The passion

One of rock's unheralded geniuses, Jason Pierce of Spiritualized was on the cusp of greatness when an illness nearly killed him.

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Jason Pierce is the great unsung hero of British rock music. As the singer, songwriter and philosophical pulse of his epic rock band, Spiritualized, he has written and performed some of the most audacious, ambitious and moving music of his generation. He is a remarkable, driven figure who chronicles his life in his art and recently came within a whisker of chronicling his death in it - and yet you may never have heard of him.

Pierce is the cult hero's cult hero. For more than 15 years, he has used Spiritualized to make vast, insatiable, gospel-tinged music that is rivalled only by Radiohead in its scope, intensity and integrity. Indeed, he could have achieved Thom Yorke's superstar status, were it not for the fact that he shuns the limelight with a ferocity that leaves even the famously publicity-shy Yorke looking like Paris Hilton.

Pierce is a singular figure in British culture and Spiritualized are a unique band. They make hypnotic, towering music in which Pierce ponders questions of life, love, mortality and his own drug abuse. Far more than poor, dazed Pete Doherty, he embodies the romantic, Byronic ideal of the artist who lives hard and loose in pursuit of the truth and sends back pained missives from the edge. He does not do small talk, and neither do Spiritualized.

Jason Pierce's music has always offered a candid window into how he lives - and his latest installment is a staggeringly visceral account of how he nearly died. Early in 2005, Pierce was hard at work on his group's unnamed sixth album. In June, he took a break from the studio to appear at the South Bank's prestigious Meltdown festival at the invitation of that year's curator, Patti Smith. It's a sign of his status in the eyes of music fans that many Meltdown attendees regarded him as a greater draw than fellow participants Yoko Ono, the Smiths guitarist Johnny Marr and Television, but Pierce did not enjoy his performance that night.

Playing alongside Smith and the legendary My Bloody Valentine guitarist Kevin Shields, he found that the breathing problems he had recently been experiencing were getting worse. By the end of the set, he felt seriously unwell. Two days later, the musician was persuaded to make a reluctant visit to his local East London doctor. After a quick examination, the concerned doctor referred him to the Accident & Emergency (A&E) department of his local hospital. Leaving the surgery, Pierce became so weak that he had to phone a musician friend to help him to stumble to the Royal London Hospital.

Whether or not his troubles stemmed from an immune system ravaged over the years by his notorious fondness for narcotics, Jason Pierce had contracted double pneumonia. By the time the Royal London's medics had hooked him up to drips and a ventilator in an intensive care ward, his lungs' alveoli were filling up with fluid and preventing oxygen from reaching his blood. On life-support, he was taking a breath every second.

Pierce's hospital ward contained six beds. Over the next four weeks, the inhabitants of five of them passed away. As the singer drifted in and out of consciousness, his close friends showed him photographs of his two young children to lend him the will to live. His partner Juliette Larthe, a video producer, was offered pre-emptive grief counselling. It really didn't look like he was going to pull through.

"All that I can really remember are the life-support machines that were bleeping at different times and different frequencies all around me," he says now. "It was like a beautiful music. This may sound crazy but I didn't even mind being in intensive care. It was OK. All I could do was surrender myself to the doctors. "Did I think that I might die? Well, it's a really difficult thing to imagine. Where do you start? I'm not trying to be mystical but I didn't even feel any fear. I have no idea why, because I'm really not a particularly brave person."

After a month at the Royal London, Pierce was finally well enough to be discharged. Yet illness had wreaked havoc on his body; his already skinny 5 ft 10 in rock-star frame was positively emaciated at 38 kg. Returning to the studio, after a few days grudging recuperation, to resume work on the Spiritualized album that had been so rudely interrupted, he experienced an epiphany. "I listened again to the music we had been recording and it all seemed to relate to my hospital experience," he says. "It was genuinely harrowing and emotional to listen to, and that was when I hit upon the title. I decided to call it Songs In A&E."

