Kurt Cobain, Nirvana's frontman and the song's author, claimed that this song was inspired by a television report of children suffering from cancer. However, many believe it was really written about his shaky but passionate relationship with his wife, Courtney Love. The lyrics do tend towards this latter interpretation, since they seem to concern themselves with an unstable romance between two individuals. It's worth noting that the lyrics mention Pisces and Cancer, Cobain's and Love's respective astrological signs. Love, after their second meeting sent a small heart-shaped box, containing, among other things, a doll's head, to his hotel room. This is believed to have inspired the song's title. Cobain and Love both shared a love and fascination of dolls.
The "Heart-Shaped Box" could be a reference to a uterus. The lyrics talk about the situation of an aborted fetus from the first-person viewpoint. (thanks Bompsy - Madison, Wisconsin)
There are many possible interpretations for the "Heart-Shaped Box." It could be a box for Kurt's needles, an actual heart, or a box of love letters. There is no clear explanation, which was probably what Cobain had in mind.
According to the book Come As You Are by Michael Azerrad, the idea of the song came from Courtney Love when she presented Kurt with a heart-shaped box full of precious possessions. The song switches meanings between Kurt's feelings over Courtney and his feelings on how women are treated.
A live version appears on From the Muddy Banks of the Wishkah (1996).
The original title was "Heart-Shaped Coffin. (thanks, Daniel - Wickita, KS)
There is a plastic-fetus collage on the back cover of In Utero that was designed by Kurt Cobain. This contributed to the album almost getting banned at K-Mart and Wal-Mart. The stronger reason that Wal-Mart wanted to ban the album was that it included a song entitled "Rape Me." However, Wal-Mart in the end did NOT ban the song, because Kurt Cobain conceded by providing them with a version that was slightly altered on the exterior, with the song "Rape Me" listed as "Waif Me," and with the image on the back being a zoom-in of one small part of the original back cover, so that it was difficult to tell that the image was of plastic fetuses. Bassist Krist Novoselic has commented that he told Kurt it wasn't worth it to pander to Wal-Mart like that, and recalls that Kurt responded by saying that Wal-Mart was the only store he could go to when he was a kid and that he didn't want any young fans to be unable to buy their album because of this. (thanks, Stefano - Old Bridge, NJ)
Nirvana's songs "Milk It" and "Marigold" also appeared on the single.
The lyrics, "Throw down your umbilical noose so i can climb right back" is Cobain's way of saying that he wants to climb back into his mother's womb and restart his life. Calling it an umbilical noose indicates his suicidal tendencies. (thanks, zac - Brisbane, Australia)
Evanescence recorded an acoustic version that was released on their "Going Under
" single in 2003.
The video is rather odd and depicts a little girl in what seems to be a Ku Klux Klan uniform and an old man with a Santa hat on dressed like Jesus and tying himself to a cross. It also shows a rather large woman wearing a suit of meat for the verse "meat eating orchids forgive no one just yet." Later in the video her uniform turns black and she tries to snatch unborn babies from a tree. (thanks, Quentin - Goutier, MS)
Another prevalent theory is that Kurt Cobain wrote the song about a stash of old love letters his wife, Courtney Love, was given by former flame Billy Corgan of the Smashing Pumpkins. (thanks, Bertrand - Paris, France)
This is also the title of Joe Hill's (Stephen King's son) debut novel about a lonely retired rock star who receives a mysterious heart-shaped box in the mail. Hill explained the significance of the title and its connection to Cobain: '"Heart-Shaped Box,' the song, is likewise about feeling trapped and isolated. Also, the novel is in part about the way a certain kind of very unhappy person will use loud, intense music to hold self-destructive urges at bay, something I think [Kurt] Cobain tried very hard to do. But I only made a mental connection between the two things because of a lucky accident. I was writing the scene where UPS delivers the ghost–in reality, a haunted suit–and I was listening to iTunes, and Nirvana’s 'Heart-Shaped Box' just came up on random play. So I put the haunted suit in a giant heart-shaped box, and, eventually, it became clear that ought to be the title."