Around this time last year, Margaret Chardiet almost died. Days before the noise artist was supposed to go on her first European tour, doctors discovered a cyst so large it almost brought on organ failure. The subsequent surgery and healing process was long and intense. During the weeks of bed rest, a dying man lay next to her in the hospital, crying out for his daughter to join his side. For whatever reason, she never showed up.

In the rearview, Chardiet’s situation sounds like hell, and so does her latest album as Pharmakon, Bestial Burden. In a recent interview with Pitchfork, she described the theme of her second LP for Brooklyn-based label Sacred Bones as “[a] desire to show the body as a lump of flesh and cells that mutate and fail you and betray you—this very banal, unimportant, grotesque aspect of ourselves.” It’s a grim focus on the corporeal, a lens that Chardiet has projected her nightmarish music through before; on last year’s Abandon, the roaring final track was gruesomely titled “Crawling on Bruised Knees”, the cover art a shot of Chardiet’s lower torso covered in maggots. On the cover of Bestial Burden, she literally turns the inside outwards, with grisly-looking butcher’s-shop organs placed accordingly on her upper torso and chicken talons glued to her fingers.

Musically, Bestial Burden is a considerable step forwards for Chardiet, a feat that’s more impressive when considering that the genre she works in doesn’t necessarily call for artistic growth. Before releasing Abandon, Chardiet established her presence with a run of small-press releases similar to many noise musicians past and present, so that record wasn’t so much her debut as it was an introduction to a somewhat wider audience. If the depth-charge blasts of Abandon showcased an exciting emerging voice in experimental music, Bestial Burden elevates Chardiet to an even more accomplished plane. The sense of control that she wields over this nasty, fire-breathing music—a push-and-push-harder tension between pummeling rhythms, swaths of power-electronics static, and her impressive, chilling howl—provides a sense of structure that makes this very out-there music easy to grasp for those outside of noise music circles.

Still, chaos reigns on Bestial Burden, an album that sounds like anything but a safe space to inhabit. Chardiet’s steadier focus on rhythm provides a sound structure nonetheless annihilated by jet-engine roars, bursts of mechanical heat, and ear-bleeding screeches. Paradoxically, the harshest and most alienating moments on Bestial Burden arrive when the record is at its quietest: album opener “Vacuum” practically serves as a portal into the record’s landscape, as Chardiet’s vocal hyperventilation is backed by a undulating fuzzy drone that rubs against the ears like a drill to the teeth. “Primitive Struggle” lays wet, heaving coughs over a heartbeat-like rhythm that eventually grows to an insistent thud, bleeding beautifully into the death-march stomp of “Autoimmune”. By turning the human body’s failures into rhythmic tools at her disposal, Chardiet has created the truest form of body horror.

Fittingly, her voice is the album's most expressive instrument, at times recalling black metal’s pitchless burn. While her vocal approach on Abandon came across as sprawling and freeform in its presentation, Chardiet takes the shape of a menacing furnace on Bestial Burden, giving off blasts of heat and steam that are deeply felt even as they recede into the darkness. In the aforementioned interview, Chardiet groused about the reception her difficult music receives: “When I put that out to someone and the only thing they can say is, ‘Oh look, it’s a girl screaming,’ I want to fucking kill them because I’m literally pouring my heart and soul out, being so vulnerable.” On Bestial Burden, her voice casts jagged, threatening shadows, but on a record that concerns itself with bodily disintegration, Chardiet’s forcefulness is a necessary human constant.

Her most surprising performance arrives on the album’s closing title track, seven minutes of pulsing tones that culminates in tangled noise and mutated vocal strangulation. Before “Bestial Burden”’s satisfyingly destructive conclusion, though, Chardiet expresses herself in a way that stands apart from the rest of the six-track record; her voice sways and swerves with disorienting clarity, sounding almost psychedelic with every half-spoken dispatch. Chardiet has played it straight previously when it comes to her vocals—her cover of “Bang Bang (My Baby Shot Me Down)”, featured on Sacred Bones’ 2013 compilation Todo Muere Vol 4, was surprisingly faithful to the original—but the wavy, near-meditative form of “Bestial Burden” is, at least for those who just arrived to the Pharmakon party a year ago, unexplored territory. As a whole, Bestial Burden highlights Chardiet’s ability to re-draw the boundaries of her own artistic approach, ripping out its guts and creating something new out of the decaying remains.