Chapter XLI achieves its tragic and powerful effect mainly by following through on the painstaking preparation of all the chapters that have gone before. For instance, the nurse's instructions that Catherine change into a nightgown upon her arrival at the hospital remind us of the nightgown bought for the hotel stay on the couple's last night in Milan, perhaps even hinting that it was on that evening that Catherine conceived the baby she is about to bear. Similarly, card games among the patrons of the café where Henry eats during the baby's ill-fated delivery remind us of his gross misunderstanding at the affair's beginning that it was a game, like chess or bridge.
Notice that Catherine tells the admitting nurse she has no religion. About her caesarian operation, Henry tells us that "It looked like a drawing of the Inquisition." Admitting once again that he himself is an agnostic, Henry briefly regrets that the baby was not baptized, then changes his mind. There is no point in believing in God in a world that senselessly kills Aymo, Rinaldi, the baby — and "Now Catherine would die." It is a world like the burning campfire log that Henry describes, swarming with ants that he cannot save despite the impulse "to be a messiah."
Still, as anyone would, he tries bargaining with God in his desperation at Catherine's impending death. She, on the other hand, retains the courage of her convictions to the end. "Just you," she requests of Henry in response to his offer of a priest's visit. Despite everything, love is her religion until the instant she dies.
