The idea for the bullet cover came from discussions of how we might visually represent the intersection of medicine and conflict. First thoughts centered around images of gear worn by medical staff in the field. For us, however, these objects repeatedly failed to express the severity of the experience that we wanted to explore in the issue. One object kept coming up in our discussion: spent rifle casings. On their own they carried an innate, powerful backstory, presented in large numbers they provided a visual metaphor for what is left behind. The idea to clear out the center of the field and form a medical cross then provided us with the visual interpretation of the medicine-conflict intersection.