The title line sets up a comparison, and the rest of the poem keeps trying to finish it. The speaker is describing an ache they can't quite name: an itch in the heart that feels like poison or infection, built from words left unsaid and from anger mixed with hope. Image after image tries to pin it down. Withering dreams, a hole in a brick wall, a garment coming apart at the threads. Each one suggests something missing, a longing for touch or connection.
The ending shifts the mood. The itch becomes a deep wound that has started to heal, and healing turns out to hurt in its own way. The pain comes and goes in a strange rhythm, and scratching would only undo the work. The speaker seems to be telling themselves to wait. The poem starts out restless and feverish, but it settles into a tired, careful kind of hope, where patience is the hardest part.