The speaker had a childhood disability--"my strange, unruly hands"--that made tying his shoes a task to be dreaded, symbolizing failure. He addresses a caregiver who patiently ("for three years, for an hour each day") had taught him to tie his shoes. She reassured the child, "The doctors don't know / everything. You will be normal // someday. Normal."

The caregiver has also experienced bodily difficulties--from curvature of the spine caused by childhood spinal [tubercular] meningitis. She tells the child about her out of body experience ("You told me you'd died once") when she had seen herself on "the table," the "frantic" doctors calling her back "to the particular / boundaries of the flesh." She allowed them to bring her back.

Now, the adult speaker, no longer disabled, ties his shoes "by instinct," "my mind giving itself // up to the common world / of things" but when he focuses on the task, he slows down and remembers his caregiver; he becomes aware of his body, he becomes aware.