Nashe begins the poem with the speaker’s exclamation “Adieu, farewell earth’s bliss; / This world uncertain is” (Lines 1-2). From the first lines, Nashe sets the tone for a serious meditation on death and the transience of life. Within the first stanza, the speaker also introduces the personified figure of Death, whose ominous presence looms throughout the poem. Death’s “darts” (Line 5) or arrows come for everyone, and no one can “fly” from or escape them. While the things of this world may be “uncertain,” the speaker is convinced of the certainty of death, particularly the speaker’s own oncoming death. With this increasing certainty of death and the foolishness of youthful, “lustful joys” (Line 3), the speaker concludes the first stanza with the poem’s constant refrain: “I am sick, I must die. / Lord, have mercy on us!” (Lines 6-7).

The progression of the lines in the refrain highlights the speaker’s growing despair. The speaker first acknowledges their sickness; then, with hardly any pause, the speaker immediately concludes they “must die,” for the “swift” (Line 12) and deadly effect of the plague is too obvious to ignore. Finally, the refrain references a plague prevention practice from Nashe’s era.