Made up of two thirty-second refrains, ?A Turn for the Worse? is deep and funereal, ringing of sorrow, grief, and death. In the first refrain, the violin lilts and meanders like the wail of a grieving widow, and at 0:35 the clarinet comes in, echoing the violin?s refrain in a dark call-and-response. The piano, cello, and accordion provide slow, mournful accompaniment, and in the first refrain, the tubular bells chime as if they were death?s final toll.