Monday, June 9, 2008

"What Sarah Said" by Death Cab for Cutie

Photo of PianoFinding this song about death in the ICU almost seems too easy when you consider the name of the band, Death Cab for Cutie (DCFC), but I had actually listened to this song for a long time before my friend Laura Morrison made me listen closely to the lyrics at a palliative care conference. (For your indie-rock Jeopardy knowledge, the name of the band comes from a send-up of Elvis in The Beatles Magical Mystery Tour.)

For those of you that don't know any 20-somethings, Death Cab for Cutie is an alternative rock band from Washington State, often hailed as a darling in independent/alternative music circles. The common themes of DCFC's music are love and loss with some very catchy melodies and intelligent lyrics quite distant from most pop cliches.
A critic noted Ben Gibbard, the lead singer/songwriter, often writes to

'immortalize watershed moments. Whether that moment for each of us is the moment love begins or ends, passing romances, death or chance encounters, there is a Death Cab for Cutie song about it.'
Therefore you can see the popularity amongst teens and young adults.



(For subscribers, If you do not see the Immem widget for listening to the song, click on the title to go to the original post on Pallimed: Arts & Humanities)

DCFC have a few songs to be featured in upcoming posts, but for now we will focus on "What Sarah Said," from the 2005 album "Plans." (I highly recommend the whole album.) It opens with a haunting piano melody reminiscent of the repeated beeping from telemetry monitors in a hospital. Within the repeating melody you hear a second melody beginning with ascending notes with a hopeful sound, that slowly fades and descends into a soft melancholy plateau in the background. The same ascending/descending 2nd melody comes back again in the second verse with the ascending portion coming with the only positive emotion in the lyrics "But I knew that you were a truth..." The ascending portion of that melody never makes its presence again in the song until near the very end. Every line in this song represents the difficulty of being the family or friend of someone ill and dying in the ICU. The two lines I find most insightful are:
"And it came to me then that every plan is a tiny prayer to Father Time"
"And I looked around at all the eyes on the ground as the TV entertained itself"
Even making a simple plan of what you will do in the next five months, five hours, or five days, is dependent on actually surviving. Father Time and the Grim Reaper are connected by their tool, the scythe, which marks the end for one year's crop so another may grow. And it is nearly impossible to walk through a hospital without finding a television left on in a room where no one is paying any attention, and so it sits blaring reality shows and local news, everyone oblivious to its constant chatter. Even the patient for whom the TV is left on, will often dismiss the importance of leaving it on. The final lines encapsulate what palliative care staff see daily as family and friends witness the dying as a final act of love by just being present.
"But I'm thinking of what Sarah said that "Love is watching someone die."So who's going to watch you die?.."
This presence at the bedside of a dying person can be a demonstration of your love, but it can also tax and exhaust family. A variation on this line ("Love is watching someone die") is occasionally heard from palliative care professionals to allow family credit for the 'work' involved in being present at the deathbed. It is interesting to take the line "So who's going to watch you die" out of a palliative care context, as people may have a much different perception. It would be relatively easy to assume you are watching an action movie and the villain is saying this as some sort of threat to the good guy. Superficial, threatening, maybe hateful. But in the right context the same words can bring forth thoughts of love, loss and tears.

You may also notice that with the first mention of "So who's going to watch you die", the music is relatively absent except a few piano chords, until the keyboards come back in with a insistent driving rhythm, followed all together with a guitar strum (inhaled breath), a fingerpicking guitar melody (will to live), cymbals/hi-hat (neurological activity), organs (the EKG), snare drum (interventions of medicine), the main piano melody (emotions and love), and the lifting second piano melody (hope). All this as if the person had been brought back to life one last time. But then sadly just as the instruments regain some strength they begin to fade again each one going out one by one. To help you see what I hear, I have made a video to show these different elements. (To hear all the instruments clearly, use headphones and an original recording.)

video


Now available on You Tube (8/5/8) if you want to embed it on your site or see it in full screen version.
(Removed because of YouTube's copyright rules 12/08 - but still available on Google Video)

Yes there is a two-tone sound reminiscent of a doorbell at the end of the song. It is hard to hear in this video clip, but it is there. Do you hear anything different in the instrumentation?

