[ That she doesn't seem to understand where he's coming from is the real problem here. He's been trying, even if it might not be so obvious but the more he tries the more he loses. He's homeless, single, out of work, in many ways worse off now than when he came back in with a gunshot wound in his arm.
She'll always go running after Tyki Mikk. Why he thought anything else is a fucking joke.
There won't be any more "again". This is it. When he turns — and he does — it's for the last time and there's a feeling of heartsqueezing finality. For a moment there he thought they could save it, again, and then another thing happens and another and another and this is killing him, all this trying only to fail three days later. He's not strong enough to do it anymore. It's not fair to either of them.