"There's a saying in hospitals the world over," Jason Pierce tells me. "Doctors and nurses say you can tell when people are getting better because they start moaning again." He begins to chuckle.

"I love that. I love the idea that as people get better they don't value themselves in the same way." And Pierce, Spiritualized's auteur and former member of the canonical Spaceman 3, would know; a bout with double pneumonia in 2005 nearly killed him. During weeks in intensive care his weight dropped to 98 pounds. 

Pierce has since recovered, but hasn't started moaning. "It's difficult when you get inside of me," he says. "It's really hard to tell to whether I've changed."

That Pierce faced death is hardly surprising. The singer, now 42, has long been candid about his heavy drug use, singing "sometimes I have my breakfast right off of a mirror" or "there's a hole in my arm where all the money goes." But it would be downright criminal to overlook Pierce for simply "taking drugs to make music to take drugs to" (the title of a Spaceman 3 collection). Pierce is one of the seminal artists of our time, one who has captured a purity of sound, feeling, beauty, and honesty like few others. 

On the recently released Songs in A&E, Spiritualized's first since 2003, Pierce continues his trajectory through the bloodstream. A&E—short for Accident and Emergency, the British ER—fits neatly into the fully realized Spiritualized aesthetic of soul, gospel, garage, beauty, fire, heaven, longing, and yes, death. Pierce maintains a unique ability to combine simplicity and repetition into lush grandiosity through either arrangement or drone. And although each Spiritualized record shares these qualities, each maintains its own stylistic drift. On Let it Come Down, it was the addition of a full symphonic orchestra. Amazing Grace went the opposite way—back to the garage. A&E finds Pierce in a somewhat pensive, yet peaceful state. Full of strings, bells, horns, and harmony, the record is, as always, meticulously crafted. Despite this, Pierce says playing live is where he finds real solace. 

"I don't make records and then go out," he says. "I make them because the records allow me to tour. It's what I love doing. We'd travel anywhere. I've got this thing—wherever someone's hip to it, I'll get on a bus or airplane."

Collaborating whenever possible, Pierce often moves outside the Spiritualized universe. He's been known to play with free jazz artists on one hand and build drones on the other, searching for the most sublime high. "I think it's some kind of thing I'm obsessed with," Piece says of playing. "It's not just me, it's about finding this truth—this real beauty that hangs in music." Finding it isn't always easy.

"You could get 10 people to play exactly the same 10 notes," he says. "Nine of them might mean nothing but the rest might lift you mentally. It's not about the notes you play, it's not about the songs. It's where things hang between those notes. And I think that's worth the chance at any cost."

Pierce continues: "What you do when you're playing is you go after these intense moments—and they are a rarity. When you get them you try and hold on to them. You try and hold on to them forever."