DCFC's new album "Narrow Stairs" came out in May 2008. (It is very good.)

"What Sarah Said" by Death Cab for Cutie (Gibbard/Walla) from the album "Plans" (2005) from Atlantic Records.

Lyrics:


And it came to me then that every plan is a tiny prayer to Father Time
As I stared at my shoes in the ICU that reeked of piss and 409
And I rationed my breaths as I said to myself that I’ve already taken too much today
As each descending peak on the LCD took you a little farther away from me (Away from me)

Amongst the vending machines and year-old magazines in a place where we only say goodbye
It stung like a violent wind that our memories depend on a faulty camera in our minds
And I knew that you were a truth I would rather lose than to have never lain beside at all
And I looked around at all the eyes on the ground as the TV entertained itself

'Cause there’s no comfort in the waiting room&
Just nervous pacers bracing for bad news
And then the nurse comes ‘round and everyone lift their heads
But I’m thinking of what Sarah said,

"That love is watching someone die."

So who’s gonna watch you die?

45 Responses to “"What Sarah Said" by Death Cab for Cutie”

Tor Arne said...
June 10, 2008 at 10:24 AM

That was absolutely beautiful. To think I've listened to that song hundreds of times and never noticed neither the lyrics or the soundscape at the end.


Christian Sinclair, MD said...
June 10, 2008 at 10:31 AM

Well I am glad to hear that I am not the only person who listened to the song and missed the meaning for a long time. Thanks for the comment.


Anonymous said...
June 10, 2008 at 6:11 PM

Very nice!


Anonymous said...
June 11, 2008 at 12:43 PM

Thank you, thank you!


hospicenurse said...
June 21, 2008 at 9:42 AM

Your interpretation took my breath away. Wow. Thanks.


Christian Sinclair, MD said...
June 21, 2008 at 10:39 AM

Thanks for all the kind comments. I would be curious if anyone hears things slightly or vastly differently than I do.


Anonymous said...
June 23, 2008 at 7:00 PM

This is a very personal comment, but I am willing to share...I had never heard this song before, and am overwhelmed right at this moment. DCFC was my son's favorite band. When he called me telling me he was going to kill himself, he said, "Who's going to watch me die?" (He is ok now) Another note...his girlfriend's name was Sarah.
Thank you.


Christian Sinclair, MD said...
June 23, 2008 at 8:55 PM

Anon,

Thanks for sharing your story. I am glad he is doing ok.


mcd7m said...
June 27, 2008 at 8:59 AM

Hello! I am a second year medical student at the University of Virginia. I am doing a research project this summer on blogs maintained by medical students and physicians and I have really enjoyed reading yours!The post on What Sarah Said was just beautiful, and made me listen to the song in a new way. I wanted to let you know about an online journal at UVA called Hospital Drive, which can be found at http://hospitaldrive.med.virginia.edu/. I think you and your readers would really enjoy reading and perhaps even submitting material to the journal. Happy Reading!


Amber Wollesen, MD said...
June 27, 2008 at 5:07 PM

Thanks for the tip! I looked at a couple poems on the site and am looking foreword to reading more. I'm glad you're enjoying our blog.


dripsoup triptwice said...
August 12, 2008 at 8:24 PM

wow. i had developed a similar view of the song , my favorite line also being the one about the television. .. you did a wonderful job of showing the corrilation between the music and medical sense. . I hadn't heard the doorbell until now. , which adds the interpretation substantially in my opinion. as if the deceased just reached teh other "realm" and is waiting acceptance in. .. all in all. its great.


Megan said...
September 9, 2008 at 7:13 AM

I absolutely LOVED the video showing where you heard those things. This was INCREDIBLY moving, to see it from a medical point of view.

