Lyrically, this song refers to William Shakespeare's play Hamlet, and especially the Danish prince's wish to give in to his desire to gain revenge for his father at the cost of his own sanity. At the end of the song, there is a direct quote from the play: "Oh that this too, too sullied flesh would melt."
This was the breakout single for Dream Theater, but it was actually a late addition to the Images And Words album. This was down to former Kerrang! journalist Derek Oliver, who had moved onto A&R work with the band's label, Atco. Having taken the band under his wing, he suggested they write one more song for the album, and "Pull Me Under" was the result. The song's working title was "Oliver's Twist" in tribute to Derek Oliver.
After 8 minutes and 11 seconds, this song suddenly ends mid-note. The abrupt finish was inspired by The Beatles track "I Want You (She's So Heavy)" from their Abbey Road album.
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