There's a deep

There's a deep, otherworldly moaning underneath the strings. We use a percussion technique to get that sound out of the timpani and bass drum by rubbing it with a super-ball or wet finger.

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 (My producer had a real "WTF" moment when he heard that sound coming from the orchestra, by the way.) Following that with the orchestral bells seemed the obvious choice for the Angel of Death—a character not for whom the bell tolls,

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 but the one who's holding the bell and tolling it for everyone else.