Very nice lighting in this shot which definitely serves to accentuate the brittle looking details of the subject and separates it from the background with harsh contrast, silhouetting its features and giving it a wondrously grim and melancholy feel.
The eyes also slowly move up the arm, taking in the textures and eventually ending up at the twisted fingers, which I feel (and was probably intended to be) is the focus of the entire shot.
The only thing I would perhaps have changed personally is left a bit more room above the fingers as they're almost touching the boundaries of the shot. Giving more room around above this would stop the eyes trailing off the picture and hold the attention on the hand. It would also enhance the already present feeling that the withered fingers are reaching up, and completely unable to grasp out at anything, which the title puts perfectly - 'Feeling Helplessness'