Jessea L. Vaughan's poem is built almost entirely from questions. The "hole in your heart" is never explained, which seems deliberate: it reads as an emotional or spiritual wound, a "chasm in your soul," that nobody else can see. The speaker points out the gap between the healthy-looking person in the mirror and the pain underneath, and notes that a doctor's medicines and home remedies can't reach it.
The poem then turns to the problem of other people. If you show the wound, "the world will hate you." If you cover it with "extra layers of padding," the secret leaks out anyway, and people dismiss it as a fuss over nothing. That leaves the speaker with the feeling that "there's no way out."
The mood is weary and trapped, with a quiet urgency in the line about the "hour" growing late. By ending on the opening question again, the poem refuses to offer comfort and leaves the reader sitting with the problem.