There are plenty of sad stories behind this location... Most often, it is a place where one of our beloved investigators is buried forever. An extremely hilarious place for the first blind playthrough.
This is a neat card thematically, but let's do the math.
For the purposes of this, let's assume actions, cards and resources are an equivalent value, since you can always spend one action for one of either. They aren't, but weighting the value of actions and cards is even more unkind to the skull.
Playing this out costs one action and one card, starting you at a -2 deficit for no return. You have to do this early on, because things need to die around you before you can actually use it, and you can't guarantee when that will happen.
Clicking once costs one action for one resource and one card, so you're still at a net -1 deficit.
Clicking twice costs another action, so you've now broken even. You've now spent three actions and a card to gain two resources and two cards. That's equivalent to not playing the skull at all and simply clicking for the cards/resources, except with much less flexibility, and you're wasting your accessory slot for the privilege.
It's not until the third activation, requiring three dead enemies/allies and four invested actions to actually start to come out on top economically, and only barely. At that point you've heavily invested in improving your basic Get Resource/Draw Card action, something you (ideally) aren't actually using in the back half of the scenario.
That said, the upgraded version is phenomenal, if you can stomach 3xp. Assuming you can play it out and wait for three things to die around you (or two with Akachi), you can jump from a -2 deficit at install to a net +3 payoff on the first click. It even compares favorably to the elite ciggs, which continues to only draw one card/turn. It is a shame that 3xp prices it out of Leo or the ever-hilarious Bow Wendy decks, but Tony and Akachi can make great use of it.
Ludicrously good card for any evasion based rogues: you don't always care about exahusting enemies when you attempt to disengage with them, especially if they are not hunters nor if there are no clues in the location or reason to stay. This card makes it trivial to evade most foes given that rarely there are ones with more than 5 agility, and it's very good to trigger effects on evasion too
This card is straight up broken with Kymani: it allows them against any 2 agility foes to test for a base of 7 against 0, which is more than enough to discard anyone that does not have health value per investigator, of course you still want someone paired up with them that can take care of elites and victory enemies in the old-fashioned way... (Although Kymani can as well by fighting dirty with a chainsaw, it is just exp pricey) And it only gets more ridiculous with its level 3 version allowing them to defeat enemies with one action
It's even good in multiplayer: you evade a foe and leave them active to be engaged by the local guardian that cares about engaging enemies for special effects, making it a very versatile ability in the right hands: to top it off, it's ludicrously cheap too for Rogue standards, who have more than enough money to spare.
Absolutely brilliant card, don't understimate it like I did, especially if you are planning a trip to the jungle...
I recently played through Scarlet Keys with a Gray's Anatomy-focused Joe Diamond deck, dual-wielding Survival Knives. Is it efficient? Absolutely not, but it's fun.
In a vacuum, one click for +3 damage on the next attack sounds great, but considering most basic weapons (and certainly any you spend XP on) deal two damage per attack, you're netting out to spending the same two actions to deal the same four damage, but the first action provokes opportunity attacks, you're required to spend a second action to inflict anything, and three actions only nets you 5 damage instead of 6. You can alleviate these by combining it with weapons and upgrades, but you're going to be sinking a lot of cards and XP into something objectively less efficient and flexible than a big stick, and you've already sunk 5xp on the book itself.
So where does it shine? Testless damage. Blood-Rites and Ancient Stones as mentioned in the other review, but my favorite is Alice Luxley. One action to set up with Grays, one action to investigate, get a clue and deal four damage to any enemy at your location. No ammo needed, no engaging enemies, just mashing your best skill and blasting things while you do it.
The (currently) Joe-exclusive Survival Knife combo is also effective, but very niche. Using Gray's on the third action and triggering the reaction in the enemy phase nets you 5 damage for a single action, but the stars have to align to set up that scenario. More often you start your turn engaged and are left to the usual Grays > Stab two-action combo, which is frustratingly inefficient against common 2-health enemies.
It should also be noted, if pairing with the The Raven Quill, that the Supernatural Record ability is XP-cheaper and more effective than actually buying a second copy of Gray's Anatomy. You effectively get three copies of Gray's in your deck, as well as the ability to pull them from your discard in the event that it gets Crypt Chilled or similar. The total resource cost is higher, but you're already paying that for the ability to avoid AoOs.
This card seems pretty amazing, a +2 to evade in most characters who want to be evading enemies in the first place nearly guarantees success, and preventing the enemy from readying next upkeep seems like it would be really helpful for evasion, which is one of the most tempo positive but value negative basic actions in the game. However, this rubs up against the classic problem of middling cards in Arkham: the effect is nice, but not so transformative that it shakes up what your doing, and it is a nonbo with cards that do shake up what your doing, which means that it isn't exactly worth the deckslot despite having essentially no problems in a vacuum.
Specifically, a big problem with disguise in most characters who can take it is that rogues have other far stronger ways to counter the long term value problems evasion has, either via cards like Pickpocketing and Both of the Lucky Cig Cases to turn evasion into a value machine worth doing to the point you actively will keep enemies about to do it over and over, or cards like Dirty Fighting and .25 automatic to turn it into a very efficient kill tool. Or, even better, doing both.
Compared to drawing a bunch of cards and getting cash, or just nuking the enemy for 4 damage at a combat value of +4 for 1 action, exhausting the enemy an extra turn is... nice, but not exactly something you want to do in most cases. VS non-hunters usually an evaded enemy becomes irrelevant, and while exhausting a hunter for an extra turn is good, you need to use disguise at least twice with relevant exhausts and a relevant action you otherwise would like to take to see value for the action cost of playing it alone, forget about the 3 resources and a card, or the greater costs if you are using evade based econ which push the theoretical cost of this card very high indeed.
Usually, if your doing that many relevant evades, things are going so poorly disguise is probably not helping you that much. For the same reason, the tempo advantages of a longer exhaust are a bit questionable. While the exhaust lets you take heat off your primary combatant for longer by allowing you to evade more enemies if the board starts getting flooded (Ex: Using 2 actions to evade 4 enemies a turn instead of the 2 you normally could), if your combat potential is falling so far behind that you need to constantly exhaust enemies in a desperate bid to stay above water... it probably behooves you to just add more cards into your deck, such as good kill events or the aforementioned Dirty fighting alongside a .25 automatic and mauser, to ensure you don't get into that boardstate which is so poor that disguise, while theoretically helpful, probably won't actually get you to the point you win the game with.
There is one character that springs to mind as a good disguise user, and that is Rita. While Dirty Fighting is FAR more her speed, the lack of pickpocketing, lucky cig case, or the ability to combine dirty fighting with .25 auto means that evasions for Rita are mostly just a free 1 damage ping if she intends to kill the enemy, and a turn free of attack when she doesn't. While Rita is proficient at killing things, higher health normal enemies can definitely strain her coverage in a way they don't for 'real' rogues. For example, on a flop where you and another player draw an enemy each, and one of you has a 4 health nasty, a .25 auto+dirty fighting combo lets a rogue evader just nuke the 4 health beast in 1 action, leaving them 2 actions to engage and evade, but Rita doesn't really have that option, as she traded her non-event nuke potential for the consistency offered by survivor cards. Like many survivors, Rita doesn't often fall behind but lacks many tools to catch up, and stalling one enemy for 2 actions legitimately can give her the window she needs to 'catch up' and do a full clear of all enemies. It isn't amazing, nor essential for the character, but its definitely a card that has helped a relatively flat character become a lot more dynamic.