Before the Black Death of the 14th century, music was happy and frequently heard. As the plague raged, music was played very grimly or not at all. The only exceptions were people who decided that since they were going to die anyway, they might as well spend the rest of their life in happiness. The somber change in art and music demonstrated the grim reality of the new normal.

Social attitudes towards music and art changed as Europeans began to see the depression surrounding them. The horrific nature of the Black Death was reflected in the realistic depictions of human suffering and carnage as well as the symbolic use of the skeleton.