The word "and" is repeated over and over again in the poem "To the Doctor Who Treated the Raped Baby and Who Felt Such Despair." What is its purpose in the poem?

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First, I would point you to this answer elsewhere on eNotes, which discusses the double nature of the poem -- part of the poem describes the horrific trauma of the raped baby, while another part provides images of children safe in loving homes. Take, for example, the following passage:

and when the bleeding baby was admitted to your care
faraway a Karoo shepherd crooned a ramkietjie lullaby in the veld and while you staunched
there was space on a mother-warmed sheet
for a night walker
and when you administered an infant-sized opiate
there were luxuriant dark nipples
for fist clenching babes

The "and" has a double purpose. First, it serves as an additive -- it immediately preceeds each action of the doctor, and the effect is one of documenting the lengths to which the doctor must go to save the child. In another sense, the "and" has an almost accusatory effect, its repetition serving as a kind of recurring sound, almost like a tolling bell, calling attention to the horrible nature of the crime. The doctor's final question, "Where is God?" contains in it the double mood of the poem -- in one sense, we understand it to mean, "How could God allow this," but in another sense it is a little ironic, because clearly God is in the hands and caring heart of the doctor.

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