I feel like the Iron long is simply an extended metaphor for a 20th century sell out song. The way Thom speaks it's as if he's stuck; writers clot. He needed to produce a track that would keep the band on the radio and their popularity up to par. The Iron Lung keeps the band breathing but the metal is cold and shallow. He writes "This, this is our new song just like the last one, a total waste of time. My Iron Lung". He compares this track to possibly the song Creep from Pablo Honey that brought the group their original media attention. Lucky for them the song was a hit and Thom began writing amazing music again.

I feel like the song is for those who find themselves in between functioning society and a world of emptiness and depression. Directed at the youth or "young pilgrims" who find themselves hiding and covering up their thoughts in order to remain somewhat in "the norm".