Nine short lines, and most of them are spent counting people. Two people know about the scars on the speaker's hip. One person cares. A few lines later the count falls to zero: "no one knows / what lies in my head." The poem's argument sits in that shrinking arithmetic, from two to one to nobody. It ends on an image with no other person in it at all: "constantly drowning."
The subject is self-harm and the private pain behind it, though the poem never uses either term. It talks about evidence and secrecy instead. The scars are permanent ("they're going to be there / forever") but hidden by their position. The wrists, where other people might look for signs, are "clear." The central idea is the gap between what can be seen and what is true. A body can pass inspection while the person inside is struggling, and the speaker seems to know it.
The line "only one person cares" deserves a second look. If two people know and only one cares, then at least one person knows and does not. The poem doesn't comment on this. It lets the subtraction stand, and the flatness is what makes it hurt.
The poem has no rhyme and no regular rhythm. The lines are short and plain, closer to a confession made in a low voice than to a performance. The repeated "only" in the opening gives it the stiffness of an inventory, as if the speaker were listing facts to keep them at arm's length. The verb "know" comes back as "knows" with the opposite result. "Scars" and "cares" share a closing sound, which faintly ties the wound to the concern, as if the speaker can't mention one without the other.
The layout does a lot of work. The middle lines are pushed far to the right of the page, as though they were being said under the breath or sliding out of reach. "Forever" sits alone on its line, so the break forces a pause before the word, and it lands like a sentence being passed. Then comes a gap of white space before the final two words. It can be read as a held breath, or as the surface of water the speaker is beneath.
Two word choices reward a closer look. "Clear" means free of marks, but it is also what water is when you can see through it. Set beside the last line, that may be a deliberate echo, though the poem doesn't insist on it. And "lies," in "what lies in my head," most obviously means "resides." It can also mean untruths, which would suggest that the calm exterior the speaker presents is a kind of lie. That second reading is an inference from the context of hiding, but it fits.
The ending is the poem's only real metaphor. Up to that point the language is literal: scars, hip, wrists, head. All the feeling the earlier lines hold back arrives at once in "constantly drowning." The phrase is a fragment with no "I am," so it reads less like an event than a condition with no beginning or end. Drowning is usually imagined as sudden, and "constantly" stretches it into something endless, a struggle that goes on while everyone nearby assumes things are fine. The poem is untitled, just a row of asterisks, and undated, so it has to be read entirely on what is on the page.
Its significance lies in its restraint. It describes no act and offers no explanation. It shows how pain can be organized around secrecy, and why an absence of visible signs proves nothing. For a reader who recognizes this feeling, the poem says plainly what is hard to say. For everyone else, it is a reminder that "seems fine" and "is fine" are different things, and that the one person who cares matters a great deal. If a poem like this strikes close to home, talking to a trusted adult is a good next step.