The English patient tells Katharine about how he fell in love with her. He says he first saw her emerge from a plane alongside her husband, Geoffrey Clifton. He saw before him a married woman who had unexpectedly joined their expedition, and was struck by her khaki shorts and bony knees. He says that she was too ardent, too eager for the desert, but that she took it upon herself to learn all about it - she read everything about the desert, even hunting down marginal articles. The English patient says he was fifteen years older than her, but that she was hungrier for knowledge than he had expected.
He loaned her his copy of Herodotus, and she read from it at a party that Geoffrey threw for the expedition. The English patient says that this is a story of how he fell in love with a woman who read him a specific story from Herodotus. He didn't even have to look up as she read the words across the fire. It was the story of King Candaules, who was married to a woman whose beauty he could not keep to himself. The king told Gyges of his wife's exceptional beauty and arranged for him to sneak into her room and see her undress. But the queen saw Gyges as he left and realized what her husband had done. She told Gyges he had two choices: to slay Candaules and take over the kingdom, or to be killed. Gyges chose the former. Katharine finished the story, and then looked at the English patient. With the help of this story, this anecdote, he fell in love.
The English patient became doubly formal in her company until one day she came to him and said simply, "I want you to ravish me." The two became lovers. They did everything they could to avoid being found out by Geoffrey Clifton, but the English patient knew it would only be a matter of time. He was an aristocrat - he had a large circle of friends and family, one of whom would eventually find out. But Katharine couldn't handle the ambiguity of the affair, telling the Englishman that he just slid past everything with the fear of being owned or named. Eventually, she returned to her husband.
Back in the present day, Caravaggio injects the patient with more morphine. The English patient continues his story, but no longer uses "I." Instead, he talks about Katharine and Almasy. Caravaggio asks the patient who is "talking" in these memories, for the English patient cannot admit he is Almasy. The patient responds simply, "Death means you are in the third person." The English patient remembers bringing Katharine to the Cave of Swimmers and using the sand on the walls to make her body beautiful. He left, promising to return, but when he got to El Taj, he was just rounded up like a second-rate spy, despite his fervent protests about his dying wife. The patient, interestingly, refers to Katharine as his wife, even though he realizes he should have used Clifton's name.
Caravaggio asks the English patient if he murdered Katharine Clifton. He says Geoffrey Clifton was with British Intelligence - and Caravaggio responds by saying that British Intelligence knew about Almasy's affair with Katharine even before Geoffrey. When Geoffrey died, British Intelligence went to capture the English patient, and finally succeeded at El Taj. Caravaggio tells Almasy that he worked for the British as a thief and that Almasy was considered a dangerous spy - all of British Intelligence had been looking for him. The English patient knows nothing of all of this and can only attest to his love for Katharine.
Kip and Caravaggio celebrate Hana's 21st birthday. Kip remembers when he first flew into Naples, Italy in October of 1943 as part of a sapper unit. The Germans had brilliantly and viciously attacked the Italians, laying mines all over the city and even sabotaging the electrical system so it would go up in flames once the electricity came back on. The city was evacuated so Kip and his fellow sappers could demine the city.
One day, Hana sees Kip in the garden, listening to the radio on his headphones. He hears something awful, runs into the tent to grab his rifle, and then sprints up into the English patient's room. He tells Almasy that the Allies have dropped the atomic bomb on Japan, and that he wants to kill Almasy because he is a representative of the West - the West that would create such destruction. The English patient begs Kip to kill him, but Kip doesn't. Kip leaves the villa on his motorbike, promising himself that he will not think of Hana. His dismay causes him to skid and fall into the water.
Hana, meanwhile, writes a letter to her stepmother in which she finally explains how her father died. He was burned, and deserted by his men. She could have saved him, but she was too far away. The novel ends with Kip: it is years later, and Kip is a doctor with a wife and two children. He thinks often of Hana, who used to send him letters, but because he didn't reply, she finally stopped.
So much of the final chapters of The English Patient are about echoes - about the transmission of knowledge and the passing down of wisdom and lessons. Indeed, one only has to look at the final image to see this: in the last moment of the book, Kip catches a fork that nearly hits the ground. This is a seemingly innocuous gesture, but one that mirrors the moment when he caught the fuse box that almost blew up the villa. He has lost his need for a life-and-death struggle, abandoned his desire to cultivate the coping mechanisms that help him feel. He has healed somehow, found maturity, and is now ready to have his own family.
Hana, meanwhile, undergoes her own transition at the end of the novel. She writes to her stepmother, and finally we learn why she has trapped herself in the villa. Her father, it seems, was burned beyond recognition, and she was too far away to save him. Now, the English patient has become a proxy for her dead father. She traps herself in the villa, a utopian compound where she can be with him all the time, in an effort to atone for the "sin" she believes she has committed. She can't let her patient go, for to do so would mean letting go of her guilt over her father. When he finally dies, however, we know that Hana will finally be at peace: she has done her duty.
The structure gets more complicated in these final chapters, as the English patient revisits his earlier story while filling in many of the earlier gaps. We begin to see just how much he was in love with Katharine - so much so that he was blind to everything that was happening around him as the British closed in on him. Indeed, it seems that he forgot his own identity. Even now, when he is close to death, he remembers nothing of Almasy, recalling only his love for Katharine. Caravaggio keeps pressing him to absorb the name of Almasy, to claim it as his own, but the English patient cannot. In death, he only has the memory of love. Everything else is just third-person, irrelevant.
Kip's threat to kill the English patient is ironic, for he was the one who disdained his older brother's confrontational demeanor. Recall that his older brother was thrown in jail because he could not be subservient to anything English, anything Western. Now, the moment that Kip hears about the atomic bomb, he comes after Almasy, believing that if he kills an Englishman he will somehow be able to atone for all the sins of the West. Ultimately Kip doesn't kill the patient and flees, but there is lingering doubt as to whether he's ever really healed. He thinks about Hana even after he has married; even running away - from the villa, from the West, from war, from everything - cannot erase his feelings for her.
In the end, we're left with the sensations associated with healing over the death of a man who came to value love over all else. Almasy is, in fact, the truest symbol of war: a man whose identity is valued by everyone else, but who is unaware of his own political significance. All Almasy ever wanted was Katharine - so much so that he lost touch with time, space, senses, his physical identity, and his political identity. From the English patient's journey, Kip, Hana, and Caravaggio learn that love transcends all. And even if they don't absorb this fully (for they are all young, headstrong, and lost in the whirlwind of immaturity), they all have their individual moments of realization, growth, and transformation.