Over the last several days, I've railed in my head against the matroshka structure of Drupal entities. But when I tried to break out some helper functions, and when I realized what each of the different properties each entity had, I realized the complexities of entities were warranted. Life is complex, and thus Drupal is complex.
Entity references load a Media Entity, which load an Image from an image field, which load a File. The alt and title are on the Image, while the file URI is on the file.