Lucia Perillo has just finished lunch at her home in Olympia, Wash., when she tells me, “Rot is probably my favorite subject.” Perillo, a 2000 MacArthur Genius Fellow, crafts poetry that is often blunt, graphic, and written in a strangely graceful matter-of-fact tone that digs into art, nature, and the body as organism—as lustful and loathsome, as a series of functions, as a tool that is falling apart, rotting, and malfunctioning even as we attempt to force it to assist us throughout our lives. “It’s aesthetically beautiful, really, the process of decay, and biologically quite complex,” she says. “I suppose the reason I’m drawn to it has to do with my own conditions of living.”

Perillo’s new book, Time Will Clean the Carcass Bones (Copper Canyon, March), pulls together selected poems from her six previous collections, including the 2010 Pulitzer Prize–finalist Inseminating the Elephant (Copper Canyon, 2009), along with a robust assemblage of new work. The collection encapsulates nearly 30 years of Perillo’s poetic career.

The “conditions of living” that Perillo mentions are the constraints of living with multiple sclerosis. Diagnosed in 1988, Perillo’s illness has caused a decline in her independence and physical ability, which she talks about in an it-is-what-it-is kind of way: “I used to write first thing in the morning, and that was really productive for me. But now I have caregivers come first thing in the morning, because I need to put these leg braces on, and that has disrupted my former schedule. So I’m needing to adapt to writing at other times, which is difficult, I’m finding. I’m still trying to get into the swing of it, but I don’t have much expectation of myself.” Perillo is still writing, though, even as the process becomes increasingly cumbersome. “I mean, it’s hard enough to do anything at all at this point, so I should be thankful for whatever I get,” she says.

Perillo was diagnosed with multiple sclerosis right around the time she published her first title, Dangerous Life (Northeastern Univ., 1989), which won the Poetry Society of America’s Norma Farber First Book Award. The success of the debut, paired with Perillo’s diagnosis, shifted her career track from wildlife management to teaching. In 1979, she graduated with a degree in wildlife management from McGill University in Montreal and found her first job working at the Animal Damage Control research facility run by the U.S. Fish and Wildlife Service in Denver.

“Our purpose was to assist farmers and ranchers by discovering new ways to kill predators that were taking part of the crop,” Perillo says. “I was very young, and dumb, and eager to be working in my field of study, so this job had an effect over me like the Milgram experiment [on obedience to authority]. Because of the power structures that were in place, I participated eagerly in the killing without questioning it. Denver at that time [was] a pretty conservative place, and I suppose they thought I was a hippie. Trying environments make for better poems than agreeable ones do, in the same way that rot makes a better subject than puppy dogs. So in that sense it was a loss when I ended up on a wildlife refuge south of San Francisco.”

Perillo’s experiences during this period of her life surface and resurface in her work, infused as they are with complexities of her life with a chronic illness. For example, “White Rat” (from Inseminating the Elephant), in which she describes a surgical procedure on a rat, describes a bizarre epiphany: “I realized the spiderwebstuff holding us here is thin/ It was in fact difficult to account for all the people walking around not dead.” In her poem “Denver Wildlife Research Center” (also from Inseminating the Elephant), with its unadorned narrative lines and no-nonsense title, Perillo recalls watching a colleague slaughter a sheep: “You can throw up if you want to, he said, and, because I’d been given no job but/ to carry a pail, I understood this to be a kind of test.// A test to let him know what kind of daughter I would be: dogged, like a coyote,/ or meek, like the sheep, when, later, we would lace the carcass with poison to/ find out how much was needed to leave half the coyotes dead.”

