In this chapter, Hemingway briefly reiterates the theme of Lieutenant Henry's alienation from the war, further preparing him and us for his eventual flight from involvement. He is the first and only patient in the American hospital, which barely functions as it lacks a doctor. Mainly the author is setting the stage here for the escalation of Henry's affair with Catherine Barkley; the American hospital in Milan will serve as a kind of refuge for them and their love, until Henry is sent back to the front at the conclusion of Book Two.
Notice, at chapter's end, Henry's inability to sleep well at night. Throughout his hospital stay, he will continue to sleep mainly during the daytime. Hemingway's heroes are often afraid of the dark.
