doctor to do the impossible. They have lost their old religion; the priest sits at home, tearing to pieces his vestments from the mass; but the doctor is meant to arrange everything with his delicate surgical hand.’

Then the reckless willingness, in the last resort, to go along with untested, unorthodox measures, which are perhaps a little less familiar: ‘And they come, the family and the village elders, and undress me; a school choir with the teacher at its head stands before the house and to a very simple melody sings the following “Undress him, then he will do the healing, and if he doesn’t, then kill him, he’s only a doctor, he’s only a doctor”.’

After all that, to have one’s efforts angrily rejected by the patient, who then relents and seeks comfort from the offer of some meaningless reassurance: ‘Is it really so, or are you deceiving me in my fever?’ ‘It is really so, you have my word of honour as a medical officer.’

Then leaving the patient to their fate, and ending up worrying about getting old, and some other doctor stealing your practice.

All uncomfortably close to the bone!