If the Tens of Pentacles and Cups are Yin, the Tens of Swords and Wands are Yang with a Vengeance. More positive-thinking folks than myself are able to see Opportunities in these cards, whereas we chronic depressives in the room can only see the Horrible Things that these cards indicate. In this case -- well, the image says it all: you've got the weight of the world on your shoulders, baby, and you've got to bear up under it somehow.
For the design, I was able to find two (Carrie Paris supplied me with one of them) NEARLY identical images of two NEARLY identical acts, although facing each other, so to speak, as if in competition with each other. One of them featured a skinny guy hefting two fairly normal-sized men, the other a bulkier, sturdier fellow with two much heavier men on the barrel. For the purposes of the card I liked the skinny guy better than the stronger guy, but I liked the heavier subjects better than the ones the skinny guy was lifting.
So I did what any boy with a toy like Photoshop would do, and combined the two. The only practical way to do this was to cut the barrel in half, and attach the body of the fat front "passenger" onto the leg of his lighter counterpart. Hand-coloring everything post-operation helped make it look seamless.