Ghost Letters in effect stands witness to the U.S. AIDS epidemic. Because the collection also includes poems about childhood and poems that deal with desire and love independent of death and AIDS, the book as a whole resists segregation as exclusively tied to gay or HIV/AIDS culture. Individual poems, such as "Nights of 1990," which includes representations of a caregiver interacting with an AIDS patient in a hospital, are particularly effective in exposing students to an individual experience of the AIDS crisis, but this poem, like the larger collection, extends the borders of community in its compassionate exploration of loss.

Poems like "Fragments from an Explanation" evoke the way language itself becomes unhinged by death and nonetheless offers a bridge back from the isolation of grief. McCann's extraordinary language and gorgeous imagery trigger memory and emotion to create a complex understanding of death and mourning.