This poem is my personal favorite of the 18 under discussion. It is heart-wrenching. I see a parent or close relative visiting a child in the surgical ward (in England is the word "surgical" limited to actual surgery?). The patient is someone with a life-threatening condition or a terminal or progressive illness. He need not be a child, of course, but I immediately think child because I associate the clowing around with something you do when someone doesn't quite understand how ill he is. The narrator will do whatever she can to amuse the patient and keep his spirits up, while inside she wants to howl her grief and pain like an animal. She wants to lash out at someone, but can find no one on whom to focus her anger.
I would not change the order of the couplet. It isn't until the final line that we know the patient is probably dying and that the narrator is aware that each visit could be the last time she sees him. Surely what the narrator knows is the climax of the poem, not what dogs or monkeys know.
Carol
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