I agree on the amputated hand. She wanted to do her own pose for this one. Originally, I did it portrait oriented, but the funky hand thing she was doing was worse than an amputated hand so it became horizontal. Having worked with her before, and knowing consistency is not her strong point (sure it's the age), I grabbed the shot when everything else lined up in her pose.
This was shot outdoors at a location i had been waiting a long time to use along with the right lighting. It all came together yesterday.
Thank you for all the great comments as well as feedback.