The English patient flashes back to another of his memories, describing the time in Cairo when he was in love with Katharine. One day he asks his friend Madox what the spot in the front, right at the base of a woman's neck, is called. Madox tells him to pull himself together.
Caravaggio tells Hana that he thinks the English patient is not really English. He thinks he is a Hungarian man named Almásy who worked for the Germans during the war. Almásy had been a desert explorer throughout the 1930s. He knew all about the desert and its dialects, and when the war broke out, became a guide for spies, taking them across the desert into Cairo. Caravaggio thinks the patient is Almásy because one night the patient suggested some very peculiar names for the dog—names only Almásy would know. Hana sticks to her opinion that the patient is an Englishman.
Caravaggio continues, telling Hana the whole story of the Hungarian man. Almásy had helped the German spy Eppler get across the desert. Eppler was an extremely important man, as he delivered coded messages directly to General Rommel through a code hidden in a copy of the novel Rebecca. Almásy was known for both being able to fly planes and being able to sound English. He was educated in England and in Cairo he was even known as "the English spy." Caravaggio is almost certain that the English patient is Almásy.
Since being wounded, Caravaggio has become a morphine addict. Hana noticed that he found and raided her supply of medicinal morphine as soon as he got there. Now Caravaggio wants to give her English patient a Brompton cocktail—morphine and alcohol—to get him talking. Hana is concerned and thinks Caravaggio is too obsessed with her patient's past. She figures that it does not matter what side he was on now that the war is over. Hana tells her patient that Caravaggio thinks he is not English. She also tells him that Caravaggio was a thief, albeit an unsuccessful one, in Canada.
After the Brompton cocktail, the English patient talks freely about the events that led up to his plane crash. He tells Caravaggio exactly where he was in the desert, having just left the Gilf Kebir. Driving through the desert, his truck exploded. He assumed it had been sabotaged by one of the Bedouins, as there were spies from both sides among them. Escaping the explosion, he set out in the direction of a plane he knew was buried at one location in the desert. After four nights of walking, he arrived at Ain Dua, where the plane was buried. There, he cooled himself in the waters of the well and entered the cave where Katharine remained. He had promised to return to her. He found her in a corner wrapped in parachute material, dead. He approached her, as a lover does, and made love to her dead body. He then carried her out into the sun, dressed, and brought her to the plane.
Katharine had been in the cave for three years. In 1939, she was injured when her husband Geoffrey attempted a murder-suicide with his plane. Geoffrey had somehow found out about their affair and intended to kill all three of them in one moment. He was supposed to pick up the English patient in the desert at an appointed time. He arrived, but was flying erratically. He landed not fifty yards away from the English patient, intending to crash into him and kill all three at once. But the English patient was unhurt and Katharine was only injured by the crash. Still, she was too weak to walk across the desert, so he carried her to the cave to wait for him. He left his copy of Herodotus with her. He promised to come back for her and take her to safety. Three years later, he did.