Elizabeth Schmuhl employs vivid imagery and rich symbolism to explore themes of transformation, growth, and decay in her poetry. She often uses natural elements like rivers, orchards, and seasons to symbolize the cyclical nature of life. For instance, the river represents the flow of life and the body's connection to the natural world, while the orchard symbolizes growth and decay, reflecting the speaker's own transformation. Fish swimming through the speaker's veins and blood staining the earth signify the merging of the self with nature. Schmuhl also uses imagery of decomposition, such as rotting flesh and decaying leaves, to convey the inevitable process of decay and the transient nature of existence. Through these vivid and often disturbing images, she explores the complexities of human experience and the interconnectedness of all living things.