Dickinson opens with a doctor's checklist: throe (spasm), hurry in the breath (respiratory distress), ecstasy (from Greek *ekstasis*, standing outside oneself). These are physical symptoms, the kind a 19th-century physician would note at a deathbed. But then she calls the whole process 'denominated Death'—a word from law and finance meaning 'officially designated.' It's as if she's saying: these physical events get labeled 'death,' but that's just bureaucratic naming, not explanation.
The scare quotes around 'Death' do heavy work. Dickinson uses them the way we'd write 'so-called'—skeptical, distancing. She observed many deaths (Amherst had regular epidemics; she lost friends young) and wrote nearly 600 poems touching on mortality. Here she's questioning whether what we call death is actually what's happening. The physical signs are real, but the interpretation might be wrong.
CONTEXT Dickinson never published this poem. It's from the fascicles—hand-sewn booklets she made for herself around 1862, during the Civil War when death was industrialized and everywhere. Her private poems got more experimental, more willing to challenge religious certainty.