The poem sets two layers against each other: a surface that looks fine and a hidden world underneath that may not be. In the first lines, the speaker pictures faults, cracks in the earth, running "busy as lace" below the ground. The comparison is delicate and almost pretty, yet it describes something that could split everything open. That tension runs through the whole poem.
The speaker admits to drinking, and gives a reason: fear of seeing "all the sickness." The drinking reads as a way of not looking, though the poem doesn't spell out what the sickness is. It could be damage to the land, or something wider and more personal. The title, "Fallen," adds a sense of loss or ruin.
The final question is the most unsettling. The speaker asks how the land can still seem good when so much seems wrong. The mood is uneasy and quietly bewildered, a person caught between what they see and what they suspect.