Thanks Donna. I really appreciate your comment. Occasionally I try to understand how I process this type of art. It works better when I just respond. I bought my first digital camera in the 90s. It was a pen. I've been playing for a long time.
Sort of John, I start with an image of a physical piece. In this one it was watercolour hands I created for a nurse. Then I layered a photo I took to create the dots - edited, transformed ... until I had something close to a pleasing effect. Then I reversed and layered the hands again. And then, I played to create curves/shadows until I got here.