"Hymn to God My God, in My Sickness" starts off, appropriately enough for a hymn, with images of music. As the poem's speaker lies on his deathbed, he prepares himself to join the choirs of heaven—but not in quite the way that readers might imagine.
First off, the heaven this speaker imagines isn't spectacular: it's not a palace, a temple, or a kingdom in the clouds. Rather, it's a "holy room" he's making his way toward—a simple chapel, maybe. It's what happens inside that chapel that matters.
Listen to the way the speaker unveils his idea of heaven in lines 2-3:
Where, with thy choir of saints for evermore,
I shall be made thy music; [...]
Line 2 here might encourage first-time readers to get ready for an image of singing with a heavenly choir: think harps, wings, haloes, all the clichés about what heaven might be like. Instead, the speaker casually slides into the idea that he "shall be made thy music."
In this speaker's vision of heaven, then, the souls of the dead are transformed into song. Each person becomes an interwoven part of something vast: many individual notes form one eternal symphony. If that's so, God is the composer and the conductor of this divine music.
Looking back, readers will observe that this whole first stanza is an apostrophe to God—a God whom the speaker refers to not with a formal "My God" or "Dear Lord," but as a simple "thee," as if God were a friend sitting quietly at the speaker's bedside. (This quiet stands out next to the poem's title, with its intense cry to "God My God"—the kind of cry one might make from the depths of terrible pain.)
Everything in these first lines thus helps to create a mood of mingled intimacy and awe. God is right there next to the speaker—and God is the great composer of the music of heaven. Heaven is a simple "holy room"—and heaven is a place of miraculous, mysterious, beautiful transformation.
This first surprising image of a heavenly metamorphosis will be the first of many in a poem that's all about transformation. Endings will transform into beginnings, pain into glory, and a sickbed into a sailing boat.