Here's the first version of the book cover that Free Press came up with. The foreign words, which all mean crazy in different languages, are supposed to form the image of a globe. The problem is that the readers -- unless they are exceptionally multilingual -- are not going to get the joke. Still, it was exciting for me to see a visual manifestation of the ideas in the book.



In the next version the designer at Free Press had the idea to replace country names with disease names. This left the question of what do do with the space over America. I suggested putting a phrenology head over the U.S. I was hoping that it would suggest both that the ideas came from us and that they had an element of pseudoscience.



This version made me more nervous than anything else. The fine people at Free Press seemed excited but I was worried that there was something else out there that we hadn't thought of. Authors are notorious complainers so I endeavored to continue the dialogue about the cover design with Free Press without sounding like I was just hard to please. I'd watched my friend Po Bronson engage in epic cover-discussions with his publishers. His tactic was to get involved, not just with criticism but with ideas and solutions. So I enlisted the help of JD Beltran, a friend and a talented artist and designer, to help me keep the conversation going.

In a matter of a day or so she came up with some startling ideas. Including:



and



and


I posted all the versions in the kitchen at the San Francisco Writers Grotto where I work and asked the 33 writers there to rate the cover concepts from- 10. Interestingly, JD's images tended to get 1s or 2s or 9s or 10s. Which is to say that people either really liked them or found them profoundly disturbing. In the end, I decided that I couldn't risk turning off a large chunk of my potential audience.

The map cover concept rated solid 7s and 8s. No one was thrilled but people thought it suggested a smart and interesting book. In the end the process gave me confidence in the designers at Free Press. All that was left to do was to figure out was something else to do with the space over America and also to suggest causation.  The solutions we came up with are unsubtle (nothing suggests causation better than arrows!) but get they point across.

Writers I've met over the years have some pretty harrowing stories about book cover negotiations -- tales where they get steamrolled by by the sensationalist or lowbrow proclivities of the publishing house. I'm sure editors and publishers share their own stories about writers who complain bitterly and endlessly about their covers. Less often told are the stories where everyone acts in good faith to keep the conversation alive until a reasonably good solution presents itself.

Here's the final version: