We’re going to spend a few articles exploring and dissecting the visual novel Nurse Love Addiction by Kogado Studio. There will, of course, be major spoilers ahead.
You might think you know what you’re getting with a pastel-coloured visual novel called Nurse Love Addiction that depicts five pretty nurses getting along swimmingly with one another on its cover art. And you might even be partially right; this is a visual novel with an all-female cast of (trainee) nurses and multiple narrative routes, promising potential romantic entanglements with all of the main heroines.
It’s so much more than that, though. And that’s what we’re going to delve into from today.
Asuka Osachi is a young woman who, towards the end of her high school life, was feeling rather directionless and unsure what to do next. She considered herself to be the founding and chief member of what she called “The Jellyfish Club” due to her habit of drifting aimlessly through life, much as a jellyfish drifts through the deep blue sea.
But one day, something changed. In the depths of her closet, she found an old picture book that had obviously meant something to her as a youngster. The book depicted a youngster chasing the stars — a visual image that Asuka keeps returning to, as she finds it both striking and relevant to her own situation — and, in the back pages, apparently in her own childish handwriting, a seeming promise that she would become a nurse.
Not having any better or clearer idea of what sort of ambition she should have, Asuka took this as a sign that she should pursue the study of nursing after her graduation from high school. And so it is that at the outset of our story, we join Asuka and her younger sister Nao as they begin their studies at the Teito Nursing Academy.
Asuka is an immediately striking protagonist that many of us will find rather relatable, particularly if we’ve lived a life where things haven’t quite gone according to plan — or indeed a life without a real plan. She can be lazy, irresponsible and much too dependent on her ever-reliable younger sister, but her heart is in the right place; having taken the significant step of embarking on training for a specific career, she is determined to do what she can to succeed, if only to discover the truth behind those childish scrawls in the back of that old book.
Almost from the outset of the main narrative, though, we’re presented with a number of tantalising mysteries. What are the memories from her childhood that Asuka has forgotten? Why does she get such strong headaches in the rainy season? How does Nao manage to make those pains go away so consistently using what appears to be a simple, made-up, nonsensical “magic charm”? Why is Asuka greeted with the words “I finally found you” and “it’s not what it seems” upon meeting her fellow students (and resident pre-existing couple) Sakuya and Itsuki for the first time? Do Sakuya and Itsuki really have a mysterious “healing hands” power? And what is their teacher Kaede so anxious about?
In traditional multi-route visual novel fashion, you don’t get all of the answers in any one playthrough. After a common route — which itself has a few branching points and alternative scenes — the narrative diverges into specific paths for each of the main heroines, plus an “After School” ending where our leading lady doesn’t actually end up with anyone at all. For today, we’ll be contemplating Nao’s route; there isn’t really a “correct” order to pursue the routes through the game, but Nao’s provides a significant amount of background information that it’s interesting to have in mind when you explore Sakuya and Itsuki’s routes in particular.
Nao and Asuka are close. Very close. Indeed, one of the first lines in the game is Nao threatening to kiss Asuka if she doesn’t wake up and get out of bed — a bit of an empty threat, given that Asuka doesn’t seem altogether bothered by this being a possibility, but she eventually relents.
While Nao quickly shows herself to be the more responsible of the two sisters, some immediate questions are raised over her motivation for being at the nursing academy alongside Asuka; is she really making choices for herself?
“In her anxiety over my well-being,” Asuka explains, “she joined the same nursing academy as me. She calls herself my ‘miracle drug’. She picked up the nickname after I called her that once a long time ago.”
Here’s the first hint of the “addiction” from the title, though one can argue it might not be clear whether it’s Nao or Asuka who is “addicted” to the other — or whether it’s both of them. Either way, throughout the common route and into Nao’s specific storyline, it becomes clear that Nao cannot leave Asuka alone, and that Asuka has a hard time not relying on Nao for help keeping her life organised.
