Allen Ginsberg dedicates this poem to his mother, Naomi, who endured a series of mental breakdowns and several stays in various sanitariums before eventually receiving a lobotomy (a procedure used then as a last resort—they are no longer legal—that severs parts of the brain from one another and dulls or completely eliminates emotional experience). When the poem begins, Ginsberg is walking the streets his mother once did,

Toward education marriage nervous breakdown, operation, teaching school, and learning to be mad, in a dream—what is this life?

His mother was, evidently, a vibrant person who was a teacher before her breakdowns, a real person with dreams and aspirations and pride and hope for the future. She was a "little girl—from Russia . . . frightened on the dock." She raised a family and had a life before it was all taken from her. Ginsberg seems to ruminate on these details for some time. Now, however, he says to her,

There, rest. No more suffering for you. I know where you've gone, it's good.

Now, he hopes that she has escaped all her pain—"Death let [her] out, Death had the Mercy"—and she can be finished with everything, returning to a place and state of being that existed before anything and everything else in the world.

He considers

All the accumulations of life, that wear us out—clocks, bodies, consciousness, shoes, breasts—begotten sons—your Communism—'Paranoia' into hospitals.

And he wonders what it is like for her now. Is it dark or radiant? Does she see God or just the void? He feels unable to guess, though hopes that she is not just a body in her grave, "a box of worm dust."

In the next part, Ginsberg refers to sanity as "a trick of agreement." It's as though we only appear to be sane because we agree with a majority of others; by disagreeing in some way—perhaps via what is called paranoia (from which Naomi suffered)—we appear to be insane, and so those who "disagree" are locked up. Naomi believed that her mother-in-law plotted against her and that the doctors in the sanitarium had planted devices in her to control her. In the poem, she says,

"Allen, you don't understand—it's—ever since those 3 big sticks up my back—they did something to me in Hospital, they poisoned me, they want to see me dead—3 big sticks, 3 big sticks—"

On the bus together, she raves about the evil doctors and "'The Bitch! Old Grandma!'" to him, detailing her paranoid delusions. Young Ginsberg, at twelve years old, takes her to another sanitarium and rides home on the bus alone. He goes on, detailing the next several years of her mental deterioration and his attempts to cope.

Ultimately, he wonders,

O mother
what have I left out
O mother
what have I forgotten
O mother
farewell

The poem is troubling but still loving, as though this son who saw it all wants to do his mother justice: honest justice. She is not just teacher or mother or patient or person struggling with mental health; she is all of this and more. Her life was more, and the poem seems his attempt to eulogize her (perhaps because he missed her funeral).