This song uses a hospitalized woman's musings as a metaphor for a broken relationship. A&E is short for "Accident and Emergency." (In America, A&E is the television network "Arts and Entertainment")
Alison Goldfrapp told the Sun newspaper February 15, 2008, the story behind the song: "It was inspired by a few hours I had in A&E on a Saturday afternoon. It was nothing serious but I remember they pumped me up with loads of painkillers. I was standing there looking at all these rugby players coming in on trolleys - arms up there, noses round there. They were in those weird green gowns they make you wear and it was all a bit surreal. And I suppose A&E is a sort of metaphor for a relationship that was going horribly wrong. That's all mixed up in the song too."
Will Gregory (synthesizer) explained to the Guardian newspaper January 25, 2008 about the album title, which came to Alison Goldfrapp in a dream: "It had to be heady, like you'd hear it by accident down a corridor in a slightly echoey room. It had to have an effect like music in spaghetti westerns, like when a child gets shot in the head and suddenly there's a major chord. It had to combine beauty and darkness."
In the same Guardian interview Alison Goldfrapp explained how a 2006 acoustic session for BBC Radio 1's Jo Whiley influenced the more understated sound of Seventh Tree: "We were very against playing them before it - one, because we're not an acoustic band and, two, because people often want to hear you unplugged as they think that validates your status as musicians, which we're very anti. But we were so desperate to take our music down a few notches, we went sort of, unggh, nyaaargh, oh-kaaaay. And then - ha! - we loved it."
Uncut magazine March 2008 asked Will Gregory if he used real guitars on the album. Gregory replied: "Neither Alison nor I play the guitar, so we'd play sampled guitars on keyboard. Then we'd ask friends to replay them, and realized they'd need a million fingers. Sometimes the sampled guitar made it to the final round!"
This topped the Billboard Hot Dance Singles Sales chart.
Alison Goldfrapp expanded on the album title in an interview with the Daily Mail April 18, 2008: "I got the (album) title from a dream I had about a large tree with white wispy branches and the number seven written on it. I woke up in the morning and immediately rang Will to tell him I had a name for the record."