While there are elements of codependence there, it’s not necessarily a bad thing; the pair of them tend to keep one another in check, and Nao in particular has a positive influence on Asuka, encouraging her to push herself and grow as a person. Indeed, Asuka recalls that her school reports pegged her as someone who, “when excited about something, she sets extremely high goals for herself, but compromises immediately”.
Nao’s presence helps her to stave off that tendency to compromise long enough for her to actually achieve something; indeed, Asuka almost expresses surprise towards the outset of the narrative that she had managed to “come this far from a little scribble on a picture book” — though this doesn’t mean that she doesn’t make some fairly major mistakes along the way.
It’s something that many of us can doubtless relate to. Grand ambitions are easy to talk about, but actually following through on them can be a whole other matter. And while that transition from high school to either further education or the humdrum world of tedious employment is probably the best opportunity you’ll get to take a major step in a particular direction, it still takes courage to actually take that step. Asuka found that courage — and one can be certain that at the time she made that decision, the knowledge that Nao would be supporting her would have made her feel a lot more at ease.
The connection the sisters share isn’t something that was always present. Much to Nao’s embarrassment, Asuka reveals a treasured photo of Nao she has kept on her phone for years, showing a very different young girl to the one we’ve got to know at the time the story is unfolding. It seems that Nao used to be something of a “bad girl”; Asuka says that even Nao’s friends used to refer to her as “the Ice Demon”, and often describes her as being “doll-like”.
“I had never seen her get mad, laugh, or do anything like that,” Asuka explains. “In fact, she hardly spoke, and when I used to ask her to play with me, Nao never went along with it. I remember thinking I had a weird younger sister. But I was busy playing with my friends and I didn’t have much time to think about Nao. I wasn’t really interested.”
It transpires that Nao’s seemingly deadened emotions had caused her to fall in with a bad crowd, and her passiveness — plus seemingly some unresolved anger issues — had saddled her with an unwanted reputation as a “bad girl”. But shaking that off would have taken effort — effort she seemingly wasn’t willing to take until Asuka decided to try and get these questionable youngsters off her sister’s back, and had ended up taking a beating herself.
Apparently unaccustomed to someone actually stepping up on her behalf without any regard for their own safety or wellbeing, this caused a significant change in Nao, and the pair became practically inseparable as a result. And, as many people find when they leave home for the first time in order to enrol in further or higher education, that transitional period of your life is an ideal time to reinvent yourself. And that’s just what Nao did.
One could argue that Asuka does this over the course of the narrative, too. While she’s quick to refer back to her old days as the “leader of the Jellyfish Club” at the slightest opportunity to engage in some self-deprecation, we see in Asuka a young woman who is willing to apply herself and do her best. Sometimes she accepts a little nudge from her sister, but her hard work shouldn’t be discounted either. As Sakuya comments on Asuka having successfully finished the mountain of homework the students were set over the summer break, “even with your sister’s help, if you really had no willpower you wouldn’t have been able to finish”.
Part of Asuka’s growth and desire to succeed comes from an external source. On the group’s first hospital training visit, she meets a girl her age named Yuki. Yuki has been hospitalised for a long time with a seemingly incurable and likely terminal illness, and is regarded as a little “difficult” at times. Asuka strikes up an immediately close personal connection with her, and finds Yuki’s belief in her inspirational; she wants to become someone that Yuki will be proud of, and someone who can teach Yuki things when she pursues nursing studies of her own.
Yuki, regrettably, does not survive, and this provides a painful lesson for Asuka to learn — one that she knew already, but one which she had been wilfully ignoring in the hope that she could continue to drift through life in jellyfish-esque fashion, everything staying just the same as always.
“There are many patients like her,” the veteran nurse Asuka is paired with on her training explains. “Since last time, after your group came for hospital training, she is not the only one who has passed away. And yet, every day, we must continue to greet our patients with a smile as they battle against sickness and injuries.”
“I understand,” Asuka replies. “A nurse must always address the patient with respect. She must treat them fairly, without bias, and must not favour one over the others. That was one of the first things our teacher taught us in General Nursing Theory.”