It's a title, and a story, that captures the essence of Spiritualized: mortality, narcotics and a mischievous sense of mordant black humour. For more than 20 years, Jason Pierce has been making vast, sweeping, cathartic music that has earned him a fervent cult following even while he has remained firmly off the radar of many mainstream music fans. Spiritualized's music marries tectonic guitars, testifying gospel choirs and lurid opiate-daze confessionals and yet manages to be resolutely life-affirming. Nobody else makes music with Pierce's obsessive single-mindedness. Alan McGee, the founder of Creation Records and the man who discovered Oasis, says Pierce is "as important to British culture as Neil Young is to American culture".

It is not the kind of comment that Jason Pierce responds well to. Three years on from his debilitating illness and looking well, if a tad bleary, behind his dark glasses, the tousled 42-year-old winces as he sips a lunchtime pint of Coke in his local London pub. "It's nice that he says that," he acknowledges in his dry whisper of a voice, "but it's not the reason that I make music. I have no interest at all in any of that celebrity crap."

Pierce is, indeed, a mass of contradictions. Songs In A&E is a mesmerising, colossal record, an album that is so raw that it is often profoundly difficult to listen to. It is hard to imagine music that could sound more personal and vulnerable and yet Pierce, as he has over the course of the last two decades, shies from discussing how much of his own soul and personality he puts into his art. He even makes a valiant attempt to argue that Songs In A&E is "not my hospital record".

"It was mostly written before my illness about characters I had invented, not about me," he says. "It was only when I came back to the songs when I had recovered that they suddenly seemed intensely personal to me. It had become so close to home that I found it difficult to listen to, and even harder to finish. "But the title describes a method of writing, and of living, more than it literally describes being in an A&E department. Isn't that how everybody lives their life, in a constant state of accident and emergency? I certainly do - my life is totally chaotic, not a series of planned events."

Nevertheless, it is difficult to listen to the album without being constantly reminded of the near-death experience that Pierce underwent while making it. The echoes are strongest on Death Take Your Fiddle, a beatific eulogy that finds him reflecting on mortality ("I think I'd like to take myself to Heaven/Because I haven't been there many times before") over rasping accordions that sound - surely intentionally - uncannily like the ventilators that saved his life.

"Yeah, that track is difficult for me to listen to," he concedes. "But the song isn't just about me. It's about the idea that death is always close, and you have to realise that to understand the fundamental essence of life and make it exciting and worth living." Lyrically, Spiritualized have always remained doggedly fixated on such big ideas. It's one of the many factors that has made them the best-kept secret of British rock music and turned Pierce into a cult icon sans pareil. For months before Songs In A&E appeared, Spiritualized's many unofficial internet message boards hummed as fans speculated feverishly on its likely contents.

The answer was more of the same, and brilliantly so. As with all the best of Spiritualized's work, Songs In A&E turns the musical language of the divine - rapt devotionals, shimmering hymnal choruses and gospel fervour - to its own subversively venal ends. Typical is Soul On Fire, a eulogy to narcotic oblivion that finds Pierce revelling in "a hurricane inside my veins" over an angelic backing. "That's actually my least favourite song on the album because it is a pop song," confesses Pierce, looking horrified at the very notion. "I normally never write pop songs. I'm more likely to write songs that may only have one chord, played so ferociously that it becomes the most important chord in the world."

Spiritualized emerged from the wreckage of Spacemen 3, the infamous psychedelic garage band that Pierce formed in 1982 with fellow Rugby, Warwickshire teenager Pete Kember (aka Sonic Boom). Influenced by the primal rock 'n' roll of Iggy Pop's Stooges and the attitudinal minimalism of the Velvet Underground, their live shows saw them bombarding shellshocked (fairly small) audiences with tectonic, mantra-like riffs and blinding strobe lighting.

