The art of embellishing popular reproduction usually entails irreverence, whether it be Duchamp"s famous additions to a postcard of the Mona Lisa or the kinds of tweaking seen on subway advertisements. The Mexican artist known as Dr. Lakra embellishes 1950s pinup-magazine reproductions to introduce a content not only irreverent but uncomfortable (and certainly contrary to the intentions of his soft-porn source material)--mortality. The series of works that comprise this velvet-bound volume began with a collection of vintage magazines about nudist camps that Lakra bought at the Sunday market on Brick Lane in London. He set to work despoiling the hygienically upbeat sensuality of these nude models with a morbid parade of skeletons and ghouls, who paw and loom at their prey with crude, lascivious glee, dragging both sex and death down to the level of earthy fact. Lakra"s ghouls are not mere doodles; in their visual character, these creatures draw on the Day of the Dead repertoire of demonic forces, Surrealist dream fantasy, Goya, Bosch, Medieval illumination and other such traditions, updated with the contemporary edge of tattoo art. Health & Efficiency is an illuminated book of mortality for the age of the centerfold. Dr. Lakra began as a tattoo artist in Mexico City but soon brought his skills to bear on pulp imagery, etching his designs on the skins of characters found in vintage magazines. "Lakra" is a Spanish colloquialism meaning "scum" or "joker" and also refers to a blemish or scar, and by extension to a socially disgraceful group or individual.