Lyric discussion by nycpunk1 

With lyrics in general, and artists like John Darnielle in particular, I think it's a mistake to force literal translations for every line. When he talks about the "special secret sickness" in this song, the vagueness of it is intentional. Whether there was a real life parallel to this story or not, Darnielle's trying to evoke teenage feelings of confusion and helplessness in a way that "you have cancer," or "you have AIDS" can't. Not knowing what's wrong is part of the terror, and it comes through brilliantly.

On the other hand, I think the narrative vagueness of the last lines is not entirely intentional. Rather he is sacrificing literal "clarity" to imagery. Cul-de-sacs are connected to death as dead-ends, but also work to maintain the suburban setting of the song. Alleyways are connected in our culture to danger, crime, filth. The police are coming to get him. Why? Is he suicidal? Is he on drugs, committing crimes, violent? We don't know, and any attempt to specify requires more information than exists in the song. What we do know is things are going so poorly that his only response is the same as in his childhood, "listening to dance music."

"...so this is what the volume knob's for..." What an amazing line.

An error occured.