Most readers will have to look up "Dysthanasia." It comes from Greek roots meaning "bad death" and is used for dying that is prolonged or made harder by medical intervention, the opposite of euthanasia's "good death." The title does a lot of work, because the poem's seventeen words never explain it. They put us in a room instead, where a death is being managed and a draught of ordinary air is the only thing moving freely. The central idea is that when dying is handled by technology, the exit stops being a departure and becomes a procedure, and the natural world is left to supply the only gentle gesture.
The first line carries a deliberate double meaning. To "doctor" something is to treat it medically, but it is also to tamper with it, as one doctors evidence or a photograph. "Life's doctored exits" therefore holds care and interference in one phrase, and the poem never settles which it means. "Exits" is also a theatrical word, a stage direction, which hints that a death can be arranged and timed like a scene. The colon after "slippery" then sounds like a clinical definition, as if a diagnosis is about to be explained. "Slippery" works physically, since it suggests wet, hard-to-hold surfaces, and also morally, since the phrase "slippery slope" belongs to arguments about how far medicine should go. Nothing in these exits can be firmly grasped.
The explanation, when it comes, is purely sensory. "Suction / at this end" gives the machine's side. The word "suction" is isolated on its own line and surrounded by hissing s-sounds (exits, slippery, suction, this), so the poem seems to make the noise of the apparatus it names. Suction is also a forceful, drawing-out action, the opposite of letting go. "This end" is a pointing phrase, as though the speaker stands in the room gesturing. Judging by the imagery, we are at a bedside, but the poem never says which "ends" it means. They could be the head and foot of a bed, or two ends of a body, or the beginning and finish of a life. That vagueness lets each reading add its own unease.
The other end is wonderfully ordinary: "a breeze / from the window." The line break after "at the other," makes us wait a beat, and what arrives is as light as the syllables, "a breeze." Against the mechanical pull of suction it feels unforced, even tender, yet it is also faintly ironic. The window offers the exit that the body, tied to its equipment, may not be allowed to use. Some readers may recall the old folk custom of opening a window at a deathbed to let the soul out, though the poem itself never says so. The breeze may be a hint of freedom, or it may be only a draught.
The form is as pared down as the subject. There is no rhyme and no regular metre. The lines contract and release, running roughly five, four, two, three, four, two and four syllables, so the poem seems to breathe unevenly, like a patient. Short lines and a single sentence, joined by a colon and a semicolon, give it the balanced coolness of a medical note. There is no "I," and the only emotionally loaded word is "slippery." That restraint is the poem's tone. It reports and does not plead.
This is what makes the poem significant. A debate that usually fills essays, with arguments about autonomy, prolonging life and the limits of treatment, is reduced to two sensations at two ends of a room. Pickering does not tell us whether the suction is compassion or intrusion, or whether the breeze is relief or neglect. He sets them side by side and lets the reader feel the gap between them. A student may find it useful to see how much a poem can do with so little. One pun, one isolated noun and one plain domestic image are enough to make a large ethical question feel physical, and the last picture, an open window with ordinary air coming through it, stays in the mind after the argument has gone quiet.