Apparently it was mostly because the title of the novel had to be kept. Because I agree with you, in the movie this anonymity is somewhat lacking.
In the novel it makes much more sense, because the fact that the patient is Almasy is not directly revealed for quite some time. And even when it is (and it's more like Caravaggio’s suspicion), the fact doesn’t matter much to anyone else. So throughout the novel he’s referred to as „the English patient” or „the Englishman”. He’s anonymous.
To be honest, that was part of the story’s charm. To me at least. He was just a man with a story – no name, no identity, only his memories. Like so many people during the war.
I’m not comparing the film and the novel, because in many ways it is a completely different story. Not better or worse, just different.
Though, if you loved the film, I would advise reading the novel. Gives another layer, multiple layers actually, to the whole story.
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