There is a book with a stethoscope and a bookmark on it

Rich details, exquisite, Chinese style, thread bound book

lowres, bad anatomy, bad hands, text, error, missing fingers, extra digit, fewer digits, cropped, worst quality, low quality, normal quality, jpeg artifacts, signature, watermark, username, blurry, (((mutated hands and fingers))), ((poorly drawn hands)), ((poorly drawn face)), (((mutation))), (((deformed face))), ((ugly)), ((bad anatomy)), (((bad proportions))), (((extra limbs))), extra face, ((double head)), ((extra head)), (big breast), (((extra feet))), monster, (text), (logo), [blurry], (penis), light particles, dirty lens, dust,