This man is a surgeon on the flagship of a fleet of ships that float in the air. They are an independant group of refugees and outcasts in an early-industrial-age alternate-earth that has been excessively polluted. Vast areas of land are uninhabitable, and the seas are unsailable. The fleet flies over what would be Siberia in our timeline. The picture was drawn in 2003 with photoshop. The character and strange earth is from a lengthy conversation with a friend.