they felt pressured by their fans to keep the same sound as their previous album, as they were worried about alienating their listeners, which stopped them from expanding their sound. The album's title was taken from a short story in an issue of Burn Collector by Al Burian of Milemarker; Kensrue said it "basically [asks] the question, 'Do we, as artists, have the responsibility to do something more than ... entertain?'" Riley Breckenridge said they were reading McTernan's copy of it during their spare time in the midst of The Illusion of Safety sessions. The Artist in the Ambulance opens with "Cold Cash and Colder Hearts", an aggressive track that showcases Teranishi's guitarwork and Kensrue's vocals. It is the result of blending two songs together; Teranishi said the "spooky" section, which refers to the part with strings and palm-muted guitars, was initially played on a guitar that was enhanced with an auto-volume delay pedal. They switched it to a heavier version that was reminiscent of the work of Isis, before settling on the final version. McTernan sauid Barnett's string section "really took it over the top" with the instruments doubling the sound of the palm mutes. Eddie Breckenridge originally wrote the track's 5/4 section as part of an aborted 10-minute track. Thrice unsuccessfully attempted to put the section in every track before leaving it in "Cold Cash and Colder Hearts". "Under a Killing Moon" switches between older forms of metal and hard rock. The band wanted another heavy track; Teranishi wrote the verses' guitar riff during a practice session. The song's ending guitar riff is slower in tempo because it had been played to a slow beat from Riley Breckenridge, and was later sped up and incorporated into the track. Both riffs were influenced by the sound of Killswitch Engage, to whose work Teranishi was listening on the days he wrote the parts. The lyrics initially worked well with melodic chord progressions but did not work when the band worked on the song during a practice session. Kensrue then decided to scream the words, which he felt worked better with the final song. "All That's Left" is the result of the band's desire to experiment with more-traditional song structures with The Artist in the Ambulance; its chorus section bordered on space-esque progressive rock before being reworked. Kensrue rewrote the song's lyrics around eight times and said the final version talks