This ICE has been doing some work in Blue Sun: Powering the Future. At first, it was a test, to try and counter I've Had Worse. It works beautifully for that purpose. First, you look at the runner's hand. Do you see anything you would like to snipe? (I've Had Worse, Plascrete Carapace, Self-modifying Code, ...) If you can get a counter without breaking the bank, go for it. Use it immediately if you intend to bring it back at the start of your turn.

But here is the beauty of this ICE: You don't have to use it immediately. Keeping it means the runner has to be even more vigilant.

• If he stole a 3 point agenda and ends his turn with 3 cards, Punitive Counterstrike.
• Scored The Cleaners, SEA Source + Scorched Earth is lethal.
• Before committing to a SEA-double-scorch play, use a token to make sure there are no I've Had Worse in hand.

If you need that 6 credits right now, you have a window after the runner discards where you can use the token, before the start of your turn.

The problem with Spinal Modem is not trace ICE. It's with effects that add a trace on access, like, Ash 2X3ZB9CY, Manhunt, Bernice Mai and Self-destruct.

Brain damage is manageable, actually, unless the corp is actively trying to flatline the runner. Some flatline decks even attempt to inflict brain damage, in which case this console can become a liability.