The lyrics to this song are amazing, and so incredibly true, as I'm sure you know, of an ICU, waiting on someone to die. My 16 year old cousin was killed earlier this year from a car accident. This song perfectly describes waiting in the waiting room, waiting to hear results from tests...everyone waiting, staring at the ground....TV's are on, no one is watching them....In the end, she was taken off life support as the brain damage was too severe, and organs were donated, helping someone else to live....but anyway, I'm off track. Did you read what DCFC said about this song? It was in a magazine.

"...There's a song on the record called, 'What Sarah Said,' and we have a friend named Sarah, and she was talking about her husband and talking about how she was walking down the street with her husband and she got really emotional when she realized that she was going to have to watch her husband die someday. And that's kind of an allusion to that, because you're with someone you love, someone that you're planning to spend the rest of your life with, but the only thing on your mind is that you're going to have to watch them die in 50 years...."

Anyways, thank you again, SO much for the video with the visualizations.


Christian Sinclair, MD said...
September 9, 2008 at 7:40 PM

Megan,

Thanks for the comments.

I tried to find the magazine your quote was from, but all I could find was that it was attributed to Under The Radar magazine. I could not find the exact quote on their website, but did find this from frontman Ben Gibbard: (http://undertheradarmag.com/bengibbard.html)

Obviously, these songs are pieces of fiction, and I’m not deliberately putting less of myself into the songs. Like, “What Sarah Says” has a line that says, “And it came to me then that every plan is a tiny prayer to father time.” And the song is about someone sitting in a waiting room of a hospital waiting to hear if someone is going to be OK. That didn’t happen to me, but I can put myself there and write it as a piece of fiction, and I like that.


purple-daisies said...
October 5, 2008 at 5:08 AM

I just found this. After working in an ICU environment for most of my nursing career, it was hauntingly familiar. Thank you!! I love DCFC, and it never listened to the song that way before.


Christian Sinclair, MD said...
October 20, 2008 at 11:32 PM

Thanks for the comments purple daisies. I am glad someone else who had ICU experience saw some similarities in it.


Anonymous said...
November 14, 2008 at 2:48 PM

I actually have had no experience being a nurse or doctor but I can very clearly feel the emotions that are portrayed in this song. It is, in one word, beautiful.

Your interpretation is exactly how I felt, but just had no way of explaining it. I can remember the first time I heard this song and it actually bringing tears to my eyes without fully listening to the lyrics. Very powerful.


Anonymous said...
November 14, 2008 at 7:59 PM

oh whoops, I also meant to mention that you hear a sort of doorbell in the beginning of the song also... I'm not sure if thats the organ or what?


Christian Sinclair, MD said...
November 16, 2008 at 10:14 AM

Anon 11.14,

Thanks for your comments. I didn't hear the doorbell at the beginning of the song. I might have to listen to it turned up. On the album it starts out with the piano melody.


Victoria said...
December 4, 2008 at 6:21 PM

I believe the song does have greatly to do with watching your loved ones die, but I see it differently. To me, it is not only watching someone die physically, but mentally and emotionally. When you see someone you love going through alot, you hate seeing that way and sometimes just want to run away. When you see someone needs you, despite what they say and if they think they are fine themselves is true love to me. My boyfriend had left me through a difficult time, and I realized while listening to this song that it was the truth. Love wasn't only happiness, it could be sadness. Love is truly watchign someone die.


ICU RN said...
March 27, 2009 at 11:19 AM

I am a new RN in an ICU. Watching someone die is the most emotional experience I've had to date. The lyrics alone in this song are amazing, but your interpretation of the instruments was unbelievable. I could close my eyes and see exactly what you were describing. Thank you.


Anonymous said...
April 24, 2009 at 11:55 AM

Wow. I am an admitted cynical a** prepared to feel nothing, but that was amazing. Very touching. Never thought of it that way.


