Hand held, manual focus, Program mode, bounced Speedlite.

Other info:

Exposure: f/4 1/60s, ISO 3600
Exposure Mode: Auto
Focal Length: 60.0 mm
Lens: EF-S60mm f/2.8 Macro USM
Flash: Fired, compulsory mode
Metering Mode: SpoEvaluativet
Subject Distance: 0.2m
Custom Rendered: Normal process
White Balance: Auto
Scene Capture Type: Standard
Model: Canon EOS50D
Camera Raw
White Balance: Custom
Temperature: 5325° K
Tint: +30
Fill Light: 32
Blacks: 11
Brightness: +59
Contrast: +31