I think that there is a dominant theme of memory and point of view throughout the novel. The fact the patient lacks full memory of what happened and can only piece together what happens through various figments and fragments of imagination, triggered only by other elements, songs, or sounds helps to bring to light that there is little hope for absolute totality. In the end, consciousness is shown to be limited, only being helped by solidarity with others in the hopes of coming closer to a whole. At the same time, I think that there is a theme of therapy that is present in the novel. The Patient, Hanna, and Caravaggio, to name a few, end up achieving some level of healing through talk therapy and articulating their own feelings. It is through therapy and coming out from an emotional point of view that these characters can make sense of the horrific nature of war and its consequences.
The novel offers, in its characters, particularly in the patient himself, ambiguities: they are in war, full of fire and destruction, yet they attempt to restore themselves, or others. So the novel and the character of the patient tell us that we can believe two opposing ideas at the one time: love = hate (patient and affair), fire = water (Caravaggio falls into a river on fire).
The characters in that Italian ruin reject the roles allotted to them by war and war itself represents ambiguity in terms of how we are let off the biblical hook of God’s edict – thou shalt not kill.
In the way Ondaatje tells this story of The English Patient, not with a definite beginning, middle and end, he offers rejection of the traditional historical way of telling the story. Through his focus on characters who are dislocated, Ondaatje has made a kind of patchwork quilt of a story. The pieces, all differently colored and not at all the same, form a rich narrative of complex human identity. Ondaatje’s story and his way of telling it are like the patient himself, with cul de sacs of memory and taking up different points of views on questions, just as the medieval historians who consulted with the invading allies offered a wrong perspective – in terms of time frame - on how to take the medieval Italian towns.
Ondaatje’s themes are like the patient’s story of an adulterous affair and its tragic outcome, like his wanderings in the unsullied desert that had nothing much to do with the official history (His – story) of war, like the sullied saint he is (laden with guilt about that love). So the reader comes away feeling that if we can forget linear history – the official versions of events with its very narrow singular view of events - that if in fact we tried to understand the rich mystery of other selves, then maybe none of those characters would have had to try to restore themselves in a ruined villa in the Italian countryside. They would not have to take themselves out of the current of ‘their’ world history and its inexorable erasing of human lives. They would not have had to plunge into the pool, the well of the patient’s Christ-like mystery. In fact, the patient would simply not have existed in that place and time. Christ is dead – long live humanity.