The Metamorphosis

Franz Kafka’s 1915 novella The Metamorphosis is widely regarded as one of the seminal works of 20th-century short fiction. Since its publication, it has been analyzed and reinterpreted through countless critical lenses and schools of thought. A common thread among many interpretations is the conclusion that alienation and dehumanization lie at the core of The Metamorphosis.

‍The Metamorphosis tells the story of Gregor Samsa, who wakes up one morning to find himself transformed into a gigantic beetle. In the original German text, Kafka uses the word “ungeziefer,” a phrase that translates to “a small, undesirable creature.” The narration of the story often provides glimpses into Gregor’s psyche, laying bare his internal struggle with his sudden metamorphosis. These internal narratives offer insight into the experience of living with chronic illness, disability, and the medical trauma that often accompanies.

Gregor’s first and overriding concern is not his shocking transformation, but his inability to get out of bed and go to work. This culminates in his frantic attempts to convince his manager while locked in his bedroom that he is still fit for the job, all while trying to hide the fact that he has, well, become a gigantic bug. The scene would be absurdly comical if it did not so accurately capture the lengths to which people living with chronic illness often push themselves to meet society’s expectations of normality and productivity. Societal and systemic forces (and pop culture, surprise!) reinforce this mentality. Gregor’s transformation into an “undesirable creature” and his fixation on demonstrating his continued value through returning to work, reflects the relentless demand in our society to define one’s worth by productivity. In our culture, value is often measured by output, economic contribution, or visible usefulness. When illness or disability interrupts this, people face not only physical challenges but also moral judgment, internalized guilt, shame, and the fear of social rejection.

To this end, Gregor’s sudden inability to work and provide for his family reflects the unraveling of his sense of identity and purpose, a profound source of grief shared by countless patients in the aftermath of a medical stressor. These early practical obstacles foreshadow the deeper psychological transformation Gregor undergoes throughout the rest of the story.

What makes Gregor’s story especially poignant is the alienation he experiences - not only from his own body but from those around him. The reactions of Gregor’s family (confusion, denial, avoidance) compound his sense of isolation. While they initially care for him, their compassion erodes into resentment and rejection. They never attempt to truly understand if Gregor can communicate, think, or feel. Instead, they close doors (literally and figuratively) shutting him out of their lives.

As Gregor begins to accept his new form and act in accordance, he finds a brief moment of relief. Yet this fragile acceptance is quickly overshadowed by shame and confusion. His sister’s early attempts to help seem compassionate at first but gradually cross boundaries, removing his belongings and stripping away pieces of his identity without regard for his comfort or consent. Gregor’s efforts to express distress are misread as aggression, fueling a vicious cycle that deepens his alienation. In time, his family severs emotional ties completely, shown most starkly when they abandon his name altogether and refer to him simply as “it.” The stages of dehumanization have reached their end.

The Metamorphosis reminds us that illness and disability are more than physical states; they are transformations that reach into every aspect of a person’s life and relationships. Gregor Samsa’s story shows how these struggles can deepen when others respond with fear, impatience, or neglect. As Gregor’s body changes, his sense of self erodes under his family’s resentment and society’s rejection, until he is no longer seen, or sees himself, as fully human. 

For us as clinicians, Gregor’s fate is a reminder that our commitment to humanizing care carries more power than we often realize. We cannot always prevent the physical hardships of illness and disability, but we can guard against the subtle erosion of identity and dignity that so often accompanies them. By recognizing the invisible burdens our patients carry we can help ensure that they remain seen as whole people, not reduced to “it.” In every encounter, no matter how routine, we have an opportunity: to listen, to bear witness, and to remind our patients through our words and actions that they are not alone. 

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