I expect that Image Grain will not be seen as 'an integral part of the message' of this photograph.
The objective is to use a pine cone to suggest a disembodied human heart, cradled within a surgeon's palm (hence the title: 'The tree surgeon.')
Why? No particular reason; I just picked up a pine cone & thought it looked a bit like a heart.
The role of the 'grain' is to shift the two elements (the hand and the pine cone) a little closer together graphically, to imply that they are made of the same stuff ... thus rendering more credible the human characterisation of the pine cone, and making the hand look like it belongs to a tree surgeon rather than a heart surgeon.
Likely far too obscure (even for me). Bear might get it.
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Very interesting subject and title. Had I been looking at this in the challenge I may have gave you a 6 or 7 based on the graininess and meeting the challenge. However, looking at it after reading your comments I would say you did a fantastic job creating exactly what you discribe.
I do think your lighting might be a little off. The fingernails just seem to overly exposed and that becomes a distraction.
Keep up the good work and i'll be looking forward to seeing more.