"Your body is a burning building and I will not be the one to fetch
the fire hose. That is your job. Always has been.
Ana, aim the nozzle at the living room.
Hose that sucker down.”
In this poem Ana is actually anorexia basically in girl form. Those lines mean that Ana is destroying herself from the inside out (burning up), and it’s her responsibility to save herself by putting out that fire, and no one else’s responsibility.