Read it as a poem about serious illness, most likely a hospital stay, though the poem never says so outright. The beeping machines, blinking lights and "crunchy paper" (perhaps a hospital gown) suggest a patient whose body is wasting away, "gauntness / eating away the bones." The speaker turns this into a strange party: the monitors are the music, the lights are the mood, and death is a dance partner waiting at the "blackened edge."
The ferryman and the gold coin come from the old image of paying to be carried across to the land of the dead. Here the coin seems to stand for money, or perhaps time, needed to keep treatment going and stay on this side. The tone is wry and weary, with dark humor in calling the body a "useless lump." Yet the title, and the final stanza's "maybe, just maybe," leave room for hope. The speaker walks a tightrope between heaven and hell, wanting the music to keep beeping a little longer.