When i start the game, after the initial fading titles (patreon and such) the screen stays black. the background noise starts (dripping etc.) but there are no images or anything. Am i missing something?

maybe try F11, going from fullscreen to windowed? Sounds weird but I've had many games do this and opening it on an alternative monitor or changing my resolution has fixed it. Fun game hope you get it working. Or if you are familiar with config files and can find the settings change the settings from full screen to windowed?