And yet she had ignored it. While it’s undeniable that her short-lived friendship with Yuki had an obviously positive impact on her motivation and general attitude towards her studies, she had also been setting herself up for a hard fall.
One of the major lessons to be learned here is the fact that the things you rely on always being there for you may not always be present. And that is certainly relevant to the relationship between Asuka and Nao — though by this point we may well be questioning which one of the pair might stand to “suffer” more should they become more independent from one another.
While all this has been going on, Asuka has been developing feelings for Sakuya — something that Nao has very much noticed, and claims that she will “support”, but also very much appears to not be okay with. Following a major fight between Sakuya and Itsuki, Asuka is clearly torn between worrying for the couple’s wellbeing, and wondering if this might lay the groundwork for a relationship with Sakuya of her own. Nao’s response to Asuka’s pondering this, meanwhile, is to remind her of something that is clearly important to her.
“Remember, sis, I am your miracle drug and your sweet sister,” she says. “I love you, sis. I. Love. You.”
By this point, there have been a number of flirtatious incidents between Asuka and Nao, including an almost-kiss on their dormitory room floor the last time Nao attempted to fix her sister’s headaches with her “magic charm”, and an erotically charged session of spreading sunscreen on the beach. Interestingly, neither of the pair seem to think that there is anything strange or questionable about this potentially incestuous arrangement — indeed, Asuka wonders rather openly in her own narration whether or not a day could come when they would be “more than” just the “good little sister” and the “no-good older sister”. Something is going on somewhere.
A major turning point occurs in the narrative shortly after the school’s annual festival, which Asuka and her friends, as first-years, are tasked with putting together an attraction for. Their gimmicky “nurse café” — in which they take customers’ blood pressure and then offer them a low-sugar, low-fat menu if it’s a bit high — proves to be a huge success, despite initial disagreements over the concept, and the day seems to go well.
At some point during the day, Asuka is passed a note from Sakuya, inviting her up to the school roof that evening after the festivities are over. She attends, not sure what to expect, and is even more surprised when Sakuya suddenly kisses her without explanation before departing in a cloud of mystery.
She doesn’t have much time to contemplate the meaning of all this, however, because it’s at this point she is stabbed in the stomach by an unknown assailant. It all happens so quickly she is unable to identify who the culprit is, and, naturally, she shortly has more pressing concerns on her mind, such as her insides leaking out of the gaping hole in her midriff.
Asuka awakens, unharmed, to a tearful Nao who was worried she would never wake up. Nao claims she found Asuka collapsed on the roof, and an examination by their teacher supposedly revealed that this was due to exhaustion and anaemia. She doesn’t appear to know anything about the apparent assault Asuka suffered, but Asuka remains oddly convinced that it really happened, despite there being no evidence of it on her body.
It’s at this point that the whole feel of Nurse Love Addiction becomes very different, as you might expect. The unexpected violence — and the graphic depiction of it both through visuals and narration — coupled with confusing, conflicting accounts in the aftermath creates an almost palpable sense of unease and mistrust, and for much of the rest of the narrative many readers will likely find themselves expecting the worst any time something vaguely out of the ordinary happens. And indeed, there are multiple instances of events occurring seemingly specifically designed to set the reader on edge after this point; every time there’s an unexpected noise behind a closed door, one can’t help but wonder if Asuka is going to walk into some sort of horrifying scene as soon as she goes to investigate.
It doesn’t help that by this point in the story, it feels like someone — possibly everyone — is lying to Asuka. Itsuki keeps teasing her with talk of “the truth”, Nao keeps disappearing after school until late at night instead of walking home with Asuka, Kaede seems determined to walk in on Asuka at the most awkward, inappropriate moments and misunderstand what she’s seeing, and Sakuya is absent from the action for a significant proportion of the time thanks to her mother falling ill and eventually passing away.
It’s the changes Asuka witnesses in Nao that seem to break her heart the most. The first real hint that something is wrong in this regard comes when Nao suggests the pair of them move on from childish fancies, and that Asuka should take some medicine for her headaches in the rainy season rather than relying on Nao’s “magic charm”. Oddly, though, Nao seems extremely upset when Asuka complies with this, despite the fact it was her idea in the first place.