Spacemen 3 were an extraordinary anomaly at a time when alternative music meant the studied post-Goth rock of The Cure and Echo & the Bunnymen, and the doomed pro-Labour Party Red Wedge movement helmed by Billy Bragg and Paul Weller. Supremely apolitical, Spacemen 3 were far more interested in chemicals: Kember in particular regularly regaled interviewers with tales of the pair's heroin use and their best album, 1987's Perfect Prescription, boasted the prescient dream-pop of Call The Doctor. Three years later, they released an album of early demos under the even less ambiguous title of Taking Drugs To Make Music To Take Drugs To.

Perhaps unsurprisingly, given their shared recreational habits, Pierce and Kember's relationship slowly deteriorated. By 1991 it was beyond repair and on their farewell album, Recurring, each of them made one side of the record before promoting it via separate interviews in which they slagged each other off. Pierce has not spoken to Kember since, not even when a promoter contacted him last year offering a hefty sum for a Spacemen 3 reunion.

"We fell out because of all the usual rubbish that goes on in bands," he shrugs now. "What on Earth would be the point of trying to reform? Music is all about pushing things forward, not revisiting the past." After Spacemen 3's demise, Pierce formed Spiritualized with his then-girlfriend Kate Radley on keyboards. The new group began honing a sound that was far more based on Delta blues, gospel, soul and lush orchestral symphonies than Spacemen 3's avant-garde primitivism. Two early albums, Lazer Guided Melodies and Pure Phase, saw them craft beguiling ethereal music that squinted at the world through a serene morphine haze. They could not have had less to do with the prevailing musical mores of the time - American grunge rock and post-acid house dance music - if they had played kazoos and trombones.

Yet it was 1997's Ladies And Gentlemen We Are Floating In Space that really marked Spiritualized's musical coming of age and established them as cult colossi. An audaciously ambitious and brilliantly realised masterpiece that reached No 4 in the UK charts, it made spectral, plangent use of the London Community Gospel Choir to enhance its songs of vertiginous emotional highs and subterranean lows. At the height of Britpop, UK music magazine New Musical Express voted it its album of the year, ahead of Oasis, Blur and Pulp.

It was not, however, a happy record. Radley had left Pierce for Richard Ashcroft, the singer of rival Britpop band The Verve, whom she was eventually to marry, and Ladies And Gentlemen We Are Floating In Space sounded lovelorn beyond repair. One track, Broken Heart, a gorgeous lament that was the musical equivalent of a tear, found Pierce drawling "I'm crying all the time/I have to keep it covered up with a smile/I'll keep moving on for a while/Lord, I have a broken heart."

Another track, Cop Shoot Cop, opened with Pierce snarling, "Hey man, there's a hole in my arm where all the money goes" over a squall of feedback, and the overall impression was of a man escaping heartbreak via voracious narcotic consumption. Tellingly, the CD even arrived wrapped in a box designed to look like a pharmaceutical prescription package. The great Jason Pierce conundrum, however, is that he makes music of yearning, peerless truthfulness and then resolutely refuses to discuss how, if at all, his personal life has informed it. The singer has always steadfastly denied that Ladies And Gentlemen… is a break-up record and remains convinced that such a literal interpretation of music is too limiting.

"You don't listen to 1930s blues music like a historian, to get an idea of what it was like to live in the 1930s," he argues. "You listen to it because it deals with human, universal issues, and because great lines like 'Be my baby' or 'I can't stop loving you' still resonate. It was the same with Ladies And Gentlemen. That is what the album title was meant to convey - look, we ARE all floating in space! How exciting and phenomenal is that!"

Spiritualized have always been prone to grand flamboyant gestures. In 1998, they staged a show on the 114th Floor of Toronto's CN Tower in order to play "the highest gig of all time"; the Guinness Book of Records testifies to their success. To accompany the release of 2001's somewhat bombastic Let It All Come Down, which featured over 100 musicians, two promo videos saw Pierce first marching across Mount Etna in an astronaut suit, and then suspended hundreds of feet in the air from a helicopter.

