The poem "To the doctor who treated the raped baby and felt such despair" seems to move between contrasting settings. How can you tell? What...

There are two major contrasting settings throughout the poem. One setting remains constant while the other refers to a diverse number of settings similar to each other. The fixed setting is that of a surgery in a hospital in which the surgeon (or doctor) who is named in the title is performing life-saving surgery on an infant who has been raped. The speaker constantly refers to what the doctor is doing in the surgery and then contrasts it with a situation elsewhere, in the homes of those who are not victims or who have not been exposed to the atrocity which has been committed. Dowling says, for example, 

...when the bleeding baby was admitted to your care
faraway a Karoo shepherd crooned a ramkietjie lullaby in the veld
and while you staunched
there was space on a mother-warmed sheet
for a night walker
and when you administered an infant-sized opiate
there were luxuriant dark nipples
for fist-clenching babes

These three contrasts compare the desperate actions of the surgeon in dealing with this trauma to situations in which the mood and atmosphere is restful and calm. While the horrifically injured baby was being attended to, a farmer elsewhere on a sheep farm was crooning an Afrikaans lullaby to put another baby to sleep. As the doctor was trying to stop the loss of the traumatized baby's blood, somewhere else, in another home, a mother was keeping a bed warm for a sleepwalking child. While the doctor was administering a drug to calm the infant in his care, there were mothers, elsewhere, who were calming their babies by breastfeeding them.

The stark juxtaposition between the settings emphasizes the horror of this most atrocious of crimes. On one hand, you have an innocent, harmless infant who has been severely violated, and on the other, you have little ones who are fed and taken care of by their loved ones. In the one situation you have desperation and urgency, while in the other you have peace and quiet. The speaker illustrates, furthermore, that while for some life continues normally and as it should, others are maliciously maligned and brutally abused. The horrendous nature of what has been done to the infant is encapsulated in the doctor's question: "Where is God?" The doctor expresses doubt that such an evil could have been enacted during God's watch.

In the end, the speaker expresses a universal trust in the kindness and skill of the doctor who is attending to the infant --an innate trust that we all share for those caregivers who give their all to ensure our well-being. The gratitude for what this particular practitioner is doing and has done is profoundly expressed, and one feels that dedicating the poem to such a one is not only right but also deserving.