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.