In his discussions with the therapist, Alex returns frequently to the subject of his nose. To Alex, his nose is a constant reminder of his Jewish identity; to the audience, Alex’s obsession with his nose symbolizes the anxieties caused by his preoccupation with his Jewish identity. That Alex cannot remove or change his nose is a symbolic reminder that he cannot stop being Jewish. Instead, this symbol is fixed and stares back at him every time he looks in a mirror. Furthermore, he cannot hide his nose in public, so it becomes a symbol to everyone around him of his enduring Jewishness. In each chapter, Alex returns to the subject of his physical features, and his nose is the most frequent recipient of his ire. His nose becomes the focal point of all his anxieties, becoming a public broadcast of the aspect of his existence that he finds most confusing.

As well as functioning as a symbol of Alex’s inner turmoil, his nose symbolizes his relationship with his father. Alex believes that he inherited his father’s nose, as he explains while tracing an outline of his face on his father’s office paper. In tracing his own nose using his father’s instruments, Alex frames himself and his appearance as a product of his father’s design.