Composition
"Live to Tell" is a pop ballad, with background instrumentation from a keyboard, a synthesizer, a funk guitar and a mix of synthesized and real drumming. According to the sheet music published at Musicnotes.com by Alfred Publishing, the song is written in the key of F major, is set in common time and moves at a moderate tempo of 112 beats per minute. The song starts with an instrumental introduction, performed by a synthesizer with the bass pedals set on D minor. Then the key suddenly changes to its relative major, F.
Madonna's vocal range spans two octaves, from G3 to G5. As she begins to sing the first verse, the bass pedal changes to C major, changes back to F during the chorus, and back to D minor during the chorus closure. This process is repeated during the second verse and chorus, which abruptly ends in a silence, with only the low and lifeless sound of the synthesizer, set in D minor. Madonna then starts to sing the bridge (or middle part) — "If I ran away, I'd never have the strength" — between the tonal keys of D and F, closing with the repetition of the chorus until the song gradually fades out.
Lyrically, "Live to Tell" portrays the complexity of deceit and mistrust. The song is also about childhood scars and had an extreme emotional pitch. According to the book The Heart of Rock & Soul by Dave Marsh, the archetype of songs like "Live to Tell" is The Platters' song "The Great Pretender". In an interview about the song, Madonna said, "I thought about my relationship with my parents and the lying that went on. The song is about being strong, and questioning whether you can be that strong but ultimately surviving."
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