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Fleet Foxes – He Doesn't Know Why Lyrics 15 years ago
I agree with songyone. When I heard this song I immediately came to this conclusion.

'Penniless and tired, with your hair grown long
I was looking at you there and your face looked wrong'
Implies an evident change in appearance - unkept and not for the better as goes with drug addiction.
'Memory is a fickle siren song' He is alarmed by what he rememebered and what is now in front of him.
'You don't say a single word of the last two years' - he's feeling shame/nothing positive to say.

See your rugged hands and a silver knife - knife may imply a fight of sorts?
Twenty dollars in your hand makes you hold so tight - desperation for money for drugs.
All the evidence of your vagrant life - lost, homeless

And you will try to do what you did before - He realises it's a pattern that will repeat.

Pull the wool over your eyes
For a week or more - the denial and cycles of addiction

Let your family take you back to your original mind - Family taking you back again and attempting to help.

'There's nothing I can do
There's nothing I can say'
The helpless bystander who is unable to break his addiction for him.

It should get played at an Nar-Anon meeting.

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