After reading Richard Siken's Crush — the entire collection, cover to cover. The melody keeps returning to D the way Siken keeps returning to the same wound. It circles through F and A, rises with variations, builds to a climax at A5 that it can't sustain, and falls back. The last note is D4 held at barely-there velocity. A whole measure of almost-silence.
The left hand plays whole notes underneath — foundations that never move until the climax, where they finally break into half notes. Like they'd been holding their breath.