When Odilo is known as Dr. Friendly, working with children in the hospital, the narrator talks about one family in particular. Mrs. Goldman has two children, an infant and a little girl of three "whose hips we have decided to destroy." Tod is actually healing the child after some kind of severe injury, but, seen in reverse, the narrator misinterprets Tod's actions as destructive rather than healing. At this point, the narrator says,

I keep expecting the world to make sense. It doesn't. It won't. Ever. You have to harden your heart to pain and suffering. And quick. Like right away at the very latest.

While Tod works as a physician, the narrator constantly sees patients start off healthy and smiling, and then, through Tod's actions, they grow weaker and more ill. Then they leave. Of course, Tod is actually helping them to get better, but the narrator views Tod's life backward, interpreting effects as causes. Thus, Tod appears to the narrator to be heartless and cruel at times. This is ironic just as when, later in the novel (but earlier in Tod's life, when he is called by his original name, Odilo), the narrator believes that Odilo is creating life rather than destroying it when he gasses Jews in Auschwitz. Seen in reverse, the narrator misinterprets Tod's healing actions as destructive (which makes the world not make sense) and Odilo's heartless destruction of life as a beautiful act of creation.

As Odilo Unverdorben, he arrives at a monastery in Portugal where he seems to be seeking not only sanctuary but spiritual aid. Father Duryea gives him his new identity, and Hamilton says,

I still want to heal, Father. Perhaps, that way, by doing good . . . 

It seems, then, that the man hopes to atone for his great multitude of past sins, and we come to understand, perhaps, why he works so tirelessly and doggedly as an older man, a doctor, in America. He hopes to heal himself by doing as much good as he's done evil. He explains to the priest that (in the camps, as we later learn),

We lost our feeling about the human body. Children even. Tiny babies.

We begin to piece together, now, why Tod and John had nightmares about babies, "bomb babies" the narrator called them. The narrator felt as though these dreams were premonitory, seeing the man's life in reverse order, but we now understand that Tod/John/Hamilton is haunted most by the lives of the young children that he took at Auschwitz.

The entire story is pervaded by this sense of plunging toward something dreadful. Odilo doesn't just have a secret, something shameful or ugly; he has the worst possible secret one might imagine. The narrator, despite his seeing Odilo's life in reverse impresses us with this menacing and foreboding mood throughout. He says,

How many times have I asked myself: when is the world going to start making sense? Yet the answer is out there. It is rushing toward me over the uneven ground.

Ironically, the narrator thinks the world makes more sense when he sees Odilo's actions, in reverse of course, at Auschwitz. He believes that the man is finally doing good in the world, that he is creating life rather than demolishing it. The narrator anticipates some past horror and, instead, finds scenes that the narrator considers hopeful, beautiful: dead bodies coming to life by the use of carbon monoxide, children entering the lab diseased and weak and leaving it healthy and well. The narrator is mistakenly heartened by the most heartless actions Odilo has ever taken. He anticipates hate and finds love, while we are left to anticipate hate and realize the painfully dramatic irony that the narrator does not, and cannot, understand.