The song is about trying to help someone who has both mental-health problems and a drug problem. It’s about trying to reach that person through a variety of methods but ultimately failing. The song does not tell us the fate of the person whom everyone was trying to help, but the mournful and forlorn feeling of the song is not hopeful. The title, then, is ironic because the life likely wasn’t saved. The inspiration for the song stemmed from Isaac Slade’s time in an actual facility for troubled teens. He recently said in an interview that one of his friends was the president of that school and invited both him and Joe King to participate in one of their weekend retreats. Slade says that the kid with whom he was paired was just 17 years old but had alienated almost everyone in his life.

 Wide-Ranging Influence

The song has appeared in dozens of television programs over the years since 2005. It’s in 31 episodes of “Grey’s Anatomy” alone. It’s interesting that the song was included in the medical drama not because of the relationship of teens and drug abuse but rather because of the concept of saving lives itself. In fact, most of the other programs where the song has appeared in the soundtrack are either medical dramas or police procedurals where saving lives is one of the central themes of the show. Some examples include “Scrubs,” “CSI: NY,” and “Cold Case.” In feature-length films, the song was integral to “The Blind Side’ and “The Girl Next Door.”

The Wives’ Parody

A song like “How to Save a Life” can be prone to parodies of dark humor. Slade tells the story about how the wives of the group members hid and then jumped in on one of the takes during the chorus. They had written their own lyrics to the chorus, and the words were “How to Shave Your Wife,” which Slade shyly describes as disturbing. The group, however, with tongue-in-cheek aplomb, laughs good-naturedly at their wives’ naughtiness.

Not Right the First Time

Percussionist Ben Wysocki had chosen certain sticks for the song and thought that they would provide just the right sound. When the band heard the recording, they collectively thought that it wasn’t the right sound. So, Wysocki had to fly out to Los Angeles to rerecord the percussion track. The same thing was true about the piano, the soft, almost tinny sound of a toy piano not fitting in. Slade went to the other side of the country, New York, to rerecord the piano part on a huge Yamaha grand piano. It was successful, and the song peaked at No. 3 on the charts.

Lyrics

Step one, you say we need to talk
He walks, you say sit down, it’s just a talk
He smiles politely back at you
You stare politely right on through
Some sort of window to your right
As he goes left, and you stay right
Between the lines of fear and blame
You begin to wonder why you came

Where did I go wrong?
I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

Let him know that you know best
‘Cause after all, you do know best
Try to slip past his defense
Without granting innocence
Lay down a list of what is wrong
The things you’ve told him all along
And pray to God he hears you
And I pray to God he hears you

And where did I go wrong?
I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

As he begins to raise his voice
You lower yours and grant him one last choice
Drive until you lose the road
Or break with the ones you’ve followed
He will do one of two things
He will admit to everything
Or he’ll say he’s just not the same
And you’ll begin to wonder why you came

Where did I go wrong?
I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

Where did I go wrong?
I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

How to save a life
How to save a life

Where did I go wrong?
I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

Where did I go wrong?
I lost a friend
Somewhere along in the bitterness
And I would have stayed up with you all night
Had I known how to save a life

How to save a life
How to save a life

Source: LyricFind

Songwriters: Isaac Slade / Joseph King

How to Save a Life lyrics © Warner Chappell Music, Inc, Wixen Music Publishing

Listeners of Pop Rock music, might also appreciate the song Mr brightside by The Killers.