Summary:

Spoiler alert: for educational purposes, this annotation reveals plot lines and may interfere with some viewers' enjoyment of the film. In the opening scene, Juliette (Kristin Scott Thomas), looking ashen, drawn, and nervous, sits in an airport as her much younger and radiant sister Léa (Elsa Zylberstein) rushes to meet her.  Léa brings an eager, if somewhat forced cheer to their halting conversations during this meeting and in their car ride to the home Léa shares with her husband, their two small adopted Vietnamese daughters, and her mute father-in-law.  From this awkward beginning, the sisters try to cross the chasm of a fifteen-year separation.  The cause and nature of the separation gradually unfold in small, slowly paced scenes of ordinary life at home, at work, in a café, during dinners with friends.  These scenes form the visible surface under which secrets and plangent, unacknowledged emotions lie, sometimes erupting into view, sometimes gently suggested.
    
The cause of the separation is the prison term Juliette has served in England.  We eventually learn that the sentence has to do with the death of her child, with her being a physician, with her child's suffering from cancer, and with the application of her medical knowledge to end his pain.  Following the court sentence, Juliette's parents refuse to acknowledge her, her husband divorces her, her sister buries memories of their childhood and chooses not to give birth, family and friends never visit her in prison.  We also learn that Juliette remained inexplicably silent throughout her trial.  She continues to say very little as she settles in with Lea's family and circle of friends, who are baffled by her sudden appearance in Lea's life.  But as Juliette's participation in her sister's circle increases in fitful starts, she becomes cautiously more communicative and brighter.

During a confrontation with Léa at the end of the film, Juliette reveals that, more than avoiding a shameful appraisal from others, she remains silent because there are no words to express her pain.  Being in prison made literal the isolating psychological state she inhabited.  "The worst prison is the death of one's child," she says.  "You never get out of it."  With these words, the film places the wound and the pain at the core of its main character in the inescapable vulnerability of motherhood.    

    

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Summary:

It is part of the interest of this film that it is not easily summarized. The present tense of the film is the final year of World War II, the setting a bomb-damaged villa in the hills north of Florence, the action four characters seeking shelter there and attempting to undo some of the damage of the war.

The title character (Ralph Fiennes), whose identity is a mystery at the beginning of the film, was badly burned all over his body when his plane crashed in the desert. He lies in a bed, morphine deadening his pain and loosening his memory, reminiscing about a love affair with Katherine Clifton (Kristin Scott Thomas) and his career in military intelligence as a desert expert

The young Canadian nurse Hana (Juliette Binoche), emotionally shut down as the result of her work in the war and the death of her lover, has refused to withdraw with her Red Cross unit and lovingly tends to the badly burned patient and develops an intimate relation with Kip (Naveen Andrews), a Sikh munitions expert who by day disarms unexploded mines and bombs. An American nicknamed Caravaggio (Willem Dafoe), a criminal who has been recruited by military intelligence, shows up and probes with increasing intensity into the mystery of the history and identity of the "English" patient, who he believes in some way responsible for the amputation of his thumbs by the Germans.

Much of the film consists of flashbacks through the point of view of the English patient, who it turns out is a Hungarian count, Laszlo Almasy, an explorer and geographer of the north African desert, who in his deep devotion to Katherine Clifton did in fact commit a treasonous act that indirectly led to Caravaggio's amputations. The film ends with Caravaggio finally forgiving the badly wounded Almasy, Hana granting Almasy's request of a peaceful death, and she herself leaving for Florence, where we expect she will meet Kip, who has just been reassigned there.

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