misery
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1) Paul links his pain to the tide at Revere beach. He reminisces to the time when he was a child sitting on the beach with his parents, waiting for the tide to go down to once again reveal the pilings. He sees the tide as a monster, and reminisces about it every time his drugs wear out. He wants the tide to go back down to welcome his happy place, (the beach and pilings.)
2) These thoughts reference the idea of Paul's freedom. The lines go back and forth, relating to two things, one, Africa, his safe-hold, and two, memories and metaphors for what is happening.
He first mentions Africa, then the line "As long as they played fair" references to his childhood when he was at day camp at Malden Community Center. The children used to play a game named "can you?" They team leader told the children about being in deep south America with Lions surrounding a person named Careless Corrigan, he then said "can you?" and started his stop watch...