The attack had left him with hypoxic brain damage, leading to dystonia, an extremely rare condition that causes chronic pain and a drastic loss of motor skills. Mary Wren, a member of Cardiacs’ label Alphabet Business Concern said: “We are comforted by the fact that he left us quietly, albeit suddenly”. It is not unreasonable to assume that his death was related to this condition.

In an interview with The Quietus a decade after his heart attack, Smith likened living with the condition to “wearing a skintight bodysuit made of fishnet all around you with electrical pulses going all the time”. “This is what my body feels like unless I fall asleep”, he told Sean Kitching, “this I have called my digital pain, and bashing my head or something what hurts loads or any sort of normal pain, like toothache, I call analogue. Also, I can’t write or hold a pen or use a computer”.

Originally forming as ‘Cardiac Arrest’ in 1977 with his brother Jim, Smith helped curate the band’s unreplicable sound by fusing together rock’s most famous ideological nemeses prog and punk, with results that were aggressively technical as often as they were playfully childlike (in a feature for The Guardian, lifelong admirer Peter Cashmore once called them “lovely one moment and unlistenable the next”). 

Shifts in their early lineup pushed Smith from guitarist to being the face of the group (now renamed ‘Cardiacs’) taking control of lead vocal duties in 1981. Over the course of the decade, the closest the group came to commercial success was their 1988 (sort of) hit “Is This the Life?”, but their adventurous (if at times uncompromising) sound earnt them a devout following that included Napalm Death, Radiohead, Faith No More and Blur. Damon Albarn once told Louder Than War: “Cardiacs were an early inspiration for all of us in Blur. I remember one of their gigs at ULU. It was amazing, one of the most magical live performances I’ve ever seen”.

Smith married saxophonist Sarah Cutts in 1983, who remained a member of the band until the two amicably separated in 1990. The two remained firm friends, even releasing new music together with fellow Cardiacs member William Drake as The Sea Nymphs. As strong as their 80s output is, it was their 1996 album Sing to God which has become regarded as their masterpiece, and has gained an underground status as a cult classic. Watch music journalist and video essayist Oliver Kemp dissect the album below: