Set against the backdrop of burgeoning scientific advancements and philosophical debates, the novel subtly questions the limits of human understanding. The sanatorium itself, intended as a haven for healing, becomes a microcosm of societal anxieties, with patients grappling with physical and mental ailments that defy easy categorization. The presence of the Empusa, a mythical creature known for shapeshifting and preying on the vulnerable, further blurs the lines between reality and delusion, challenging readers to confront the limits of rational thought.

Tokarczuk deftly interweaves ancient folklore and mythology into the narrative, grounding the novel's sense of unease in timeless fears and superstitions. The Empusa, with its shape-shifting abilities and predatory nature, embodies the anxieties of a society on the cusp of change. Its presence serves as a reminder of the enduring power of myth and folklore, even as modernity attempts to explain away the unexplainable. The novel invites readers to consider the ways in which ancient beliefs continue to shape our perceptions of the world.

Set in a time of shifting gender roles and burgeoning feminist movements, the novel subtly examines the position of women in early 20th-century society. The sanatorium, a predominantly male space, becomes a microcosm of the larger societal structures that confine and define women's lives. The Empusa, often depicted as a seductive female figure, can be interpreted as a symbol of female agency and transgression, challenging the restrictive norms placed upon women.