Carl Fink sends this in: “I’ve never read Notes from the Underground, but this SMBC is a complete mystery to me. Dad is underground? 18 hours of reading books aloud comforts a dying man? What is going on?”
Mouseover text: “Suddenly regretting that I didn’t just draw a word for word graphic novel of the entire book twice.”
Bonus panel:
Comics I Don't Understand 
It’s a dad joke. You know, kid says “I’m hungry,” and dad says “Hi, hungry. I’m Dad.” In panel 2, the book starts “I am a sick man.” Dad starts panel 5 “Hi a sick man” and includes the whole book before introducing himself.
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There’s a popular dad joke that that goes something like this:
Child: “I’m tired!”
Father: “Hi, Tired, I’m dad!”
This is a twist on it, albeit one that doesn’t work because “I am a sick man” doesn’t have the ambiguity of “I am sick.”
I don’t know which is worse: That the father used his final words to tell a pretty common joke, or that he did it wrong.
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The dad joke here is that the dying dead is taking the entirety of Notes from Underground (except for the initial “I am”) to be his son’s name.
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Sorry, the dying dad, not dying dead.
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