Rumah Sakit was founded in 1998 by John Baez, Mitch Cheney, Jeff Shannon, and Kenseth Thibideau. Their eponymous debut album was released in 2000, which AllMusic described as "a heady mix of mathy time signatures and dense musical passages that craftily, oftentimes dreamily, intersect." In 2002, the group released Obscured by Clowns, continuing their trend of comically referencing Pink Floyd titles. Often likened to Don Caballero, Dinosaur Jr., Rodan, and Tortoise, Pitchfork described Rumah Sakit's consistently unique ability to "keep a keen eye out for two things: emotional intensity and an awareness of unity and consonance." This, and the group's legendarily intense live shows, as what divided Rumah Sakit from the herd.