There is a simple (and pedestrian) reason why the poem takes place—as much as it takes place anywhere—behind a hospital: Williams was a practicing pediatrician at Passaic General for 30 years. He writes about what he knows, a doctrine in line with his perception of the privilege of poets to reveal the stunning (and unsuspected) beauty all around them and then share that realization.

If readers approach the poem as a more traditional kind of literary artifact, they would have the obligation to explore the hospital for levels of suggestion: It is a place to heal, thus the poem insists on the urgency of optimism and the possibility of redemption; it is a place where people die, thus the poem insists on a bleak sort of pessimism and struggles against the unsettling dark of the modern world; it is a monument to relentless urban construction, thus the poem critiques the contemporary urban blight-scape of rapid development and oppressive constructs; the word hospital itself comes from Latin, meaning shelter for weary travelers, thus the tiny poem itself offers a respite for the reader from the stress and emotional barrenness of the world. Of course, this ultimately becomes something of a game, pitting one creative reader against another.