So I decided to draw this after getting my first tattoo, I picked a large design so me and the artist had quite a while to chat. I noticed she had a skull in her tattoo parlour and asked her about it (she also had a stuffed fox, and a mummified baby alligator dressed up in a skiing get up) she pointed out a green stain on the skull, and told me when she ran it by a historian that the stain was likely caused by a silver shroud pin as it rested against her head which put it at quite a few hundred years old.
So I wanted to draw a lady in a shroud, along the way I added poisonous plants to every corner to add to the spookiness . I also observed brain surgery in person and noted that the skull was screwed back into place with a small plate which looked almost floral, which is what the circular emblem behind her head is meant to represent.
Please excuse the reflections, I didn't want to risk wrestling with the frame to get it out.