One day last summer, while driving through Utah to play a gig with his band Cursive, frontman Tim Kasher was hit with a sudden strong chest pain. The indie-rock five-piece went on to play as scheduled that night, but the next day Kasher checked into a Salt Lake City hospital, where he learned that he had been singing with a collapsed lung. He was told that the condition required surgery, without which the risks included serious stress to the heart. Fortunately, he’d checked into a Mormon hospital with great doctors who believed in strong painkillers. By November, Kasher was back on stage playing sets with both of his bands, Cursive and the Good Life, at a CMJ showcase for Saddle Creek — the music label/collective, home also to Bright Eyes and the Faint, that’s scraped aside steak as Omaha’s juiciest mail-order product. As the seven-hour night wound down with one of the label’s compulsory group sing-alongs, he was jumping around on the risers, puffing an accordion across his chest.

So you might think that Cursive’s new album — The Ugly Organ (Saddle Creek), which they’ll support with a gig at the Somerville Theatre this Monday — resulted from Kasher’s health scare. After all, at 28, he’s an elegantly blunt lyricist with two concept albums already to his credit: Cursive’s Domestica, a wrenching chronicle of a failing marriage, with musical nods to early Fugazi; and Black Out, an album of interwoven songs about a year of heavy drinking that he recorded with the more pop-oriented Good Life. But though a collapsed lung might seem fertile territory for a songwriter who’s often obsessed with internal failure, The Ugly Organ is not that album. " When something like that occurs, " he explains, " you have to shut yourself off emotionally to get through it. So I’m still kind of waiting for the repercussions of actually having gone through that last summer. "

Instead, The Ugly Organ is a concept album centered on the recurring figure of a grotesque robed organist, who extracts tales of betrayal and surrender from a cohort of loosely related characters. " The way we write, we really like to have a cohesiveness with the songs. And so what started as being less conceptual ended up with the songs all having a relation to each other. I don’t really see it as an album: I see it as a book of short stories, in that they should all be bound to each other. There should be a reason why songs are on the same record. At the same time, I don’t think it’s necessary that I should have to write a concept album every time I do one. "

On The Ugly Organ, the organist seems to bring out the worst in people, directing small scenes of conflict that unfold not unlike (gasp) a staged rock opera. Kasher even went so far as to annotate the music in the liner notes with cues and wardrobe descriptions — summoning sleigh bells, angry women, harlequins and, at one point, the ugly organist’s appearance as a butcher who turns on his creator — the singer — and tells him to cut all this dramatic shit. The closing " Staying Alive " appears to offer resolution of sorts: it’s a 10-minute journey featuring ambient guitar, fading bombs of distortion, and a ghost choir that quietly repeats, " The worst is over. "

But though this particular battle may be over, the war, Kasher says, goes on. " I think we’re still pretty embedded in paranoia. I think that we really want to push the envelope on what that sounds like: paranoia and frustration. I don’t know why we are so absorbed with that right now. " It’s suggested that the entire country seems to be with him on this point. He laughs. " Yeah, that’s probably what it is. It seems to me like that’s what needs to be written, you know? "

Cursive play the Somerville Theatre, 55 Davis Square in Somerville, this Monday, March 24, at 8 p.m. with No Knife and Minus the Bear. Call (617) 931-2000.