The concept behind Utter Scorn's debut album Paroxysmal Endemia lays the foundation for all forthcoming music for the band.  It is a conceptual death metal album with a sci-fi horror narrative:

In a distant parallel universe, there exists a planet known as INIMICUS.  This planet is suspended in tidal lock with a sun that is 1.4 x 10^3 times greater than that of the milky way.  Given its unique orientation and position in its solar system, it is host to the most extreme climates in which a carbon based life form can survive.  On the western hemisphere, an infernal hellscape of deserts and volcanic caverns, and on the eastern hemisphere, a bleak expanse of frigid tundras and ominous glaciers.  Both hemispheres are occupied by races of hybrid exoskeleteon/endoskeleton creatures, and these alien races have been at war with each other for eons.

In the west, a terrorist cult named Odium aka The Cult of Scorn, and in the east, a fascist regime named Discriminanda aka The Cult of Discrimination.

The Odium are endowed with supranatural abilities.  They perform incantations to summon predatory beasts that carry out their incursions.  They are a cult of religious extremists who worship an omniscient and vengeful goddess, and being the original inhabitants of INIMICUS, they believe that they are the supreme race.

The Discriminanda have the advantage of superior firepower, they use advanced modern weaponry to oppress and eradicate the enemy.  Since they have evolved to develop such advanced technology and also the ability to adapt to extreme cold, they believe that they have the right to total supremacy.

There is a third alien race on this planet that lives in the subterranean meridian colony, or the STMC.  This society is comprised of endoskeleton creatures who live in a series of underground tunnels and bunkers.  They cannot survive the harsh climates of the planet's surface, or at least not very far away from the meridian, so they must stay underground for most of their lives.  They live in fear of both the Odium and Discriminanda, and are often exploited for slave labor and used as currency between the two tyrannical organizations.

Then we have our main character...

There is a phantom endoskeleton creature who is referred to as "the sewer dweller".  He is a condemned scientist who was banished by the rest of the STMC for kidnapping and performing torturous experiments on other endoskeletons.  There is a deadly parasite that is endemic to the STMC, and the sewer dweller is the only scientist capable of detecting and possibly curing it.  However, the only way to research a cure is by performing vivisections that kill his subjects.  He believes he is trying to save the colony from extinction, but the rest of the endoskeletons view him as a serial killer who preys on the innocent.  And so, he is exiled to the sewer system to lurk in the deepest, darkest corners of the colony.

But that doesn't stop him from finding ways to conduct his research.