Those of us who live in video games have always had the luxury of a rather juvenile approach to our video game lives. Did you screw up? Go back and try it again. Do you want to be good or evil? Here are two options for you. Here's what will happen depending on what you choose. Change your mind about which option you wanted? Well, that's alright — just go back and try the other thing.
Heavy Rain is a gut-wrenching, heart-breaking, emotional stranglehold of a game particularly because it violates all of these things that we've been accustomed to in video games. But first, some advice:
Play the game on the hardest difficulty, even if you're not super familiar with video games. Unless you're missing more than a third of so of the prompts, you shouldn't pick the easier route. This game is much more interesting if you make mistakes.
This game is much more interesting if you make mistakes.

And, the choices you make in the game are just as human, and just as insane. The sort of thing you're choosing to do in this game is organic and real in a way that I haven't seen in any other game to date. This isn't a game that gives gravitas to grand, sweeping decisions that you're making. There are no defining moments of choice. There is no Playboy X moment in this game. This game is much dirtier and much meaner than that.
There was one point in my first playthrough where I was confronted with a quick, simple decision, and implicitly given only seconds to choose — and I was completely paralyzed trying to make this decision because I had no idea if one of the options would perhaps kill me, or if the other option would perhaps result in the failure to find my son. In fact, I spent so long trying to weigh my options that the game stopped waiting for me and just moved on. The genius of the choices in this game is in the fact that you have an investment in those decisions (emotionally for the characters, as well as personally for your own time playing the entire remainder of the game), and as a result it becomes practically as real as it is for the characters in question.
Similarly, fight scenes are about as intense as any you'll find in any game, simply because the stakes are so incredibly high. And, with fights and intense action happening fairly often, you'll be about as exhausted as these poor characters by the end of the game.
I'd rather stop my review here. I think that everyone should play this game once. I think that while it may not be a revolution in the way games are made or told (it is, but it's too much of an insane effort to be replicated within pretty much any other game), it is an incredibly well-conceived and -executed experience that everyone should experience once — particularly those that spend a lot of time playing video games.
And, perhaps once is the right number of times to play this game. Going back and seeing how other decisions play out I found ruined the emotional value of the scenes. Real people, after all, don't get to time-travel back and figure out what might have otherwise happened. That nagging feeling after the game ends that perhaps you could have made better decisions, but not being completely certain, is part of the experience. Of course, if you want to get all the trophies in the game, you'll have no choice.
Either way, though I think everything else about the game should be inconsequential in relativity to what I've already described, this wouldn't be a proper game review without considering all the other components that make this game a game.

The sound in the game is also superb for the most part, with the obvious and oft-mentioned complaint about some of the voice acting. I didn't find it as distracting as others, but it was definitely a present problem. The music gets a bit repetitive after a while, with only a couple generic calm-yet-sad leitmotifs, and a small handful of oh-god-i'm-going-to-die cues.
Perhaps the most broken part of this game is the simple act of walking. After playing the game for a few minutes, you start to understand why the game controls like a tank (you hold R2 to walk, and then use the left stick to turn), but that still doesn't excuse the fact that the way it carries out said tank-controls is so awful. Sometimes you'll find yourself on the cusp of an invisible, virtual corner of the game, trying to get to the other side of the corner, but because you're a few inches off, you'll turn around like a drunk clown several times before finally giving up, walking several feet away, and trying it again. There must have been a better solution here than tank controls. Added to the fact that the way it's animated gives the impression that you're dragging these people unwillingly along by a piece of string attached to their noses, and it serves in general to make something which should be fairly simple incredibly frustrating.
Again, though, I think these things are inconsequential relative to the actual merits of this game. Everyone should play it once — perhaps precisely once, perhaps at least once, but once nonetheless.