Wealthy living
The life of Rani is the one shown as enviable, comfortable, and privileged. But is that the happiest life? The novel uses the flourishing imagery of wealth to contrast with Rani's suffering. It seems that none are free from the grips of the human experience, and although Rani believes she can attain freedom from suffering through a certain lifestyle, the wealthy lifestyle seems to be self-explanatory, so she never discovers when it is the source of her misery.
The hustle of poverty
The gardener's daughter, Reshma, doesn't have the opulent choices that Rani does, but that forces her to make choices with a sense of deep responsibility. She believes that she can make a peaceful life from the dirt, and she attempts that with her husband, inspiring him to a deeper love. Together, they work very hard to make ends meet, but that doesn't matter, because they are fulfilled, together, and ultimately happy. The imagery of hard work and responsibility lead Reshma to joy.
Hospital and health
The imagery of the hospital is a jarring transition for Rani. Instead of being surrounded by her status quo, by her normal life with all its extravagance, she is now reduced to a hospital room where she is just a specimen on a table. She isn't immortal, like she makes herself out to be in the privacy of her own life, but rather, she is an animal with serious health issues, and the change of scenery is striking to her, causing a transformation.
The hint of Europe
Ruth is a Londoner. She doesn't bring the whole city of London into the novel, but she does bring a European point of view to the situation. She sees the situation through slightly different lenses, and for some reason, Rani's struggle with anorexia is critically important to her. Perhaps this use of imagery is designed to show a European audience that this story isn't stuck in Pakistan. The story of wealth corrupting human happiness is universal and critically important.
