The game in itself is bad. It is either a sign of mental sickness, or a very good prank. That is beyond discussion.
But used properly, one can turn FATAL into the roleplaying experience of a lifetime. And that is what I did.
I was storytelling a game of Mage the Awakening, and my players just refused to be horrified by anything. The Abyss, the Shadow, the urban intrigue was just not working. So I took them into the depths of Mister Hall's sick mind.
Their characters where taken into a place of non-reality, a place where the undescribability that is Byron Hall's masterpiece was reality. I read bits and pieces from the book to set the mood. It was a spirit realm populated by spirits of rape and depravity whose bans where made of mathematical insanity, and where logic is just an empty word.
In general, it worked. My players where horrified. Two decided their characters too sullied to ever be played again. Character sheets were burned. Dice were thrown into rivers. Young men questioned their ability to ever have sex again.
As you can see, even if he completely lacks any ability to create a coherent roleplaying system, as a horror writer Byron Hall is an undisputed genius. As a horror character he gets even better.