The track was the first of three UK singles from the band's last studio album Strangeways, Here We Come. As such, it was the last single to include newly recorded material on the B-side. It holds the distinction of containing the last recorded Smiths song, "I Keep Mine Hidden". Also included—and recorded at the same session—is a cover version of a Cilla Black song, "Work Is a Four-Letter Word".

Morrissey's insistence on releasing this single incurred the wrath of Johnny Marr, due to his dislike of the B-side, and he left the band not long afterwards. Marr recalled to Record Collector magazine in 1992: "'Work Is A Four Letter Word' I hated. That was the last straw, really. I didn't form a group to perform Cilla Black songs. That was it, really. I made a decision that I was going to get away on holiday. The only place I could think of was L.A. L.A. was the only place I knew where there'd be sunshine, so off I went. I never saw Morrissey again." The video, which featured clips from the film The Leather Boys (starring Rita Tushingham), was directed by Tim Broad. BBC Radio 1 refused to play the song. Morrissey later commented, "You're not really supposed to like those songs. They're very depressing and not supposed to be played on radio."

The cover features playwright Shelagh Delaney from a 1961 edition of A Taste of Honey. The photo was tinted grey for 7"s in all countries except in Australia where it was tinted green as for the 12"s. This was the second time Delaney appeared on a Smiths cover; she appeared as the cover star on the then-recently released Louder Than Bombs album. According to Johnny Marr, the Bob & Marcia song, Young, Gifted and Black, had an influence on this record.

The song is a first person narration by a man whose friend's girlfriend is in a coma. The narrator describes his conflicting feelings ("There were times when I could have murdered her/But you know I would hate anything to happen to her"). He says he doesn't want to see her then says he does. The repeated assertion "I know it's serious" is undercut by his careless tone and "the light playful accompaniment by the other members of the band".

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