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Joel started writing this in the early 1980's about a relationship he then had with supermodel Elle MacPherson. Their backgrounds were so different that he knew the relationship would fail, which it did. He predicted the end of the relationship with the line "And you can have this heart to break."
The title comes from television journalist Linda Ellerbee's signature line and best-selling book title. (thanks, Ken - Louisville, KY, for above 2)
When Joel appeared on The Howard Stern Show in 2010, he said that this was his least-appreciated song - the best one that casual fans aren't aware of.