Both Let It All Come Down and its follow-up, 2003's Amazing Grace were reasonably successful commercially yet the latter in particular carried hints that Spiritualized's musical formula could be yielding diminishing returns and even nearing self-parody. The album sleeve featured an outstretched arm seemingly waiting to receive a syringe. It is pleasing, therefore, that Songs In A&E represents such a devastating return to form for this singular band. Nevertheless, its genesis was not easy. Returning to the record while he was convalescing from his near-fatal illness, Pierce found himself suffering the musical equivalent of writers' block.

"I was having real problems with it," he admits. "I started trying tricks that had worked on previous records, like adding multiple instruments to songs to make a big Phil Spector sound, but it sounded artificial. It wasn't working and I wasn't sure where to go next." Salvation came from an unlikely source. In April 2006, Pierce was asked to play a multi-artist acoustic concert at London's Barbican in tribute to US singer-songwriter Daniel Johnston, a gifted but severely troubled musician whose bipolarity is so severe that he verges on autism and has frequently been institutionalised. An admirer of the extreme honesty of Johnston's work, Pierce agreed to appear, but had severe misgivings.

"Everything I had ever done musically had been about power and electricity," he says. "I'm not the sort of person who sits with an acoustic guitar in his lap and sings songs to people, so I had a huge fear about how I was going to approach the evening. "Juliette [Larthe] suggested using a string quartet and some singers from the London Community Gospel Choir, but I said that would be making too big a deal of my songs. Then someone said, 'You don't get gospel singers in for you; you get them in for the audience.' So we did it and playing with them could not have been a more powerful, amazing experience."

Backstage at the Johnston show, Pierce also met Harmony Korine, the enfant terrible arthouse film-maker behind such movies as Kids and Julien Donkey-Boy. Korine was working on his latest movie, Mr Lonely, the surrealist story of a commune of celebrity impersonators living on a Scottish island. "Harmony asked if I would like to write some music for the film," says Pierce. "I already knew his work really well and liked it, and he is a beautiful and crazy man so of course I agreed."

"He put me into a studio and I found it incredibly liberating to be making music where I didn't have to sing words and I wasn't central to the songs. As well as the movie soundtrack, I put little Harmony interludes on Songs In A&E. They infected the songs next to them and gave the album a real sense of space and drama." The Daniel Johnston concert also gave birth to a Spiritualized sideline. Pierce now frequently plays shows with a four-piece gospel choir and a small string section as Spiritualized Acoustic Mainlines.

"The Acoustic Mainlines shows can be massively emotional," he reflects. "It is impossible to stand in front of a gospel choir in full voice and not be moved by it, regardless of whether you believe in what they are singing. Sometimes, I look into the audience and see people with tears rolling down their cheeks. "We took the acoustic show to the Apollo Theatre in Harlem and I couldn't afford to fly the choir out so we hired gospel singers in Queens. They weren't happy with some of the lines I asked them to sing, such as 'The devil makes work for these idle hands of mine' and 'Lord, let me be a liar, because when men tell the truth, they are all alone.' But it was just a wonderful experience."

Three years ago, Jason Pierce looked unlikely to live to see the release of the album that was to become Songs In A&E. Now it is out, he baulks at my suggestion that he must regard his dose of double pneumonia and month on a life-support machine as a warning that he should apply the brakes to his lifestyle. "I can honestly say," he grins from behind his shades, "that it has made no difference whatsoever."

Old habits clearly die hard. Typically, of far greater concern to Pierce is the fear that the scope and magnificence of Songs In A&E, the fragile beauty of what is already one of the albums of the year, may be ignored if listeners choose instead to focus on the lurid, if somewhat ghoulish, story behind its creation. "I hate the idea that people are just going to say, 'Oh, he had a near-death experience and then he wrote an album about it,' because that's not the case at all," he complains. "If anyone knows anything about me, it's that I have never worked in that autobiographical way.

"My one comfort is that I know, in time, these little anecdotes about me will fade and become completely irrelevant. They will just be side-notes that people either won't know or won't be interested in. All that will be left is the only thing that matters out of any of this - the music."

Ian Gittins writes about music for The Guardian.