The glockenspiel tries in vain to hail the momentary establishment of A major; but in the end it is the insistence of C♮ (the note with which the work so strikingly began) that forces the movement and the symphony to close in a desolate A minor, without melody or rhythmic pulse.

Timothy Day writes that "the operation was successful, but he lived for many years in constant fear of the tumour recurring, and from 1908 to 1913 the shadow of death lay over his life.

In the year before beginning the symphony, Sibelius had met many of his contemporaries in central Europe, including Arnold Schoenberg, Igor Stravinsky, and others; his encounter with their music provoked a crisis in his own compositional life.

Later, when asked about the symphony, he quoted August Strindberg: "Det är synd om människorna" (One feels pity for human beings).

The symphony briefly had a nickname, Lucus a non lucendo, an expression that literally means "a grove from not shining", suggesting, in this case, a place where light does not penetrate.