A clinical image would seem an obvious choice for the BMJ ’s front cover. But each time we decide to use one we have to think an extra thought—will it upset the postal workers or readers’ children? Anything remotely gory tends to cause complaints. In the past we have covered potentially alarming or offensive images with an opaque wrapper. But we felt this was unnecessary for this week’s cover. I’m sure you (and the Royal Mail) will tell us if we were wrong. Either way we hope you’ll appreciate the image and read the two linked articles. They highlight the dangers of what A Fogo and colleagues call “rapidly …