The poem is a first-person narrative from the diary of a paranoid schizophrenic person, the character complains of persecution from "the old woman in the room above" who "has put an electric suction cup on the floor..." "the waitress says its salt, but I know arsenic when it's put before me..." and many more horrors. When he is served food with mustard he thinks it is "to mask the bitter odor of almonds," presumably a reference to cyanide. According to the poem, the victim has amassed "500 notebooks with 500 pages in each one" and records all the wrongs done unto him in the books. He thinks that his enemies are part of a massive government conspiracy and mentions the FBI and the CIA. He is also superstitious; he knows chants and he wears charms.
The poem is recursive, ending where it begins, with the stanza "I can't go out no more. There's a man by the door in a raincoat"
The poem also has ties to the Dark Tower epic. When King originally began writing The Stand, he wrote "A dark man with no face." This became the description for Randall Flagg and is an exact line from the poem.