I wanted to do something similar to this one but couldn't think of anything which would create a kick as you have done here. You've made a simple shot create an impact. Good one, I wish I could read a little more of the note though, I can't really make out if it is a suicide note, or is it the reason for committing suicide. A "Dear John" or something? I would also have prefered the whole note to be in focus, the foreground part is just a tad blurry as are the pills on the far right. It's a great crop and well thought up image, good one.