2020 Covers & Artwork

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June 2020, Volume 130, Issue 6

I usually do not author the cover narrative in the first person. I try to create space for the message to come from the collective consciousness of our colleagues worldwide with the assumption that we all subscribe to similar persuasions. I spent some length of time concerning myself with how best to portray the idea of frailty for this issue. We equate frailty with the elderly but, truthfully, the concept is more aligned with any one individual's index of resilience. Understand that I constructed this image during a time in which a worldwide pandemic shifted into a full-on assault on humanity. Frailty began to take on a new meaning. Recent times have mandatorily compelled us to consider our vulnerability. Our physical and, more importantly, psychological constitution has been challenged. Of all things, I had to convey impermanence. Bleak as it may seem to think we are no longer the apex predator, there is yet one force of nature that can temper a molecular machine that rages through our populace, and that is time; time to reflect, time to be introspective of the things that really matter, and time to heal the frail.
Naveen Nathan, MD
Cover Editor and Illustrator

May 2020, Volume 130, Issue 5

In creating the cover image for an artificial intelligence themed issue of Anesthesia & Analgesia, the idea of transforming organic and cellular thought into a geometric, starkly mathematical stream of intelligence was pursued. Much of this can be seen as the topographical anatomy of the neuron shifts into wireframe models of Schwann cells, which themselves transmute into digital data streams. Articles in this issue entertain how the age of data will bring forth machine learning and robotic technology into the practice of anesthesiology. Acknowledgment is offered to Colin Behrens, whose original image of a neuron was used as the substrate for this final image (found at pixabay.com).
Naveen Nathan, MD
Cover Editor and Illustrator

April 2020, Volume 130, Issue 4

This month's cover artwork reflects the reality espoused by the attendant articles contained in this issue. As anesthesiologists, we strive to create a harmonious arc of care for our patients that finds us ever more frequently in the preoperative realm of their management. Unfortunately, the feather-weight mass of our aspirational goals for patient care are often no match for the density of production pressures, billable actions, and timeliness of surgical intervention. Achieving balance between these two worlds seems almost impossible. The referenced articles thoughtfully underscore the need for focus on preoperative optimization; that our current, mere 'assessment' should evolve to comprehensively and deliberately improve the physical status of patients in preparation for surgery.
Naveen Nathan, MD
Cover Editor and Illustrator

March 2020, Volume 130, Issue 3

The cover artwork this month juxtaposes the anguish of pain with the visual analog scale that is too often misinterpreted in our assessment of patients. Attaching a number to an emotional state is by all estimates contrived and far too often is why this scale is not utilized the way it was intended. Herein lies the theme of this issue, a sharp focus on 'prehabilitating' patients through psychological education in their understanding and expectations of pain and, ultimately, to empower them.
Naveen Nathan, MD
Cover Editor and Illustrator

February 2020, Volume 130, Issue 2

The image on this month's cover uses a translucency effect for icons related to perioperative care as they hover about a tablet-based app. This reflects just how early the stages are for the development of meaningful remote technologies in anesthetic practice. The ideas of teleconferencing for preoperative consultation, intraoperative remote monitoring, and postoperative surveillance are just the beginning motivations for a rapidly evolving technology. Articles in this issue provide a comprehensive description of available use functions of remote technologies in anesthetic practice and their potential to transform our practice.
Naveen Nathan, MD
Cover Editor and Illustrator

January 2020, Volume 130, Issue 1

Although we focus our attention intensely on the heart's pump function, we often succumb to the mystique of its ability to generate electrical activity. Perhaps this is because the electroconductive cells of the heart do not so easily fit the mold of direct or alternating current power sources. Biologic systems which evolved in a water-based environment decidedly have to be more complex than the simple electron flow through copper wiring. This, of course, makes them just as complicated when it comes to all the environmental (physiological) forces that create aberrations of rhythm. As our patient population ages, so too will the integrity of their internal circuit boards.
Naveen Nathan, MD
Cover Editor and Illustrator