He was nauseous when he awoke in a cell that was like a dank pit, and, in the days and nights that followed the operation he realized that until then he nearly had been in a suburb of hell.

This first quotation describes the narrator after an operation. He has, after receiving a bump to the head, narrowly avoided "dying from septicaemia." The simile, "a cell that was like a dank pit," vividly describes the poor conditions in the hospital. The word "cell" is usually used to describe a room in a prison, and "dank" suggests an unpleasant coldness and an uncomfortable humidity. The metaphor at the end of the quotation ("he nearly had been in a suburb of hell") could be describing the hospital, or the narrator's proximity to death before the operation in the hospital. Either way, the narrator's time in this hospital is the catalyst which changes his life. Hereafter, he is never quite the same again.

It was as if he were simultaneously two men: one who was moving through an autumn day and his country's geography and one who was locked up in a clinic and being put upon by methodical staff employees.

In this second quotation, the simile, "it was as if he were simultaneously two men" links back to the idea that the narrator's time in the hospital had some kind of lasting, even seismic, impact upon him. He came out of the hospital divided, as if his consciousness had been divided between one version of himself who left the hospital and another who remained there. This rather strange idea is characteristic of Borges' work, much of which later came to be classified as 'magic realism.'

"Darkness began settling over the countryside, but its scent and sounds could still reach him through the iron bars on the window."

There is, in this third quotation, an ominous sense of foreshadowing, with the settling darkness alluding to the fate of the narrator at the end of the story. The image of the "iron bars" connotes imprisonment, emphasizing the sense of foreboding. The prison imagery also links back to the "cell" described in the first quotation. The hospital perhaps imprisoned the narrator metaphorically as well as literally. He has, since he was confined to a "cell" there, been confined within the effects of the operation.

The train car was different. It was no longer the one it was when it left the platform in Constitución Station: the plains and the hours had run through it and transfigured it.

The strange, surreal, magical-realist tone of the story is evident again in this fourth quotation. The narrator wakes up on a train that seems to literally have been changed while he slept. The metaphor in the quotation describes how "the plains and the hours had run through it and transfigured it," meaning that the external landscape ("the plains") had somehow found its way into the train, and time ("the hours") had somehow taken on some sort of physical property, and both together had transformed the train as if they became manifest as, for example, a deluge of water. This strange metaphor continues the idea that the narrator has, since his stay in the hospital (or since the bump on his head which preceded it) somehow become unhinged, or dislocated from reality.

On the ground, propped up against the counter, a very old man, stationary like an inanimate object, was curled up. His advanced age had shrunk and polished him as streams do to a stone or as the succeeding generations pass judgment on men.

This fifth quotation describes...