
This has been updated to match my "Signature Weakness Project." I have done my best to make sure that the original content isn't altered too much, out of respect for any comments.
A very rare "attach to the agenda" signature weakness. Looking at the two elements, the effect and the discard condition, we get:
The effect: Attach to the current agenda. Carolyn takes a direct horror. If all horror generated isn't healed by the end of each round, add a doom to the agenda. While this weakness, like many, is pretty situational, it's still nasty in most settings, and can be scenario-ending. You never want to lose turns to "add doom" effects, and, unless you draw this at the Witching Hour or draw it on a low-doom agenda (or are lucky enough for all investigators to avoid or soak any horror), it's likely to cost you a couple of turns, especially since, if drawn during upkeep, the horror Carolyn takes from the card will generate a doom before anyone can heal it. The team can stick close and have Dr. Fern desperately heal instead of advancing the act, but that is its own kind of tempo hit, as is having everyone try to maintain their horror soak and own healing abilities. The only real mitigation is getting better horror healing (which Carolyn does as she gains XP) and have everyone mind their soak. This card is made slightly worse by the annoyance of having to track who gained horror each round.
The discard condition: Advance the agenda to which it is attached.
All in all, this is an above average signature weakness, maybe even way above in scenarios with high doom agendas.
Box vs book Since Foolishness, while cute as a button, is not the best Ally in the game, and this is a pretty harsh weakness, I suspect most players will choose the "box" over the "book" or including both in building a deck (the two signature weaknesses have a really bad synergy). Which is a pity, because I like the Dreamlands flavor.