Cartilage Operating Altar Review

Cartilage 

Operating Altar 

Everlasting Spew 

2026

San Francisco has a pretty lengthy and storied history in hard and heavy music. Bay Area thrash, a vibrant and long-standing DIY punk scene and some of the craziest death metal/grindcore bands. The latter is exactly where the local sickos in Cartilage are coming from on their brain bending newest album, the 9 song maelstrom that is Operating Altar. 

Cartilage is what one would call gore metal (much like Exhumed, Impaled etc.) but there is so much more going on here. For starters, this is a concept album where they are “sharing the tales of a mad surgeon hell-bent on continuing decades of misdeeds at his venue of choice: St. Petersen’s University Hospital.” A grisly concept notwithstanding, the production, mixing and mastering (recorded and mixed by Scott Evans [Neurosis, Exhumed, Autopsy] and mastered by Leon del Muerte, is also worth mentioning. The guitars are chunky high gain with incredibly proficient sinewy riffs from guitarist Theresa Flory, who also contributes vocals (be they growled or shrieked) behind the angered bellow of lead vocalist Mark Wallace. The bass pedals relentlessly behind skilled and multi-faceted, multi-tempoed drumming. Nothing is over loud OR under heard and everyone gets a chance to individually shine. It's modern production, but it absolutely captures the raw elements of their sound. 

Starting us off is “Metal, Bone and Sinew”. The weaving in and out of multiple snaking chugging guitars and the screams to low gutturals vocal approach is on full display and contains a HARD breakdown section where the guitars stutter and stop behind a mid-paced percussive flurry before blast beating us to death. “S C.D. (Sudden Cardiac Death”) follows with an intro that recalls prime “Grin” era Coroner before the speedy double bass plods and trem picking and pinch harmonics over the dual vocals leave you gasping for breath. Cartilage have always been extremely talented players, but these first two songs suggest they wanted to expand their own chaotic game. 

 “The Autopsy: A Surgical Sonata” follows the same grinding template but also brings in some prime Morbid Angel half time, double kick riddled intensity. “The Sanguine Fiend “churns and chugs forward with that carefully curated dual vocal approach (the grind parts scream, the deathlier elements go guttural) but remain understandable for the duration. My guess is that this was done by design, since each song is a continuation of the story of the good (or mad surgeon, whichever) doctor. The next few songs (“A Lymphatic Labyrinth of Rolling Rot” and “Among the Offal”) follow suit but then something unexpected happens. “Anatomical Incantations” is propelled by a downright dirty and chugging 4/4 verse riff that is the standout for me. They do go full on blasty chaos with a truckload of time changes in this one too, but the ever so slight deviation from their established formula for this record really perked my ears. The title track rolls on after it with a return to the schizophrenic vocals and swirling, fast moving notey guitars and grind blasts. I feel it's important to point out that Cartilage's grind side while noisy and genre accurate, is way more controlled than most. They don't do it for entire songs but pepper them throughout as if to enhance the other parts and give them more impact. In doing so those blistering feral blasts also carry more weight and hit twice as hard when they show up. THAT is dynamic songwriting folks. Closing things out, “Stitch By Stitch” is the best track on the album to my ears. All the facets above return, but they return this time with a bruising and absolutely melodically shredded lead section, harmonized runs, and a creepy funeralesque keyboard intro. It's as if they said, “Ok, but check this last one out!” The mid-tempo breakdown section at 1:42 is the riff winner of the album. 

So, Cartilage while in years past have had their tongues firmly in cheek and have written fun but crushing death/grind and gore metal, have taken a stab (sorry, had to) at being a bit more serious this go round. Bands that are releasing their third full length rarely sound newly inspired, much less attempting a conceptual album. But then along comes Cartilage, who have upped every ante they have and delivered an exhilarating and macabre thrill ride that will catapult them into the who's who sector of the grime filled subgenres they populate. Operating Altar just might be the “Necroticism” for the latter 2020's. Consider me chuffed….

RIYL- Carcass, Exhumed, Impaled, Coroner, Morbid Angel, Repulsion, Terrorizer, Impetigo

~TB