The vanilla DoMT that serves as a magic item in the game just wasn't interesting enough, especially since we had a slightly larger group of players than normal. So our DM had a table of 52 cards with their own effects for our Deck instead. We were playing on Roll20, so we would have the system roll a number for us for what our random card was. iirc, the vanilla Deck has 20 cards, so you'd just roll a d20 to pull a card and check the table in the rulebook for the effect if you didn't have some kind of physical version to pull from. It's just that a lot of DMs don't even use the vanilla Deck because it's got cards that, like, reverse your character's alignment, could instantly kill a character, could summon powerful enemies that might end up with multiple party members dead, or it could give the character some super OP stuff. Basically a very unbalanced and easy way to derail the campaign or ruin the fun for some people. That's why DMs will often use custom tables with more tame effects, if they use the Deck at all.