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Fistula 

Idiopathic (Shifty Records)

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Medina's Fistula plays soot-black stoner metal so pained that it belongs in an ER. This is pointedly coarse masochism, equal parts doom, grind, and bleeding vocal cords. Singer-guitarist Aaron's glass-gargling shrieks will test the mettle of even the most hardened headbanger, and his guitar playing is equally barbarous: massive, sun-obscuring riffs add impressive girth to all nine tracks on Idiopathic.

Fistula lands its one-two punch in dirge after dirge, keeping the album slow and suicidal. But what makes Idiopathic work isn't simply its extremity, but the fact that the band has taken the time to infuse its songs with hooks, if not melody. Opener "Firekiller" is a lumbering brute, with bluesy, devolved guitar and hulking rhythms; "Fear of One" is a welcome shot of velocity, with breakneck beats and indecipherable, screeching vox. It all ends with a take on "Cocaine" that tears J.J. Hale's original limb from limb. Recommended for sadists and sludgecore aficionados alike.

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