You're involved in a rather hideous car accident, leaving more or less every bone in your body broken, with the exception of your left arm. Which means that when you come to in the hospital, and people start talking to you, you're very limited in how you might be able to respond to them. You can throw a thumbs down or a victory sign, make an "ok" symbol, flip someone the bird, and rock out with devil horns.
These translate roughly to "no", "sweet", "yes", "bugger off" and "rock on"/"hail satan". You use them to work your way through a range of conversations, which proceed as a string of monologues, with the occasional simple choice. You're given a suggestion to agree or disagree, or go madly off script. That results in a branching plot structure, with the decisions pushing you down different branches of a tree to end up in ten different possible scenarios.
These plot lines are mostly surreal, with a fair bit of silliness. We've got trips to space, political satire, prisons, cults and stalkers. They tend to end in death pretty consistently though, but sometimes run on after that. The satire is a bit on the nose, given you find yourself a somewhat loathed president at one point, and have a plan to make things better by building a big fence.
But oh god does the writing suck. I can't tell if it's meant to be funny or controversial, but it mostly fails at both. Your main nemesis, a grumpy nurse, is basically cardboard, and the other characters are even shallower. You can't skip ahead to choices to change the end result, so you've got to sit through the painful dialogue every time. It's not even voiced, with the dialogue being given via that vague mumbly sound effect commonly used to do an impression of speaking.
I wanted it to be a joy, but instead it's a chore. I can't say it's worth playing.