He looks back into the crowd, wipes the blood and then explains
How she slipped from this existence to the realm of the deranged

from Lupe Fiasco – Lamborghini Angels Lyrics on Rap Genius

Meaning

In this verse, “he” refers to the doctor performing a surgery (which may be metaphorically used to describe the main topics used in mainstream hip-hop and/or other types of assimilating into American society such as institutionalized education systems, mainstream media, etc.).

Remember, everyone is expected to behave and act a certain way… and anything that is considered a threat to these ideas is deemed insane.

By having this lobotomy-like operation on her brain, society can eliminate its opposition (which they persistently persuade people to characterize as “crazy”, “deranged”, “retarded”, “mentally challenged”, etc.) and continue its instillment of mainstream messages.

No matter what, though, women are always going to looked upon negatively in society.

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