On Adapting // Crawling, Iron Lung‘s follow-up to their 2022 return EP Mental Distancing, you again see the band centering on themes of medical care and mental health; this time it’s an ardent post-COVID album, reflecting on everything from the mental effects of lockdown to the state of American healthcare in its wake. All of this happened during the time Iron Lung were on a lengthy sabbatical from full-length records; we’re now 12 years on from 2013’s White Glove Test, I feel fucking ancient.

But like I said, Adapting // Crawling isn’t the beginning of this. A follow-up in more than one sense, the album was thematically presaged in the aforementioned Mental Distancing—a solid EP in its own respect. A thematic continuation, yeah, but what the album notably isn’t, however, is a musical continuation; none of the bizarre industrial influences heard on a track like “Only Human” are present, and Adapting // Crawling follows on from White Glove Test with some deviations.

The short intro and partial title track, “Adapting,” sounds like war drums in the deep, all foreboding, these shrill synth-strings beckoning the explosion of “Internal Monologue.” “Whatever we were, we are certainly not that now” Iron Lung greets us, and appropriately the record differentiates itself from their earlier material with a sound of relative clarity. Things won’t stay that way, of course, but going from the goddamn apocalyptic sound of “Industry Ending” to “Internal Monologue,” you hear an immediate shift in the priority of its production. Both records were handled by Greg Wilkinson, so the change is intentional, and manages to straddle the line between harshness and clarity without feeling overly-produced. I think I’ll always appreciate the sound of an album like White Glove Test more but I think given the subject matter of the new record, it’s an appropriately clinical sound, aiding its delivery.

“Shift Work” stands out with its gang vocal delivery atop these staccato, triplet guitar chugs, while “Poisoned Sand'”s start-stop flurry flits between violence and tension. A version of “Everything Is A Void” first appeared on Mental Distancing but it doesn’t at all feel detached from the tracklist, produced in a way that feels cohesive with the rest of Adapting // Crawling. “A Veiled Eye” has these open chords near the end that give it a looser feeling which is a nice respite from the preceding whirlwind.

“A Loving Act” is fucking horrible and gnarled, one of the best tracks in their discography, with great lyrics—”Bathe the body in rose and saline” is particularly evocative—and a slower pace that juxtaposes the hardcore assaults that surround it. A false finish at the halfway point leads into a drawn-out, sour section of slide guitar that fades out to an ending of distorted crashes, like the sound of an anvil being struck in an ice crevasse. It continues through to “Purgatory Dust” which acts like a bunker buster to the idea of a momentarily sedate pace, very immediate and memorable, with these closing drum fills that lead again into “Virus.” It’s a very well structured album; a lot of powerviolence neglects that type of thing because, fair play, you’re there for riffs, so why even bother taking the time? But Iron Lung show their craft most vividly in how they manage to make an album that feels considered without losing any of its visceral, immediate quality.

Both “Purgatory Dust” and “Purgatory Dust (Finale)” are described as a pair of tracks that “conjures the monotonous terror of surviving an active pandemic” and as such they feel like the collective centrepiece of the album, forming a triptych with “Virus” in the middle. All three emphasize themes of medical horror, with “Purgatory Dust (Finale)” giving a more personal, lived fear to the album with the lines “Enshrined In Iron. Lung gives life.” It’s small but this little bit of self-reference in many ways solidifies the quality of the album’s writing to me.

I’m fucking smitten with the syncopated, acidic bass feedback you hear near the start of “Acres Of Skin,” a track with these flaying little triplets that just build and build. “Hospital Tile” is a change of pace, beginning the next musical triptych on the album. It’s sludgier, with thick slides and a monstrous tone; it’s a track that in isolation could seem a bit ponderous, but as “Cog II” hits, starting almost identically but morphing into pure Despise You worship, “Hospital Tile”‘s purpose clicks into place. Finishing this, “HeLa Cells” breaks free from its intro riff almost immediately, clearly the wildest of the three tracks, and has my favourite vocal delivery on the record. I just wish it was longer.

“Failure” is much like “Hospital Tile” but with this burning, rancid anger and these massive ascend-descend power chords that are short, stabbing and violent. “We are out here” is a simple lyric but its repeated barks, especially in the context of the track depicting ceaseless disease, mental strife and physical rot in the face of a system rotten by inefficiency, incompetence and bureaucracy, imbue it with a duality of meaning. On one hand, a lumpen, dying cry of anguish. On the other, there’s this sense of defiance in its delivery. “We are out here.” Not dead yet.

“Survived By…” ends the record with a more tangible exploration of its themes, an explicit recounting of a man’s last words before dying at the age of 45, before then expanding the scope of trauma to his family. Not the heaviest song musically—often quite open and atmospheric—but it’s a fucking bleak track, an appropriate closer.

It’s really hard not to see Adapting // Crawling as a perfect outing for a band like Iron Lung—an album as uncompromising in its message as it is in its delivery, and one of the best things you’ll hear this year.

4.5/5 Flaming Toilets ov Hell

Adapting // Crawling is out now on Iron Lung Records.