What metaphors are used in Hospital Window by James Dickey?

The first line in the poem, The Hospital Window, may be singled out for attention because it is used for both the beginning and the ending of the poem. The fact that the same line opens and closes this work gives it a circular motion, one that is very apt in a poem addressing living and dying, father and son, and the sense of roundness in human life "ashes to ashes, dust to dust," so to speak. Literally, the speaker simply means he has just returned to street level after visiting his ill father on the sixth floor of the hospital. However, the son has also just "come down" from his father in the metaphorical sense, for he believes the dying man is starting to ascend into the heavens, far out of range of being reached.