It begins with a crash, possibly an acoustic referral to Ferrari's realization that he was suffering from cardiac arrhythmia. Immediately thereafter, the pings of the EKG machine and other patient monitoring equipment surface, a constant reference point throughout this suite from the late composer. Though divided on disc into seven tracks, the work flows seamlessly, conveying an institutional feel as befitting its derivation. It's difficult not to think of anonymous exam rooms, source-less hums, snatches of conversation from fellow patients or medical staff, interjections of children, antiseptic surfaces and, above all, the repetitive noise from electronic devices from elevator doors to cardiographs. They all swirl together, creating an atmosphere at once surreal and vaguely threatening while at the same time affording a sensual fascination with this unique sound-world.

Ferrari seems to use this occasion to occasionally lapse into memories, as during the fourth track when we're transported to a horse-riding lesson, apparently somewhere in the American West, as indicated by the accent of the instructor. It's a momentary, dreamlike episode though, as we're quickly thrust back into the reality of the city, the hospital and their attendant sounds. Still, he escapes once more, into what seems to be a Japanese marketplace, a welter of voices and noise, only to be rudely awakened by someone � a doctor? � asking, "Do you have any questions?"

In between, there's a fantastically rich array of sounds, woven the way only Ferrari could, with exquisite care for timbre and separation, allowing vast amounts of air to circulate around the elements, enabling each to be perceived at the same time as individual pieces and parts of the whole. Too, there's that sense of unbalance, of being in a new situation, a potentially life-threatening one. David Grubbs, in his liner notes, thinks Les Arhythmiques is more "stamped by dread" than any of his other work and while that may be the case, it's only one tinge. Whatever qualms or thoughts of his all-too-soon demise, he clearly retains an intense love of pure sound. His heart may be malfunctioning but his ears and brain remain as profoundly observant as ever.

It's a stunning listening experience, a fine, sad late piece from one of the great sonic minds of recent decades.