Meena Alexander

Diagnosis by Meena Alexander

Diagnosis by Meena Alexander explores illness and the approach of death. Being diagnosed with a terminal illness, Alexander focuses on the moment in intimate detail. There is a sense of uncertainty, Alexander trying to focus on the present moment in order to not worry about the future. Alexander suggests that dying is ineffable, the feeling of knowing the end is coming being too great to express.

Diagnosis by Meena Alexander


Summary of Diagnosis

Diagnosis’ by Meena Alexander focuses on the news that the poet has a terminal illness and her response to this information.

The poem begins by focusing on the doctor’s words, ‘end’ signaling the approaching death. Alexander watches this scene horrified, then withdraws into herself. She discusses the ineffective nature of language, unable to accurately describe her emotions in that moment. The following day, everything goes back to normal, Alexander asked to go on with her life. Normality demonstrates that death is not the end of the world, it will continue after Alexander is gone, something she struggles to conceptualize.

You can read the full poem here.


Poetic Structure

Meena Alexander splits Diagnosis into twelve stanzas, each measuring two lines. The poem is also segregated into three sections. The first focuses on the initial diagnosis. The second stanza discusses how Alexander felt in that moment, unable to process the emotions. Finally, the third section focuses on returning to normal, Alexander sent on her way. This fragmented structure could reflect the shock of this news, the poet unable to come to terms with her own impending death.

The regularity in structure, each stanza measuring two lines, could also suggest a certain permanence to life. The form is consistent, remaining the same across the whole poem. While Alexander, and indeed everyone, is not going to live forever, there will always be a continuation of people. Life goes on, even if we are not a part of it.


Themes in Diagnosis

One of the central themes that Alexander explores within Diagnosis is illness and death. Receiving her own diagnosis, Alexander is faced with the certainty of her own death. This illness plagues her mind, leaving her unable to express with ‘language’ in the second part of the poem. This illness becomes a huge part of her life, Alexander knowing that she cannot live forever.

Another theme that Alexander discusses in the poem is language. In some cases, in fact, in most poems, language is able to convey essentially any subject. Yet, Alexander explores how something as huge as one’s own mortality can cause turn ‘language’ into a ‘torn ligament’. Alexander is left unable to conceptualize her sickness through language, the poet exploring the extent of this ability. There are some things language cannot express.


Literary Techniques

One of the most prominent features of Diagnosis is the use of italics. This differentiated font is used to express that the doctor is speaking. Yet, the italics also provide a suggestion of unfamiliarity. The doctor is telling her something life-changing, with the italicization demonstrates the strange and unfamiliar oddity of this moment. His words are life-changing, something so simple causing so much grief. The use of italics both emphases his words, while also demonstrating the strangeness of this life-altering moment.

Another technique that Alexander uses within the poem is caesura. Caesura both emphasizes words, while also creating a slight metrical disruption in the poem. When considering that Alexander is discussing the ineffability of death, with language not expressing her thoughts, these metrical breaks could reflect a sense of speechlessness. Metrical pauses expressing Alexander’s inability to verbalize her emotions.


Diagnosis Analysis

Stanzas One – Four

So how will it end?
Could not pluck my eyes from his old man face.

Alexander begins ‘Diagnosis’ with the doctor’s speech, focusing on the question of ‘how will it end?’. Alexander uses rhetorical questions across the first two lines of the first stanza to indicate a tentative tone. The doctor does not want to upset or scare Alexander, instead of bracing her with the questions.

Alexander’s response is assumedly one that asks for more information, the doctor continuing. He quickly lists the impacts that the disease will have on Alexander, focusing on ‘lose weight’ and ‘become more and more tired’. The repletion of ‘more’ displays the draining impact of the disease, slowly sapping the life from Alexander.

