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Joseph Clayton Mills
The Patient
CD and book (E167)

210×148 mm; 56pp


Belgium £17 (including postage)

Europe £20 (including postage)

Rest of world £23 (including postage)

Edition of 200 copies


The Patient [Vimeo]

“During his final illness (tuberculosis of the larynx) at the sanatorium in Kierling, Kafka was not supposed to speak, 

an injunction he obeyed most of the 

time. He communicated with Dora Dymant, Robert Klopstock, and others 

by scribbling notes on slips of paper.
Usually these notes were mere hints; 

his friends guessed the rest.”

—Max Brod


Inspired by and incorporating fragment-ary notes written by Franz Kafka on his deathbed to communicate with friends and family, The Patient draws from the texts of these conversation slips for specific imagery, textures, mood, gestures, and instrumentation. The score — essentially an index of suggestions 

to guide structured improvisation — 

was initially performed at Chicago’s 

Experimental Sound Studio in the 

fall of 2012 by Olivia Block (piano/

walkie-talkies/objects), Noé Cuéllar (accordion/ psalter/cassette player/ objects), Steven Hess (percussion/

cassette player), Joseph Clayton Mills (electronics/ cassette player/objects), 

and Jason Stein (bass clarinet). Recordings of that performance were subsequently augmented, rearranged, and assembled by Mills into the finished album. Additional material provided by Megan Rodgers and Seonaid Valiant.

See also
Joseph Clayton Mills [EP3]
Out of print


Franz Kafka died of starvation on June 3rd, 1924, his throat cinched by laryngeal tuberculosis. The intravenous delivery
of food to sick patients wouldn’t be invented for another 35 years and the swelling in Kafka’s throat caused by the infection made swallowing even water difficult. Forbidden from speaking by his doctor at the sanatorium in Kierling, Austria, Kafka would often communicate with his friends and visitors by writing small notes on scraps of paper. Some such scraps were less notes and more fragments or disconnected ideas, phrases impossible to understand without context. It’s something Max Brod, Kafka’s
friend and literary executor, recalls in the opening pages of the booklet that accompanies Joseph Clayton Mills’s 

The Patient. “Usually these notes were mere hints; his friends guessed the

rest”, he writes. Mills, accompanied by Olivia Block, Noé Cuéllar (Coppice), Steven Hess (Pan•American, Haptic, Innode), and Jason Stein take a shot 

at interpreting those fragments on this
record, using Mills’s textual score to trace a line around Kafka’s final abraded thoughts.


“The goal of this document is to suggest a vocabulary of actions”, Mills writes. 

“It should in no way be seen as 

prescriptive or comprehensive, and the sequence of elements in this document should not be construed as implying 

a particular linear arrangement”.


The 52-page score for The Patient bears only a passing resemblance to traditional musical scores. It contains a couple
of references to particular notes in the Western 12-tone system, a few bar lines (one set displays both a treble and bass clef, but is otherwise blank), a few more very precise frequencies for sine wave generator, and even a reference to Wagner’s Tristan chord, but the majority of it is filled with suggested actions of the sort written by George Brecht, La Monte Young, and Pauline Oliveros. They read ‘play for longer than you think you should’ and ‘image of water/droplets/dew’ and ‘hushed breath/for unvoiced bellows/ vocalist/friction on drumhead’.


Together they are enough to constitute 

a composition, only the number of performers is unspecified and there are no instructions for how to string individual performances together. Participants
have only Kafka’s quotes and Mills’s accompanying directions to guide them, along with a handful of photographs, drawings, medical diagrams, story excerpts, and historical summaries.
None of it is prescriptive, but all of it 

sets a very particular tone, which is why, despite the score’s innate openness, 

this performance of The Patient sounds so compact, controlled, and potent.
The instruments and sounds used to build it — piano, walkie-talkies, an accordion, bass clarinet, and even 

pages torn from a psalter — reflect Kafka’s illness brilliantly. They are 

harsh at times, and dry; distorted 

and lethargic; then atmospheric and feathered with granular noise. When 

they appear, words and phrases rise almost to intelligibility, then stop abruptly. They are threaded with interference, whispered breathlessly, and cut off as 

if by pain. 


Still, every component is clearly expressed, even when it’s truncated or mangled. Most passages are uncluttered and there are long spells of silence or near silence scattered throughout each

of the piece’s seven mostly instrumental parts, but that only emphasises the anguish in the sounds. It’s as if the audible distress of Kafka’s tuberculosis, latent in the notes he wrote, has been brought back to life. The wheezes, spasms, and sudden shocks of panic aren’t just musical expressions, they’re echoes of his condition that have traveled quietly through time for nearly 90 years.


But does it have to be so? Could The Patient ever be just an index for future performers, and so escape the gravity of Kafka’s life? What Mills put on the CD 

is a combination of improvised sounds inspired by his own text and a conscious arrangement of those sounds assembled after the fact. In this case, it’s almost impossible not to think of Kafka and A Hunger Artist or Before the Law because the text and the music is so filled with Kafka’s voice, no matter how scattered and disembodied. Maybe we access Kafka’s private world by a secret musical

door he never suspected, but that this world is put together from fragments and disconnected ideas constantly nags the
mind. Whatever narrative can be spied in those scraps of paper, they’re a product of reflection, not the scraps themselves. The score sets a tone, but that tone could slip away like a breath if the performers wanted it to. This particular performance pays homage to the score’s inspiration, but another might focus on the peonies, birds, or durations mentioned by Kafka 

in his notes. Yet another might obscure Kafka almost entirely and present a series of bodiless inflictions instead. 

That Kafka could disappear behind his own text is fitting. “Order and accidents
seem equally impossible”, he wrote. 

The Patient renders that paradox beautifully and asks its participants, whether listener or performer, to decide whether order or accident prevails.

Lucas Schleicher at brainwashed

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