This song is a very sad revelation of what it means to truly love someone. Gibbard is telling a story of what it's like to be awaiting bad news in a hospital. The piano reflects the sad realization that at some point, the person you love will die, and if you're really going to be there for them, you have to watch them. The best lyric is "but I'm thinking of what Sarah said: 'love is watching someone die.'" It's a very well written, thought-provoking song.