Lyric discussion by Appers66 

Cover art for Jesse lyrics by Scott Walker

Elvis Presley had a twin brother who died at birth, called Jesse. He would apparently often talk to his twin like he was there by his side and felt a lot of guilt that he'd survived while Jesse had died.

The riff in the background is supposedly a distorted, skewed version of Jailhouse Rock and the line "I'm the only one left alive" is actually an Elvis quote as well as a pretty good idea of the sentiment about Jesse the song is trying to put out.

@Appers66 You can definitely hear the similarity in the opening riff of Jailhouse Rock. When you listen to them back to back, it makes "Jesse" all the more erie. It sounds like a broken, warped and beaten down version of the more upbeat "Jailhouse" riff. What a masterpiece!