The first time Katharine dreamed of the English patient, she woke up screaming in the bed she shared with Geoffrey. Her dream was the first time she realized her feelings for the other man, although when she saw him and listened to him talk about desert explorations, she had wanted to slap him. Katharine was always wanting to slap the English patient, and this feeling, even though she didn’t readily recognize it, was sexual too.
Ondaatje implies throughout the novel that love is closely related to violence and hate, and these things seem to be nearly indistinguishable in Katharine’s case. Katharine’s love for the English patient often manifests in violence, as she is constantly striking or wanting to strike him. This is further evidence that the power love can change people, in negative ways as well as positive.
One day, before Katharine and the English patient made love for the first time, he asked her what she hated most. She told him that she most hated a lie and then asked him what he hated most. He answered “ownership” and told Katharine to leave and forget him. Making a fist, Katharine swung and connected with the bone just below the English patient’s eye, leaving a large bruise. Later, he examined the welt in the mirror, and realized that he had not looked at himself in the mirror for years.
Looking in the mirror, the English patient realizes that the love he shares with Katharine has made them both into the thing that they hate. For Katharine, their love has made her into a liar, as she is unfaithful to Geoffrey. The English patient becomes indebted to Katharine because of their love, which can be seen as a type of possessive “ownership.”
The English patient could not keep himself from Katharine, and when he was not in the desert, they were together. At night, he would lie in her arms, but Katharine often felt guilty about their relationship. She claimed she didn’t know what to do; if Geoffrey ever found out about their affair, he would “go mad.” As their affair progressed, Madox couldn’t help but notice the English patient’s multiple bruises and bandages, and he wondered why his friend was suddenly so prone to accidents.
Again, Katharine’s love often manifests in violence, and this is likely a product of her guilt and her anger with herself for becoming what she hates: a liar. Katharine’s insistence that Geoffrey will “go mad” foreshadows his eventual vengeance against the English patient and Katharine, which further reflects love’s power to change people and even drive one to insanity.
Whenever Katharine had to leave the English patient and return to Geoffrey, the English patient was “insane.” He couldn’t stand to lose her if it meant he couldn’t continue to hold her. It was not long before she told the English patient she could no longer see him, and he agreed. Again, Katharine was convinced that Geoffrey would “go mad.” When Katharine left for the last time, the English patient told her that he didn’t yet miss her. “You will,” she said.
Love seemingly has the power to drive Geoffrey insane, and it has the same power over the English patient. In this way, love is not always a positive thing across the board. Love can enhance one’s life and lend meaning, but it can also destroy one’s life and lead to despair and “madness.” Of course, Katharine is right—the English patient does miss her, especially in her death.