The poem takes us onto a slave ship, where captives are unchained below deck and forced up into the open air. The scene is seen coldly and from the outside: a first mate with a cloth over his face to block the smell, whips that raise welts "like anthills," and "pink-faced men" shouting at their "stock" to dance or die. The title's "medicine show" turns this into grim irony, since the dancing is meant to keep the cargo alive and fit for sale.
The speaker never states an opinion, but the anger and grief come through in the details. Even weakened bodies "remember" something the mind might want to forget, and the stamping feet recall the earth of home. The calabash and the croaked refrain "going, going, gone" sound like both a farewell and an auction. The final image of legs as flames on the savanna, flaring and dying, leaves a mood of cruelty, loss, and fragile defiance.