This and Dreamer's Curse probably contend for some of the most brutal cards from any encounter set. Especially in TDE where there's -4 in the bag on Standard and you really don't want to draw it or the autofail on this one.
Do you chance taking 3 horror or damage, or do you dump out cards in your hand that might actually have proved useful next turn? Horrid, horrid quandary. Hate making the choice every time I draw these.