Correspondence

Upside Down in the Journal

N Engl J Med 1997; 337:503August 14, 1997

Article

To the Editor:

Recent letters (April 17 issue)1 regarding a magnetic resonance image (MRI) published in the October 31 issue inspired this letter. As a long-time reader of the Journal, I have, over the past two decades, observed what now seems to be a trend, one for which I can find no easy explanation. In October, at an interval ranging between 10 and 12 years, figures are printed upside down (October 17, 1974, October 30, 1986, and October 31, 1996).2-4 To the best of my knowledge, this phenomenon is restricted to diagnostic imaging studies. Any insights that the editor might provide would be most welcome.

Charles M. Strother, M.D.
University of Wisconsin Medical School, Madison, WI 53792-3252

4 References

1. 1

   The scary MRIN Engl J Med 1997;336:1191-1191
   Full Text

2. 2

   Case Records of the Massachusetts General Hospital (Case 41-1974). N Engl J Med 1974;291:838 (Figure 1)-838 (Figure 1)
   Web of Science

3. 3

   Case Records of the Massachusetts General Hospital (Case 43-1986). N Engl J Med 1986;315:1153 (Figure 5)-1153 (Figure 5)
   Web of Science

4. 4

   Matsumura JS, Pearce WH. Traumatic carotid-artery dissection. N Engl J Med 1996;335:1368-1368
   Full Text | Web of Science | Medline

Author/Editor Response

The Editor replies:

Dr. Strother has remarkable persistence and an eagle eye. I can't explain the reversals in 1974 and 1986; they were published by two previous editors. But I intentionally turned the MRI of traumatic carotid-artery dissection (published on Halloween 1996) upside down to achieve a dramatic and seasonal effect.

Jerome P. Kassirer, M.D.