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Richard,
I did leave the background more painterly, because I wanted it to be a little shadowy and mysterious. I thought the figure was just about up to my usual level of detail--but maybe I am not aware of what you are seeing.
The reference for her head came from a video. I froze the frame and worked from a print. The trouble was that it cut off the entire top of her head from her eyebrows up. She had the wrong hairstyle, so I borrowed a hairstyle and head top from another photo. The only trouble was, that photo did not show her in the same light so I had to invent the shine and color of the hair.
After I found the head reference (which had a nice light/shadow pattern, by the way, but was missing a lot of color and value information), I created a body by using two different models. I photographed them with an off-camera flash set up to create the same exact light/shadow pattern on the faces, so the face and body would be in the same light. One of the models was wearing Ms. Worden's jacket and earrings and holding the lithotrite. However she had to wear latex gloves to hold the lithotrite. The other model I chose because her height, figure, and hands were pretty close to Ms. Worden's. I made sure my angle (height) in relation to her head was the same as that in the "head shot" reference. To do this I had the model stand on two books to make her the same height, 5' 9". This model held an "instrument" jerry-rigged out of two screwdrivers. Both models wore black jackets and cream scoop-neck blouses, and black skirt or pants. (I chose to paint the skirt.)
The stance of the models, the tilt of the head, and the way they held the lithotrite, were taken from the videos of Ms. Worden on David Letterman. I watched the tapes of her very carefully and tried to have the models imitate her gestures and the way she moved.
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