There are several themes that are intertwined all relating to the effects of war on the human body and spirit.  In a hospital in Milan, Italy, soldiers wounded in action during WWI are recovering.  At this hospital, the wounded are treated with new advances in physical therapy, they share the experience of having faced death and survived, one of the main themes of the story.

The theme of courage or cowardice is also examined through the perspective of each man's sacrifice.  The narrator has a leg wound, he receives physical therapy for his injury while an Italian Major's hand has been injured, which will likely mean that he will never fence again. Is a hero defined by his desire to charge into war without care for his own life, only concerned with fighting the good fight?  Is it wrong to want to survive, and to hold back a little and be protective of your life?  Is this what defines a coward?      

The atmosphere of the hospital, created by the doctor, who tries to convince the men that these new machines can transform an injury and restore function, offers a view of another theme, dignity and the human condition.  Even though the doctor shows them before and after pictures, the men don't believe the machines will actually work.

Hemingway is very gifted as depicting the loss and loneliness of these wounded soldiers, especially the narrator who is literally in another country.  He witnesses the event when the proud Italian Major, so stoic with his injury receives news that his young wife has died after a brief illness. Here Hemingway brings in a sense of loss, so deep that the Major loses his will or desire to understand life.  Life for him is meaningless.  

"The major’s resulting understanding of life’s cruel lack of meaning puts him in ‘‘another country’’ from the younger, still somewhat idealistic narrator. The mind set of the major is both alien to him and lonely, yet it is inevitable to all human beings. After all, the story suggests, attempts to avoid loss are only temporary."