Anonymous said...
April 24, 2009 at 12:30 PM

there is a song by the band called Muse which has lyrics that go "...our hopes and expectations... " which is a line I sometimes use when I talk to families of patients for palliative care. Sometimes I have the tune rolling in my head over and over as I talk and listen to some families. Very distracting. LOL


Christian Sinclair, MD said...
April 25, 2009 at 6:24 AM

ICU RN,

thanks for your comment. Sorry it took me a while to reply. Visualizing this song in my head over and over again was actually part of the inspiration for getting the Arts blog started. I wanted to make this interpretive video, but I had no venue for it, and every time I heard the song, I would play it again and again just listening to one instrument until I could 'assign' each instrument to some meaning or organ function. I would love to know if other people hear the instruments representing different entities.

Anon 4/24,

Knowing this made someone who is normally very cynical feel something is a very kind compliment. Thanks! The song by Muse is called "Starlight" and is very relevant to Palliative Care. So relevant that I wrote up a post about the song on Pallimed: Arts & Humanities last year! I too use the line hopes & expectations in family meetings and I often have this song stuck in my head after I use it.


usb said...
August 11, 2009 at 10:28 PM

This is interesting and really sad for me...it makes me think of what happen to my aunt, she was on life support for a while and then she came off...able to walk,talk,...but a week later she died...


Christian Sinclair, MD said...
August 11, 2009 at 10:39 PM

usb,

Thanks for adding your experience here. I am always amazed at how listening to a song can remind one of memories in such a vivid way.


Anonymous said...
October 16, 2009 at 6:45 PM

Amazing. I was on a hospital ethics committee and have been on 3 livings wills. I will share this link in a talk I will be giving on Living Wills and Death and Dying.
Remember, as Bob Dylan sang, "He not busy being born, is busy dying"


Anonymous said...
October 25, 2009 at 6:43 PM

I posted the previous comment on enjoying the video interpreation of the song,(I am the poster who was on the hospital ethic committee). I just want to add that, what Dr. Christian thought was a doorbell at the end of the song, might be the data signal on the audio tape that caused the auto reverse on the tape machine to switch on. Not sure about that but I had a similar reel to reel player a long time ago and I remember that there was a similar method to causing the auto reverse to switch. I saw the music video on http://music.aol.com/video/what-sarah-said/death-cab-for-cutie/1682619 and saw the connection between the sound and the auto reverse function. I am not positive but it might be the source of the sound.


Robin said...
November 23, 2009 at 11:54 AM

Amazing. As a Critical Care nurse, I could completely relate to this interpretation. Very touching, thank you for sharing this.


Raspberry Stethoscope said...
March 17, 2010 at 8:59 AM

Awesome interpretation. I linked from my blog


Angeloooo! said...
March 24, 2010 at 9:29 PM

I stumbled upon your blog post and I just had to share that my mind is blown.
This song has always comforted me after sitting bedside with a friend who passed away at just 30-years old of cancer. My strongest memories of that day are just staring at my shoes and hearing him breath slower and slower until it all stopped. I always took comfort in this song, but never, ever heard it the way I do now thanks to your analysis. It is so much more powerful now. Thanks for taking the time to share.


Angeloooo! said...
March 16, 2011 at 11:54 PM

I stumbled upon your blog post and I just had to share that my mind is blown.
This song has always comforted me after sitting bedside with a friend who passed away at just 30-years old of cancer. My strongest memories of that day are just staring at my shoes and hearing him breath slower and slower until it all stopped. I always took comfort in this song, but never, ever heard it the way I do now thanks to your analysis. It is so much more powerful now. Thanks for taking the time to share.


Raspberry Stethoscope said...
March 16, 2011 at 11:54 PM

Awesome interpretation. I linked from my blog


usb said...
March 16, 2011 at 11:54 PM

This is interesting and really sad for me...it makes me think of what happen to my aunt, she was on life support for a while and then she came off...able to walk,talk,...but a week later she died...