There is often tension between what Perillo describes in her poems and what she’s really writing about. In “Rotator Cuff Vortex,” she writes, “The body tells a story/ mostly about loss.” She is describing a friend who throws out his shoulder playing catch. But she is also writing about herself. In a 2009 interview with Maria McLeod for the Poetry Foundation, Perillo said she wanted her poems to be capable of being read two ways: “You could read them not knowing that I was a person who had an illness, or you could read them with that knowledge and have another reading of the poem. So I wanted them to foster two readings. Two layers. Where you could step into the poem on whatever layer you wanted to step into it on.”

Perillo plays with sound and form in fresh, inventive ways. “I read aloud,” she says. “All poets do. Sound is all a poem really is, after all, right?” In “Message Unscripted,” one of her new poems, she writes, “Think of a cloud, think of a geode, think of the mold/ on the plate in the fridge.” The poem’s off rhyme and candor are irresistible. In another new poem, “*Speckled and Silver,” she toys with form by weaving the title image into the poem using the asterisk: “I read it/ lying on the sofa in the Quince Street house/ while a particular light* washed over me/ that made me realize snow had begun to fall.”

Perillo doesn’t know how a poem will proceed until she begins working on it; every poem has its own laws and logic, has its own demands, she tells me. She mentions Denise Levertov’s groundbreaking 1965 essay, “Some Notes on Organic Form,” and pauses. “I guess that is what I’m sticking with—that every poem is a new moment, takes a new strategy.” Levertov quotes Emerson in her essay: “The health of the eye demands a horizon.” Perillo seems to directly respond in her poem, “Transcendentalism,” stating, “The work is hard because the eyeball’s heavy, riding in the bow.”

Yes, the work is hard for Perillo because of her illness, but she pushes forward with no plans of stopping. “I’d love to be able to write a series [of poems],” she says. “But I’ve not been able to do that many times in my life. I’ve said, ‘Oh, I’m going to write about this,’ but as soon as I say that it kind of blocks it up.” Perillo says her new poems are about distraction.

As in the distraction of not being able to write in the mornings, or the distraction of the Internet, or something else? “All of the above,” Perillo says. “In general, people hop sideways instead of digging. The mental energy is deflected sideways instead of vertically. Metonymy as opposed to synecdoche. In modern poetry you see many poems written about how one thing reminds us of another and another reminds us of another. Many of my poems have been built on that kind of structure, but there’s also something to be said for taking a subject and really burrowing straight into it, and sticking with it, which is harder to do in modern life. You know, we click around to websites, but we don’t burrow into the topic. There’s not depth. So in the poems I’m writing nowadays, I wanted to explore those two ways of working.”

“I’m still typing,” Perillo responds when I ask about how she writes. “I’ve been typing on the computer for years but it really adds editing into the creative process too early, I think. So I do go back to the typewriter, and I’m always telling myself, ‘You have to go back to the typewriter.’ Sometimes it’s hard to clear off the desk and move my laptop over. But otherwise you don’t even get the creative germ out of you before you’re introducing all these other assumed ideas.”

Perillo is not just a poet—she is the author of the essay collection I’ve Heard the Vultures Singing: Field Notes on Poetry, Illness, and Nature (Trinity Univ., 2007) and the short story collection Happiness Is a Chemical in the Brain (Norton, 2012), winner of the Frank O’Connor International Short Story Award and finalist for the PEN/Robert W. Bingham Prize. Perillo’s fiction was never deliberate; it accumulated over the years into what became the 2012 collection. Of the stories, she says: “I’ve always written them on the side. I guess I looked at that as my hobby.”

“One thing about fiction is that it takes a lot of hours,” Perillo says. “I mean, I have stories that I’ve started but I really haven’t finished,” she adds, addressing the difficulties of her current condition. At this point, her body, to her, is “just a ball and chain,” or “the meat cage” as she calls it in her poem “Virtue is the Best Helmet.” Yet here she is, talking about figuring out the voice-activated typing software on her computer: “I still need to check it out.” Not even the body’s burdens will stop her.

Sophie Grimes is a poetry reviewer for Publishers Weekly. She has an M.F.A. in poetry from Boston University.