"Trouble Is My First Name" is an orchestral piece from the Season 6 soundtrack.
The guitar case is opened, revealing a large wooden Ankh which Dogen promptly smashes. Hidden inside the ankh is a piece of paper. Dogen reads it and asks for each of their names. Hurley demands to know what the paper says and Lennon tells him that they all will all be in trouble if Sayid dies.
The piece is a variation on Jacob's theme.