In this highly evocative image McCarthy appears to combine the Medieval depiction of Death in the Danse Macabre with the Mexican tradition of the calaca.
Known in Spanish as la Danza de la Muerte, the dance-with-death allegory emerged in Medieval Europe around the time of the Black Death to remind people of the universality and inevitability of death. The Danse Macabre was often depicted in short verse dialogue between Death and his victims. Death in the form of a skeleton is shown summoning his chosen victims to dance while the summoned moan about their impending deaths.
During the Mexican Día de los Muertos (Day of the Dead) celebrations, one of the traditions is the use of calacas (skeletons) as decoration, including papier-mâché skull masks and small figurines. Skeleton suits are also popularly worn.