This song has several rhyme stretches : "she must be hurt very badly/ Tell me what's making you sadly" that are painful, but I like it. My theory is that the song is a ghost story. Lisa fits the mold of a mournful ghost. She "wanders alone from wall to wall/ lost in a hall she can't hear me". "Maybe some day I will free her/ though I know no one can see her" seems to further show that she is an apparition seen only be the narrator.

Another possibility is that the song recounts an experience that Stevens may have had during a brief confinement in a mental institution.