Lyric discussion by goodwinter 

the entire album is a metaphor for a destructive relationship. he is the caretaker. the roles are reversed in this song, and she just up and leaves, even though he took care of her when she was in the same position. it is sad because he realizes if he were in her shoes she would not do the same for him.

@goodwinter

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it is sad because he realizes if he were in her shoes she would not do the same for him.

it is sad because he realizes if he were in her shoes she would not do the same for him.

A piercing interpretation. I would only add that perhaps, in keeping with the hospice metaphor, she could not do the same for him. She's physically (or emotionally) incapable of helping him in the ways he's helped her. Because of this, he can't even be mad because the situation can't be helped, but he still feels it and it hurts terribly. In that way, the situation is "too much to scream, so instead [he] just started to laugh."

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