Finuala Dowling utilizes the repetition of the word 'and' at the beginning of many lines in her poem "To the Doctor Who Treated the Raped Baby and Who Felt Such Despair." The name for overusing a conjunction like 'and' is polysyndeton, and the effect is to increase the pace of the poem and to create emphasis. Beginning lines with the same word multiple times is known as anaphora and is also used for emphasis and juxtaposing ideas.
As we examine the poem, we see that this particular repetition is used to juxtapose the horrific injuries the doctor must attempt to correct with a more tranquil episode the speaker claims is occurring elsewhere.
This technique is effective for two reasons. First, the increased pace mimics the movements of the operating room team as they race to save the baby. The reader feels the intensity as he, himself, does not experience pauses in the reading. Second, the reader sees the connections between the two ideas the word 'and' links. The first is a the soul-crushing plight of the doctor, as in "and when the bleeding baby was admitted to your care," while the next is a reassurance that the whole world is not vile, as in "faraway a Karoo shepherd crooned a ramkietjie lullaby in the veld."
With each action the doctor takes, he realizes the despicable nature of the world. The word 'and' links his experience with another example pointing to a positive side of humanity.
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