Love in the Time of Cholera is written in modular, non-linear form, meaning that the events and other elements which appear in the first chapter of the novel are not explained until much later on in the book, when the author provides the reader with the complete background about a certain character, event, or idea. The explanations that appear later in the book lend significance to otherwise meaningless, mysterious elements of the novel. However, to understand their significance, it is vital that the reader identify such mysterious elements and question why they may be meaningful to the text as a whole.

In this first chapter, the death of Jeremiah Saint-Amour is prominent, and surely has a certain significance, though, as of yet, it is not evident. Most curious is that Saint-Amour's suicide is the first that Dr. Urbino has seen that has not been triggered by a tortured love, but by an acute fear of aging. The reader is provided further clues about Saint-Amour's importance when Dr. Urbino is described as having an unusually emotional reaction to his death. Also notable is the unfinished chess game in Saint-Amour's home, for it not only represents his unfinished life, but also presents questions that are answered later in the novel. Why, for example, is Dr. Urbino so passionate about chess? And why had Saint-Amour asked his lover to remember him with a rose? Was it merely a poetic gesture or a meaningful allusion? The most pressing question the chapter raises regards Saint-Amour's letter: What are the secrets the letter contains, and why does Dr. Urbino conceal them from the commissioner and the medical student? And why, in contrast, does he so desperately want to share him with his wife, the yet unnamed woman who is soon to become one of the book's central characters.

This chapter introduces us to Dr. Urbino. Clearly, the Doctor is a man of great power, esteem, and wisdom, for he is able to convince the commissioner to break the rules so that they may hold Saint-Amour's funeral on that same afternoon. Also, he can only find one man, Saint-Amour, who is a skilled enough chess player to provide him with worthy competition. Though the reader does not know exactly what Dr. Urbino has done to achieve such revered status, his prestige, power, and influence are evident.

There are three essential clues in the first chapter that foreshadow events that occur later in the novel. The first is the appearance of Jeremiah Saint-Amour's secret lover. Although the author gives her no name, Saint-Amour's love is significant in relationship to a later secret affair between Fermina Daza and Florentino Ariza. Saint-Amour's fear of aging, and his lover's comment that he had not even seemed alive during his last earthly months also foreshadow future events. These elements in particular create a foundation on which a thematic fear and loathing of the realities of old age and death is built. Urbino's thought that the city has undergone drastic change since the days of his youth serves as a similar harbinger for the thematic animosity towards aging and the unwelcome metamorphosis it necessitates.