The idiom "a hard pill to swallow" normally belongs to bad news, and the poem opens with it: "Hardest pill I had to swallow today." What follows is odd. The news is that "sometimes / The things happen the way they're supposed to." Things have worked out, and the speaker finds that harder to take than failure. The poem is built on that paradox. The man the speaker "can't stop thinking about" is "actually here," and he even turns out to be "exactly what I was looking for," yet he is out of reach: "I can't touch him / I can't have him." The pill is bitter because the good thing is in front of the speaker and still forbidden.
The central idea, though, only arrives in the last lines. The poem is less about this one man than about what he proves: that the speaker can still feel. The final sentence is a long, suspended one that takes the whole second half of the poem to complete. It runs from the shaking bones to the admission that the speaker had spent "so many months" convinced of being unable "to feel anything / Ever again." Desire, even frustrated desire, becomes evidence of life. The title makes the same point. "After" is the word the poem builds toward, and its last stretch, "After so many months", answers the title by naming what came before the speaker's numbness ended.
The form suits this unguarded confession. There is no rhyme and no steady metre, and the lines have the uneven length of someone thinking aloud. Each line begins with a capital letter, a faint formality, but the diction is entirely spoken: "so bad," "so hard," "match made in heaven." The missing article in the first line ("Hardest pill," not "The hardest pill") makes it read like a diary entry written the same evening. The word "today" reinforces this. The speaker is writing in the middle of the feeling and has not yet had time to tidy it.
The line breaks control the poem's emotional pace. The first half is restrained and halting. "Was that sometimes" sits alone on its line, a small hedge before the speaker can bring herself or himself to say that fate may be kind. The blunt repetition "I can't touch him / I can't have him" works almost like a rule being recited, and it moves from the physical to the possessive, from touch to ownership. Then comes the "But" that turns the poem, followed by "the match made in heaven..." The trailing ellipsis is telling. It is a cliché, and the dots let it hang there, half sincere and half embarrassed, as if the speaker knows how worn the phrase is but cannot find a fresher one for something this large.
After that the restraint breaks. Three lines in a row begin with "And," or are chained by it: "And I want him so bad / And I need him so hard." The parallel structure and the plain, almost childish intensifiers make the wanting sound like it is spilling out faster than the speaker can shape it. Only then does the imagery turn physical: "my bones are shaking." Bones are the deepest and most solid part of the body, so the image suggests a feeling that has reached the structure of the speaker, not merely the surface. It also makes a pointed contrast with the earlier months of feeling nothing. Numbness is the absence of sensation, and shaking is sensation at its most violent. The speaker moves from one extreme to the other without any middle ground.
What makes the poem worth reading is that it refuses the usual shape of a love poem. There is no promise of a happy ending, and no complaint that love has been denied. The speaker is frightened and thrilled at once, and the poem lets both feelings stand. The unreachable man is almost secondary to the fact that something inside the speaker has switched back on. The last line, "Ever again," is the shortest and quietest, and it works as a relief: the thing the speaker feared would never happen again is happening now, even if it hurts.