This will require a little cultural literacy to make sense.
Lou wrote about the ugly side. He wrote the songs about the hater in him but not for the hater in his audience; the anger and alienation he had towards his parents for forcing him to have electro-convulsive therapy as a teen because they thought he was a little gay. Maybe that was foreshadowing of the rest of his career
Waiting for a dealer, a junkie having an overdose, a hopelessly messed up woman who shouldn’t have children but ends up whelping three or four of them. He didn’t make drugs glorious, Lord knows that heroin and other illicit mind altering substances are not - he just wrote about where a life in drugs leads people. Imagine if he scored De Niro’s Taxi Driver.
The 70s left a dent in the man’s body. Lou cleaned up and looked dispassionately at The City around him and saw plenty of indifference and privations to write more songs about.
One way to describe Lou Reed is to compare him to The Beatles. Lennon / McCartney found it sad that Eleanor Rigby died as no one’s grandmother, where to be forgotten is no different than to be unloved or unlovable. Lou would have written about Rigby’s funeral alone, about how the vicar’s daily schedule was interrupted to bury a person who had no next of kin, about the hungover grave digger, about the internal dialogue of parishioner who came at the vicar’s request is disappointed by the small bouquet on the casket, a bouquet unworthy of taking home and putting in a cheap vase.
Shit happens in life and it because the basis of Lou Reed’s best known body of work.