Great Game Tom!
Guess wat. Im tellin u how to get all medals.
A winner is you: Beat the game.
Pacifist: No killeh teh clown at the end.
Facerape: You know when you get the chainsaw? The next room kill the guy and then let the shotgun clown boss guy come in and chainsaw his head.
The true face of evil: At the end when the clown fire head dies, put all your ammo out away from the clown, and punch him in the face!
Madness mode: u kno wat to do :D