Existential Dread (Metaphor)
There are notably few metaphors in the language of the story itself, as the doctor simply describes everything as he sees it happening. This straightforward narration contributes to the surrealism of the story, as the events the doctor narrates are anything but sensical. However, the overarching metaphor of the story as a whole is the comparison of the doctor's passivity and servitude to the state of existential dread, or the realization that one is powerless against the absurd events of their world.
The Horses (Simile)
Before the doctor can protest the groom's plan to stay behind with Rosa, the groom sends the horses on their way. The doctor says, "The carriage is torn away, like a piece of wood in a current" (2). This simile once more underscores the story's interest in human passivity, as the piece of wood to which the carriage is compared is being moved and manipulated by the force of the water around it.
The Wound (Metaphor)
When the doctor realizes that the patient is dying from a large, worm-infested wound on his side, he says, "You are dying from this flower on your side" (4). In comparing the wound to a flower, the doctor characterizes the injury as something with a life and even a beauty of its own. Indeed, the doctor seems to marvel at the wound rather than attempt to heal the patient, suggesting his predilection for passivity rather than action.