Anonymous said...
March 16, 2011 at 11:54 PM

there is a song by the band called Muse which has lyrics that go "...our hopes and expectations... " which is a line I sometimes use when I talk to families of patients for palliative care. Sometimes I have the tune rolling in my head over and over as I talk and listen to some families. Very distracting. LOL


Christian Sinclair, MD said...
March 16, 2011 at 11:54 PM

Anon 11.14,

Thanks for your comments. I didn't hear the doorbell at the beginning of the song. I might have to listen to it turned up. On the album it starts out with the piano melody.


Anonymous said...
March 16, 2011 at 11:54 PM

I actually have had no experience being a nurse or doctor but I can very clearly feel the emotions that are portrayed in this song. It is, in one word, beautiful.

Your interpretation is exactly how I felt, but just had no way of explaining it. I can remember the first time I heard this song and it actually bringing tears to my eyes without fully listening to the lyrics. Very powerful.


Phensby said...
March 16, 2012 at 10:32 AM

I run a website called My Last Song and people send in their favourite five songs to be remembered by. On one list is I Will Follow You Into The Dark, a Death Cab For Cutie song, and a really great track too. 
http://www.mylastsong.com/advice/4331/159/115/music/fave-five-last-songs/jose-gonzalez--heartbeats


amateurParent said...
March 22, 2012 at 5:41 PM

I wish you could set up a way to charge for downloading your wonderful video.  I would be very willing to pay.  Give the recording company and Death Cab for Cutie their royalty .. and pocket a bit for yourself.  Or donate. Your choice.

Years ago, I downloaded your video for a friend to use in a nursing class. It made an impression.  I was looking for it, and I was so sad to see that YT had blocked it.


Christian Sinclair said...
March 22, 2012 at 9:54 PM

I'll see what I can do. I appreciate your passion for this song which was one of the reasons I even started blogging about palliative care.

I saw Death Cab for Cutie last year and thought of writing them to tell them how this has been used in engaging medical students but I never got around to it.


Cminturn said...
April 6, 2012 at 7:58 PM

It did happen to me (twice, actually - I've watched two friends die in the ICU). The idea that Ben captured the moment so perfectly without having been there is just amazing to me.


Mel said...
July 11, 2012 at 2:14 PM

Wow... Thank you for your interpretation. I stumbled upon this as I am researching the how tos of implementing a palliative care protocol in the NICU that I work in. Brought tears to my eyes.


Christian Sinclair said...
July 12, 2012 at 7:22 AM

Thanks for the feedback. Sorry for the lack of audio. I am working on a new version with lyrics to the entire song on screen. Will post a comment when it is updated.

Christian


Tina Marie said...
July 20, 2014 at 3:46 PM

My daughter's name was Sarah, and she did end her life. Soul Meets Body was one of her favorite songs and was played at her service. I was looking on YouTube to play that song because I needed to hear it, and came across this one…. I have never even heard this song before today, and Imagine my reaction. I love this song but it makes me cry!!!


Christian Sinclair said...
July 21, 2014 at 9:10 AM

Thanks so much for sharing your personal story. It is nice to know these posts still connect with people whenever they discover them. Soul Meets Body is another great and poignant song. We here are so very sorry for the loss of your daughter.


victoria said...
December 19, 2014 at 8:24 AM

I heard this song for the first time recently and your interpretation is right in line with mine. I am an RN in an ICU/Burn ICU and this song describes my experience on any given day at work. I literally ration my breaths as I'm suctioning my intubated patients-sometimes an endless run of people who will never walk out of the ICU.
It also reminds me of my father's passing several years ago as he spent many of his last days in the ICU. (Fortunately he had the foresight to give us direction on his care at the time of his admission, "I don't want anyone to cut into me to save my life." He had a peaceful death on a medical floor with excellent hospice-like care.) I remember the TV being on and an advertisement for some show that would be airing in two weeks and realizing my dad wouldn't be around to see it and wondering what it was like to be him having that screamed in his face over and over at every commercial break.
Most healthcare professionals realize each heartbeat brings us closer to death-even if it isn't displayed on a monitor. Watching someone die is part of watching them live-love allows us to appreciate those moments. People who can take comfort in the memory of their loved one without the fear of what news they will hear have done something right.