Christopher McVey has discussed the nature of Ondaatje's use of metaphysical aspects of body, history and nation in the novel. Amy Novak and Mirja Lobnik have separately analysed aspects of the treatment of memory in the novel. Thomas Harrison and Rachel Friedman have each examined the references and use of Herodotus in the novel. Madhumalati Adhikari has critiqued the treatment of World War II and its effects on the characters of the novel.
A major symbol of the novel is the desert. It serves as a representation of the characters' war experiences and how they came to gather in the villa. A passage in the novel notes "The desert could not be claimed or owned." Carravaggio had stepped away from the war for a brief time when he drifted into the villa and encountered an old flame, Hana. Kip elects to stay in the villa, a straggler from his unit, to continue searching for explosives. He also finds there is a serene sense of acceptance in the villa and that the people need him. Hana is devoted to her patients, to the very last. Thus, she stays behind in the villa hospital when numerous others abandon it. Almásy himself is forced into the villa, essentially because the desert took him when his plane was shot down. The characters were like grains of sand that blew with the wind to be fatefully settled into the villa ultimately facing their own mysteries and finding within themselves answers to some of their dilemmas. The film adaptation also captures this aspect of the novel. There is an essay that states "The story tells the audience what they need to know when they need to know it." This is very true of the novel. Michael Ondaatje shrouds his plot like sand. Nothing is revealed until a carefully selected time in the story. Character aspects are settled in the villa like sand before being blown into destiny.
A psychoanalytic analysis of "The English Patient" helps us to understand the meaning of Michael Ondaatje's emphasis on his characters' differences and appearances. He may have been thinking about how melting pot civilizations begin by different cultures working together in spite of each other's back ground. Note how each central character living in the reconstructed villa is almost as opposite of each other in appearance as they could be. Hana was young, healthy, and capable of caring for more than one person at a time, but she mainly attended to the English patient. Much like Americans take credit for teaching southern blacks to farm land and raise a family. In contrast to Hana, the English patient was handicapped and on his death bed. But little did Hana know, in the English patient's past, he had worked with the Germans on other desert expeditions way before their paths had crossed. However, his amnesia couldn't allow him to remember such things at the moment. In other words, Hana was caring for someone who was partly responsible for her village's demise. The moral of this is that Hana, the English patient, Kip, and Caravaggio had fewer physical resemblances to each other than they had had of humanistic desires. Thus, Michael Ondaatje may have wanted us to see that what's on the outside doesn't matter as much as what's on the inside when rebuilding a village, city, or country.