
This is an actual review of this card, not a wall of text about one combo ;)
The characters have a few among them that love skills passionately. "Ashcan" Pete is good with them in particular and Silas Marsh likes to sip his skills like fine wine.
In addition to the empowering mechanics from the 0xp version, Grisly Totem grants a failure umbrella much like Try and Try Again would, this is very good for key mechanics like Resourceful, Deduction and Vicious Blow and still very efficient for pure boosts like Overpower or the desperate skills.
The fact that you can play a skill card every turn, where you know that said skills's benefits are eventually guaranteed, this is a great luxury and potentially crazy powerful. You know how bad it feels to miss a 3-hp foe with a vicious blow? Totem gives you 2 chances at it! Just make sure to bring some easy to play skills like Unexpected Courage and/or Resourceful that you can play and cash in on that bonus as often as you can.
Note that Try and Try Again is a more complete fail umbrella than totem is, even so, the extra boosts really stack up.
A big argument against totem, which requires card commitment to operate, is that it shares a slot with one of the best cards in the game. Key of Ys. Obviously if you adhere to the taboo list then totem shoots up the priority list, especially if you're playing Silas Marsh or a Yaotl based deck.
(Also p.s. the combo with Take Heart is currently legit).