I bought two t-shirts at Joann's, took them in, and switched the sleeves. I then I made a stencil of Dr. Kevorkian in Microsoft Paint and using the "freezer paper method" stenciled it onto the shirt.

NOTE: The story behind this t-shirt is an inside joke that happened on a camping trip with my friends. I don't necessarily agree with Dr. Kevorkian's views on euthanasia.