While the obvious connections with suicide or alcoholism could be drawn easily, more subtly this song could be about someone who views the world through a negative lens constantly and how as much as the writer tries to show the beauty in the world, this person refuses to see it. It's one or another between the rope and the bottle. There is no good option for this person. They can't see it. Skiba sings it in a kind of exasperated way like He's tired of hearing this negative view constantly and just allowing that person to continue feeling the way they feel knowing he can't do anything about it. You can hear it when he says maybe you're a vampire.
Cat's foot iron claw
Neurosurgeons scream for more
At paranoia's poison door
Twenty first century schizoid man
Blood rack, barbed wire
Politicians' funeral pyre
Innocents raped with napalm fire
Twenty first century schizoid man
Death seed blind man's greed
Poets starving, children bleed
Nothing he's got he really needs
Twenty first century schizoid man
Neurosurgeons scream for more
At paranoia's poison door
Twenty first century schizoid man
Blood rack, barbed wire
Politicians' funeral pyre
Innocents raped with napalm fire
Twenty first century schizoid man
Death seed blind man's greed
Poets starving, children bleed
Nothing he's got he really needs
Twenty first century schizoid man
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@Kahiara Actually I think the husband passed away,
"She sang for you last night
She heard you were calling"
Many people say they have felt, heard, or seen their loved ones after they have passed.
"Don't be scared now
Close your eyes
She holds guard tonight
Go on forward no remorse
Life will take it's course"
This is said to the late husband by a third part (never named), who encourages him to pass on. Because life will eventually continue. The phrase "holds guard" refers to the ( en.wikipedia.org/wiki/… ) which is a Christian ceremony held after someone dies. Now it is usually held right after the funeral, but in most celtiic countries the wake is held before the funeral.
"She danced with you last night so you will remember
All you have shared, a lifetime."
This sentence feels as if the only thing it wants to convey is their history together, namely, husband and wife. For the rest it just refers back to the first verse.

MAZZA
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This track is the first official collaboration between the rappers. It was produced by SAMO, slowthai himself & Kwes Darko. The track was released on January 5, 2021, in anticipation of his latest studio album titled "TYRON".
However, I think, give the year this was written, it's much more about the Vietnam war.
Being only 20 and not living at the time of the war, I can't decipher all of the symbols and some of what I do decipher may be wrong, but here's my take on it.
"Neuro-Surgeons scream for more"
I think this connects to the post traumatic stress disorder and drug use many of the returning soldiers got into after the war. They were spit at and called murderers for the deed of serving their country and this, plus the pain and images of war caused many great mental distress.
"At paranoia's poison door"
This, to me, is very obviously a connection to the paranoia the U.S. had and has concerning communism. A communist revolution was happening in Vietnam at the time led by Ho Chi Minh. U.S., at least the people, thought that if communism took root in one place, slowly, every country would turn to communism. (The domino theory.) This wasn't good for business, you see as the U.S. loves imports and exports.
"Blood rack, barbed wire"
This simply sets the scene of war. The Vietnam war is one that is notoriously bloody and violent against women and children.
"Politicians funeral pyre"
This symbolizes the selfish sacrifice politicians made by drafting young men into the war. They let these young men die for the ideas and beliefs of the government officials who were safe at home.
"Innocents raped with napalm fire"
One of the most blatently violent lines is this song, this harkens to the horrid deeds done is the Vietnam war specifically. Vietnamese women were raped by soldiers coming trough villages. Not only that, the "innocents" or young Vietnamese children were maimed and often killed by a weapon which employed a sticky mixture consisting of napalm which was lit on fire. The mixture was meant to stick to enemies while it burned. It was often blasted into homes, killing families.
"Death seed, blind man's greed"
Many people were either blind by choice or by their own naive thoughts that the war was for good. The death seed IS the blind man's greed. The man who thinks not of his brothers and sisters across the ocean plants the seed of death on their soil because he allows himself emotional distace between them and himself through his greed, therefore allowing no guilt to lie on his shoulders when he kills them or allows them to be killed. He plants the seed of death through apathy.
"Poets' starving children bleed"
This line connects, I think with not only the American families who lost sons (the beat-nick subculture was quite popular at this time and they often were poets) but also to the children in Vietnam, in tiny villages who were dying from hunger and the brutality of war.
"Nothing he's got he really needs"
Let's face it: The U.S. is spoiled we have no problem getting clean water, food, and shelter for the most part. And then we want more- cars, houses, computers, video games, money. We don't need these things. What we need is a sense of love and caring towards one another... if we had that, we'd all get wat we need. That's what I think this line is talking about. He has his material possessions but not basic good-will and love towards others.
"Twenty-first century schizoid man."
This line, repeated at the end of each stanza, is an important one. It points the blame on to the government only... but to those who refuse to see the truth of the time: That the U.S. had no bussiness rushing into another country, killing others, killing children, all to protect it's greed. The blame is on every 21st century business junkie, out of touch with humanity, greedy, schizoid, pill-popping, blind government-following man.
Cat's foot iron claw: bionics, robotic prostheses, think Terminator 2
Neurosurgeons: are putting in brain implants, doing all sorts of fun work on nervous system, and just like neurosurgeons, want more
Death's seed: The future is about cultivating death and the shortsighted "blind" greed of those trying to profit
Poets starving: yes, I agree, the end of art, while the population suffer "children bleed"
Nothing he's got...consumerism
Blood rack/barbed wire: war
Politician's funeral pyre: war is and always has been a sacrifice of the people by politicians to make money OR it means the end of politicians? Funeral pyre is ambiguous imagery
Innocents raped: pretty obvious reference to the (then) recent combat in Indochina where napalm was used on Vietnamese civilians by the US
I made an alternate interpretation of the surgeon as the soldier in a later posting. The soldier performs lobotomies with his bullets. Given the ethically questionable psychological and scientific experiments by the government in that era, I have to wonder if you are not absolutely correct.
Sax is such a crap sound, sounds like an angry bee trapped in a toilet paper tube.
Awful awful, and about as sexy (which many people quote it is) as rotting roadkill.
This is one of the few songs with a sax solo that it's actually good.
If it's not sax and is a guitar tone due to fx, what a silly thing to try and emulate.