Dream Theater vocalist James LaBrie wrote this song, which takes on a very dark subject.
"It's the after-effect of a very traumatic and horrific experience, which is being the victim of rape," he said in a Songfacts interview. "I read an article and then I saw a documentary on victims of such a heinous act, and it's really hard for the couples to go on. So, that lyric is about him telling his wife that no matter what has happened, she has to remember that he still loves her as he always has, nothing has been lost, and that she needs to see that he is still the man she fell in love with. He still does not think anything different. He is there for her, and he needs her to rediscover that yes, she has been changed by this act, but at the same time, she has to realize that there is more to her than what this act dictates. So, that's basically what that lyric is about: her trying to salvage the relationship due to that."

The phrase "at wit's end" means nearing a breaking point where you can't take it any more. It appears in the Bible, and comes from a time when "wit" referred to mental faculty, so if you were "at your wit's end," you were losing your mind. In this song, it's the woman who has reached this point, with the man trying to help her through it.

The song opens with a persistent, guitar driven-intro, with the vocals coming in at 1:10. It runs 9:21, but fades to silence 8 minutes in, returning about 15 seconds later with distant percussion. These adventurous elements are not uncommon for Dream Theater, which has always explored the boundaries of progressive metal.