 Lyrically , " Just Like Tom Thumb 's Blues " continues the theme of road weariness from the album 's previous song , " Highway 61 Revisited . " The singer finds himself in Juarez , Mexico , at Easter time , amidst sickness , despair , whores and saints . While there , he encounters corrupt authorities and women of dubious character , named in the song as " Saint Annie " and " sweet Melinda " , before seeking succor in drugs and alcohol . The song establishes a nightmare vision as the singer is influenced by gravity , negativity , sex , drugs , drink , illness , remorse and memory . In the song 's final verse , the singer decides he has had enough and finds the means to leave it all behind and head back to New York City , where things may be better . Author Paul Williams has noted that scene and situation are combined into a gorgeous evocation of muddied consciousness in " Just Like Tom Thumb 's Blues " , without ever resolving into a clear picture of what the song is about . Despite the sordid details of the singer 's experiences in Juarez , the lyrics maintain a sense of humor , and William Ruhlmann of the Allmusic website considers the song a comic tour de force . 
