When Agnes Obel was a child, she struggled with the concept that when people die, they're gone forever. As an adult, Obel came to believe that everyone we meet is part of the fabric of our minds. Those that have passed on are still in the back of her head, and their comments and thoughts influence her choices and behavior. Obel lost her father in 2014 while she was on tour. She explained to The Sun that this song is her way of comprehending what was happening to her mind when he died. "The stark contrast between trying to grasp the fact that this person is gone for good," she said, "while having to deal with the hard realities – their funeral, belongings and home."
"Island of Doom" features Obel on pitched-down piano, with layered vocals with regular collaborator Kristina Koropecki on cello.
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