The poem opens in media res, as though the speaker and the reader were already in mid-conversation; this intimate, conversational quality is a hallmark of Billy Collins’s work. “Coming down with something” (Line 2) is very likely a line the child picked up from his parents, something they would say to him when he went to them complaining of illness. He compares the feeling to the everyday plagues of childhood such as stomachaches and headaches, noting that this is something new altogether. It’s important to note that despite the feelings of dread, there is a degree of humor in this opening stanza. Words like “mumps” and “chicken pox” (Lines 6-7) are innately funny words to say, and they bring to mind a sense of dramatic hyperbole, akin to a child stubbing their toe and lamenting that they’ll never walk again. This gives the narrator an endearing and indulgent quality that fades away throughout the later stanzas.

In the second stanza the child speaks to an adult figure, which begs the question: Did they go seeking help? Did they go to a parent telling them they were “coming down with something”? Whether this opening line is in direct response to a line of unspoken dialogue, or whether it is in response to something they are only anticipating, is up to the reader to decide.