Several of the album's songs deal with the topic of death; for instance, "My Shit's Fucked Up" is a mournful lament on the aging process and the inevitable decay that accompanies it. "Life'll Kill Ya" and "Don't Let Us Get Sick" also have prominent death themes. Additionally, Zevon had a phobia of doctors leading him to avoid them for several years; that theme is included in the album as well. In 2002, just two years after the album's release, Zevon was diagnosed with
mesothelioma and died a year later. "Porcelain Monkey" is a meditation on the death of
Elvis Presley, borrowing its title from a figurine on display at
Graceland. Zevon often expressed a disinterest in Elvis' fame and some resentment towards how Elvis' death overshadowed that of
Robert Lowell (Zevon had previously explored the topic of Elvis' death on "Jesus Mentioned" from 1982's
The Envoy). A mocking laugh in "Porcelain Monkey" references
Wynonie Harris, an early rock pioneer often seen as influencing Elvis, and Zevon would state he believed
Bob Dylan was more deserving of the accolades Elvis had received. In an interview on the song Zevon stated: "We're in a world that objects so strenuously to pop culture. Sure, Elvis is fine, so what's wrong with
Ricky Martin? He can dance. I guess Elvis danced. He choreographed himself. What's the difference? I think Ricky Martin is fine, too. Who's buying Ricky Martin and
Backstreet Boy records? Ten-year-olds. And 50-year-old intellectuals weren't buying Elvis Presley in 1957. Ten-year-olds were." ==Track listing==