Larkin combines three themes that contribute to one another: Questions of health and sickness are hinted at in terms of bodily health but also in terms of mental and spiritual health. Outside the building is a living, normal world of “close-ribbed streets” that “rise and fall” in an image of breathing, “like a sigh,” where people are “free” and go about their business. This everyday normalcy is belied by the later reappearance of images of the body in stanza 7. The dream of life occurs only when “conceits” (vanities) and “ignorance congeal” like blood within a vein, a vein which itself “collapses,” taking that dream of life with it as death is confronted.

The confrontation with death is also sometimes cast in terms of crime and imprisonment. In stanzas 3 and 4, the presence of those “humans” in the waiting room is associated with something that “has gone wrong,” with “error of a serious sort.” In stanza 5, when someone is wheeled away, the “rooms, and rooms past those” into which they disappear and which are “hard to return from,” carry a sinister implication of torture. At the same time, the references to confession and to a building of many rooms also has Christian connotations of the confessional and Christ’s words about there being a place for everyone in heaven. This association is strengthened in later stanzas, with references such as the communionlike “Each gets up and goes,” and “congregations” in “white rows.” At the same time, however, that image of “white rows” could be prison cells and/or slabs of a morgue.

By mixing these three images, Larkin communicates the mixed attitudes society takes toward disease and death. The onslaught of fatal illness can be regarded as the result of moral failure, of “not living right,” or, alternatively, as an opportunity to come to terms with things that are not of this world or as the beginning step toward eternal life. The cultural reluctance to name certain forms of terminal disease renders them even more mysterious and terrifying. Larkin reduplicates this effect by leaving the building and the plight of its inhabitants unnamed.

Finally, this poem has strong associations with Matthew Arnold’s poem “Dover Beach” (1867). The image of the cliff appears in both, as does the lament that the world is a land of dreams. Most important, the “crowds” in “the coming dark” are the same as those clashing on Arnold’s darkling plain. By this connection, Larkin’s poem can be understood to be functioning at a level far beyond the immediate portrayal; it becomes a lament for the very nature of the human struggle.