I recently got it for Xbox 360 (I'd rather have gone for the PC version, but I'm at uni now and my laptop can't run it) and I started a game on medium.
I got my arse kicked so severely, I ended up turning it off in frustration.
I'm gonna start again (on medium) and play it nice and slow, not my normal FPS style of blazing through everything really really fast. I think its a game that deserves a good deal of exploration and thought
And for those of you wanting more details, I got severely beaten by that surgeon boss guy thingy-ma-jig. I had no ammo, that flame plasmid and telekenisis, and flames wouldn't work because he would dive into a pool of water and stay there for the remainder of the fight. So, it was machine gun vs wrench, no plasmids.
Second arse kicking came with my first encounter with a big daddy. Died repeatedly, finally got him down, and then...WHERE THE HECK WAS MY LITTLE SISTER? I would charge the fucker, wrench him (again, no ammo) die, spawn, charge, I eventually kill him, and no ADAM for me :<