FARK was recently running a contest to duplicate famous album covers using MS Paint. Even with a graphics tablet and stylus it's a bit like using an Etch-A-Sketch. (Paint is the drawing program included with Windows. If you've never played around with it, you can run it by clicking Start -> All Programs -> Accessories -> Paint.)
This is not to say that you can't create good (if somewhat lifeless) pictures with Paint. The artist who created this estimates it took about 500 hours of work, and I can fully believe it.
For that matter, you can use Etch-A-Sketch.
Via J-Walk Blog