So it may not be obvious from this screenshot, but this is not a horror game. Well, not exactly. No, it's a survival sim, and I don't mean the "punching trees" kind. I mean "here's a bunch of pills, syringes, a bone saw, and an in-depth manual on survival, have fun!" kind of survival game. There have been very few games like it since, and even fewer still that let you amputate limbs and survive.
Why is that last point so important? Once, long ago, I attempted a quadruple amputee run of this game. I even decided to start with the arms first to complicate things. While the game mostly adheres to sensible logic, surgery is not one of them, as you can amputate without hands. Life Or Death this is not.
I didn't manage to make it far before a tiger killed me (IIRC, removing your legs prevents you from running, not walking), but I always intended to go back. I even have screenshots of that run I posted to a ZDoom forums thread that is long gone that I may post later.
Correct me if I'm wrong (it's been a minute) but I'm pretty sure this game lets you amputate your own head with entirely predictable results.
I believe it does, yes! There's a lot of unusual ailments and ways to die, especially if you know what the various survival items do. For example, you start with a syringe of atropine. If you use it normally, it induces a heart attack. Turns out you're only supposed to use it when your heart rate drops too low, such as during shock.
The fact that the game allows you to do absurd things like that without any hesitation or warnings always amused me, and is one of my favorite design elements from games of that era. It also makes the survival guide included with the game essential. It's ironically a far more effective form of copy-protection than the included code lookup table that was included with the game, too.