The illustrations of this comic are sketchy, much like the Batman Year One comic. The faces of characters are usually detailed, except when the villains are standing in the shadows a lot. The artwork reflects the gloomy tone of the story. Light colors are usually used like grays and blues. The frames also overlap each other a lot, which was interesting because it played with the timeline of the story.
This story is told from a letter that Dr. Kinney has written to X-23, so there is a lot of inner dialogue. I don't think that would translate well in another form of entertainment, such as a movie or novel. Even though Dr. Kinney is telling the story from her letter we see the viewpoint of different characters. That would probably be confusing if it wasn't in a graphic novel where we can see the viewpoint switch by way of the photos while Dr. Kinney's inner voice can still be heard by the words.
I think the point that this comic is trying to make is that part of having ethics is going against your nature sometimes. A lot of the characters are very jaded and they have to fight against that aspect of themselves when making moral decisions. For instance, X-23 is raised as a weapon and crosses ethical boundaries a lot by killing people. However, she begins to develop her own morals and struggles with what she has done and whether someone like her can still be a good person. The fact that she could easily be a cruel person because of her past but a part of her fights against that shows a strong inner character that most superheroes have.
An important passage is after X-23 is sent on a secret mission to kill a certain family. She reveals the family to Dr. Kinney who becomes outraged and tells X-23 that she's going to get her out of there. X-23 responds by asking if it's a mission. This stood out to me because it portrays how X-23's life is nothing but "missions" and killing. In order to understand what Dr. Kinney is saying to her she has to relate it to a mission. I think that is significant to understand the overall story of how X-23 has to struggle to understand her humanity with her upbringing.