The seven sections of this long poem (128 lines) take the author from admission through a bone-marrow procedure (in front of student nurses), surgical prep, post-op recovery, urinary catheterization, and finally, a melancholic post-discharge confrontation with the decay and death of the natural world in late autumn. Sissman directs a sometimes withering sarcasm against both himself and his caregivers, nevertheless controlling a temptation to overdramatize his suffering or attack the hospital environment too harshly. Keen observation and carefully clever metaphors make poetry his best defense against his own impending death from Hodgkin’s disease.