[3] The book is a single poem, following a pregnant speaker as she traverses the destruction of the world—a time described as "the year the hurricanes began" amid other disasters, including human-induced turmoil.

"[5]Other influences for the book were pieces of "durational art" along the likes of James Turrell, Walter De Maria's The Lightning Field, and drone music.

Gelman also cited her studies in psychology as a student at Reed College and her participation in slam poetry at University of California, Berkeley as important to her realization of the poem.

[8] The Poetry Foundation called the book a "dystopic poem" and said "Rather than repeating text in full, Gelman's Vexations moves in organized disjunction through a winding narrative that insists and compels.

"[10] The New York Review of Books said "The poem makes a sound as terrifying as it is familiar: the nervous patter of a world at the end of its days.