The hand signs at the top of the painting are 'A' (on the left) and 'Z' (on the right) from the manual alphabet for deafblind people. 

When I did the painting, I had in mind at least two levels of concern.  One is about the social isolation which can be associated with dual sensory impairment.  The other is a more metaphysical question of whether there is any meaning or consciousness beyond our bodily existence.