The speaker is living with the aftermath of war, and the title, "PTSD," tells us the name for it. But the poem avoids clinical language and gives us images instead. He says he works to carry "several heavy things," as if trauma were physical luggage he has to haul around every day. One of those things is "a lie the war," a fragmentary phrase that suggests the war itself was a lie, or that he must carry a lie about it. The poem's broken syntax makes it hard to say which.
The most vivid image is the "violent red map in my gut," a pain that feels like a wound spread across the body, "enough to have killed me." The last lines turn to the home. His wife shifts in bed, "doubtful of my hurt," and that is the loneliest moment. The mood is tense, quiet, and isolated. His suffering is real to him, but even someone beside him may not believe it.