The novel intricately explores the inner worlds of its characters by delving into their personal memories and examining the effects of trauma. In Hana's journey, the narrative charts her progress from trauma through stages of denial, ultimately leading to acceptance.

The storyline is often propelled by the characters' encounters with sorrow. For example, the English patient grapples with the loss of Katharine. His deep emotional turmoil and reluctance to address her death are reflected in the novel's structure. Whenever he begins to speak or think about her, his dialogue and hallucinations undergo significant changes. In the chapter titled "Cairo 1930–1938," the patient shares his past with Hana, recounting the beginning of his affair with Katharine, narrating in the first person. However, during a drug-induced conversation with Caravaggio, he is forced to confront the details of her death. Here, his narrative style changes dramatically; he shifts to the third person, referring to himself as Almásy, his true identity. This change prompts Caravaggio to question whether the patient is speaking as himself or assuming another persona. By using third-person narration, the patient distances himself from Almásy and his suffering, enabling him to discuss Katharine's death. His hallucinations and denial of his true self allow him to detach from his personal pain, thus avoiding it. As he tells Hana, "Death means you are in the third person."

Although the patient finds no relief from his grief until his eventual death, Ondaatje portrays redemption through acceptance with Hana's character. Hana's journey involves moving from overwhelming grief and denial to healing and acceptance. Throughout the novel, she refuses to accept her father's death, even telling the patient that he remains alive in France. Kip's arrival in her life, and the joy and comfort he brings, enables Hana to experience happiness again. Despite Kip's eventual departure, Hana finds the strength to move forward. Her transformation is apparent in the letter she writes to Clara at the novel's conclusion, where she finally speaks openly about her father's death.