The clown's hand held up with palm facing the viewer reminded me of a traffic cop holding up his hand to stop traffic. That, in turn, reminded me of an image that Burt Monroy used to illustrate bevel layer effects -- a stop sign with rivets and bullet holes. So I recreated one here, but somewhere along the line, blood started seeping out of the bullet holes -- I was reminded of an incident in California where the Highway Patrol had put up mockups of police cars along the freeways to try to slow down traffic and people had begun shooting at them. Then someone mistook a real patrol car for a mockup, shot at it and kiiled a patrolman. I selected and enlarged the hand and then applied a cutout filter and added a radial blurred copy behind it. The overall look is from the ink outlines filter.