This poem breaks my heart, not because it is something overly sad or strange but just because you were able to convey so much heartbreak and emptiness so easily.

Haven't I written myself to shame?
My intestines still multiplying
among the dead. I haven't shaken
that much in ages, like I was a
willow betrayed by Katrina
and there was no shelter, for me.

^ I love this intro, I was in Louisiana during Katrina so that hit home for me as well, both literally and metaphorically. I also really really enjoy that you started the stanza with a question, it drew me in instantly.

I shook you off as if you
were a bagful of fleas,
contorted on wooden planks
while I chose to give you
the phone. "This is -----,
I'm with her now, can you
drive over here?"

^ The two line intro to this stanza is interesting, it's a description i don't think I've read before and I like how it still ties into the rest of the poem in it's own way. The conversation lines were a nice touch too because they made the poem understandable to the audience even though they aren't the same person this piece was directed at. It also conveys so much more of the emotion than would otherwise have gotten across among your stunning imagery.

I was a fool, a baby who
jumped from the crib,
don't leave me, don't leave.

^This stanza also hits home for me, reminding me of a deck of tarot cards with the fool analogy and the baby jumping. (I don't mean to offend anyone with this analogy... just what came to mind). Though the ending line is stunning, it jumps off the page. Everyone has said this at some point in their life.

But you eventually left,
I couldn't stay with you,
come to your home
and hear your hymns
praying over me
as if the roof wasn't sturdy
enough.

^ This stanza, I don't know what to say about this, nothing other than it is beautiful and I am speechless.

It was abnormally cold, that
night. You threatened to call
an ambulance, you grabbed
the flashlight from my mother's
hand and blinded me, begging
for answers about the train's
whistle and my proximity.

^ Imagery here is stunning, it not only gives us more of the scene but it shares your heart with us because the scene is so cold, is so empty. I like how you said "threatened to call an ambulance" instead of saying that they did or denying how much danger you were in. very well penned stanza.

I shrug you off, like the
fireman's jacket you offered.

"But you're shivering"
But I'm in (denial).

^ i am lumping the last two stanzas together because they form the conclusion together. They leave an impact because they build off of each other so wonderfully. i love the description of shrugging the person off like a jacket, thats simple yet it has a hold to it that a lot of other word choices just couldn't manage. And again your use of conversation was wonderfully used. Great piece as always.

You definitely blew me away with this one.