Her response is bewilderment, unable to reply verbally. Alexander simply ‘started at him’, watching him after his honest depiction of the disease. The caesura before ‘ravished’ and the following end stop place metrical emphasis on the word. The complete sense of being destroyed by the information is exuded by this word, Alexander ‘ravished’ by the information. The inability to react, ‘could not pluck my eyes’ demonstrates the poet’s sorrow. She is shocked, unsure of how to react to the news of her incoming bodily depletion.

The focus on the state of being ‘old’ when referring to the doctor, later mirrored in the ‘young’ doctor of stanza eight, places emphasis on age. Alexander is being told she cannot live to these ages, ‘old’ being something she will never achieve. The fascination with this reflects her fear of death, the poet not ready to die.


Stanzas Five, Six, Seven

Later the cuneiform earth
Stars still uncover.

These stanzas of ‘Diagnosis’ focus on language and communication, both seemingly unable to express Alexander’s emotions. The reference to ‘cuneiform’ is polysemous. On one hand, it is referring to ancient characters, drawing directly from the semantics of language. Yet, ‘cuneiform’ also relates to three bones in the ankle, suggesting a bodily connection. Both of these are then further explored in these stanzas, ‘torn ligament of language’ demonstrating both ideas in one metaphor. Language is something that is broken for Alexander, she is unable to use it as she once did. The illness is ineffable, language failing her.

Instead, there is only a ‘skeletal beauty’, language only creating a construct of the disease, but never revealing the true depth of emotion. The reference to the ‘stars’ reflect the expanse of emotions, only they can understand the feelings that Alexander is going through. For once, language is not enough.


Stanzas Eight – Twelve

Come dawn a young doctor
Set you free to summer.

Alexander withdraws from metaphor, moving back into the realistic present. The next ‘dawn’, she is discharged from the hospital, asked to continue with her life. Her dismissal is quick and seemingly careless, ‘no grandeur’ in the voice of the ‘young doctor’ that lets her leave. His voice is harsh and unfriendly, perhaps acting as a mechanism of personifying the illness itself.

The reference to ‘spring’ has a slight promise of hope. The sibilance across ‘sempiternal spring’ creates a soft and beautiful aural quality to the line. The oxymoronic pairing of ‘Flash’ and ’sempiternal’ suggests something that Alexander doesn’t understand. It could be that the poet is discussing a possible afterlife, the ‘flash’ showing what is waiting for her after death.

The link between ‘spring’ and ‘summer’ creates a sense of promise, Alexander wanting to retreat into safety. She hopes for an afterlife, the positive connotations of these two seasons creating an inviting location.

The reference to ‘light’ furthers this positivity, whilst also connecting to the idea of seeing a ‘light’, moving towards death. The hyphen creates a metrical break in the poem, perhaps reflecting the moment of death.

The final line, ‘set you free’, suggest a certain relief. Perhaps Alexander is ready for the next step, her body riddled with her illness being something she wants to be rid of. The hopeful ending, finishing on ‘summer’ promises something more, something to look forward to after death.



Meena Alexander passed away in November 2018. Although it was never publicly disclosed, it has been reported by her husband that she died of endometrial cancer. This poem could be a reflection of the moment in which she found out she only had a finite amount of time left to live. The contextual realism of this moment gives the poem a further sense of melancholy.


Similar Poetry

Tory Dent’s ‘us’ is another tragic poem that explores the impacts of sickness on a person. Dent, dying of HIV, writes ‘us’ to her husband, warning him of the future and comforting him. Both poets use poetry to express their emotions, battling against their respective illnesses.

Another poem that focuses on illness is Owen SheersOn Going. Sheers’ poem traces his grandmother’s final moments, sharing a sense of impending death with Diagnosis. Both poems contain a sense of fear and unknowing, yet end on positive notes, both accepting their fates and moving forward to the next stage of life.

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Jack Limebear Poetry Expert
Jack is undertaking a degree in World Literature and joined the Poem Analysis team in 2019. Poetry is the intersection of his greatest passions, languages and literature, with his focus on translation bridging the gap.
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