I'll get it out of the way right now: this card
is undoubtedly going to be compared to Dark
Confidant. That's an unfair comparison, because
there is only one Dark Confidant and no other
card can be him, and the Visitor does entirely
different things. There's a black-red madness-hellbent
deck that has been tearing it down in casual for
almost ten years now, and she is the ideal
headliner for it, making Delirium Skeins and
Avatar of Discord much less risky over a couple
of turns. She also adds a severe card-advantage
threat to the late parts of multiplayer games
when people have spent most of their resources,
eliminating the time delay inherent in using
Dark Confidant in multiplayer.
So, phyrexian arena on a stick with a condition
and madness. Hmph. At one point, it's kind of a
positive, as you won't instantly bleed yourself
to death, the severely low toughness is a bad
thing, but it swings for 3, so.... hmm.