This all ties in with the codependence thing introduced towards the start. Not only has Asuka been dependent on Nao for many years, but Nao has also been dependent on Asuka — just in a less obvious way. While Nao took care of many practical things for Asuka, Asuka always cared for Nao’s emotional needs — and the feeling that this support might go away is difficult to deal with, as anyone who has ever had to “let go” of a loved one will be able to attest.
But there’s something Nao’s still not telling Asuka — a feeling that something is coming to a close. Nao invites Asuka out on a date, noting to herself that it will be their “first and last date”, and makes the most of it, explaining that “taking a walk on your own and going for a walk on a date are two totally different things; it’s so different that the usual scenery feels almost as if you’re on the other side of the world.”
There’s a bit of foreshadowing here, but before we delve into that let’s sidestep a moment.
Of the many changes in Asuka’s life towards the end of Nao’s narrative, it’s probably Itsuki’s promise of “the truth” that is the most significant. But this doesn’t run smoothly; after finally mustering up the courage to look at a supposedly life-changing file on a USB stick Itsuki provides, she discovers nothing more than a text file inviting her to “wait half a year”. After that half a year passes, Asuka finally confronts Itsuki and demands the truth, only to discover that Itsuki had intended the contents of the USB stick to reveal said truth much earlier; someone had obviously tampered with it before Asuka was able to look at it.
The truth of the matter is that Asuka’s missing memories hail from a traumatic childhood that she shared with both Itsuki and Sakuya — Itsuki has video evidence of the fact, even if Asuka has seemingly no recollection of it herself. Or does she? There are a few instances over the course of the narrative where Asuka seems to have flashes of these missing memories — usually when she’s under great duress or, on one particularly memorable occasion, when she gets clobbered on the head by a blindfolded Sakuya attempting to engage in the traditional “summer episode” activity of smashing a watermelon with a big stick. She tends not to think anything of these flashes at the time, dismissing them as dreams or idle thoughts, but in retrospect given the truth revealed at the end of the narrative, they’re clearly in there, just locked away.
Asuka, Itsuki and Sakuya were orphans who were “raised” (in the loosest possible sense) at a laboratory exploring mysterious “powers”. Each of them were subject to myriad unpleasant tests, usually relating to their mental acuity and their ability to harness it in various ways. While Itsuki and Sakuya revealed themselves to have the “healing hands” power teased in the early moments of the narrative, Asuka was dismissed as having great potential but no real manifestation of any concrete powers whatsoever.
Oddly, Nao doesn’t appear to enter into any of this, but Itsuki remains adamant that Asuka shouldn’t trust her sister, because, as she said back on their first meeting, “it’s not what it seems”.
And so we come back to the “other side of the world”; a key moment in the finale where Asuka enters a whole new world, where she knows the truth about her sister, about her past, and what has been happening to her. It is the other side of her world up until now; everything she had taken for granted is different to how she had imagined, including her “miracle drug”, her “sweet sister”.
Nao’s “magic charm”, it seems, was indeed real — but it wasn’t just a means of making the pain go away. The fact that Asuka’s headaches always started in the rainy season was coincidental rather than weather-related as she had always assumed; it transpires that they were a sign her repressed memories were trying to return. And Nao’s “charm” took care of this in a simple but devastating manner: it erased those memories.
Nao, we discover, was the main purpose of the research facility in which the main cast spent their childhood; Itsuki, Sakuya and Asuka were all simply test subjects to further understand and enhance Nao’s powers, which were formidable. They were disposable, expendable resources; Nao was the only one who mattered to the facility’s owners — though not enough for her to be treated as a human being; she didn’t even have a name until Asuka gave her one.
We learn that the facility suffered a huge fire that killed the owners, but Itsuki, Sakuya, Asuka and Nao all managed to escape, and Nao managed to engineer things in such a way that she would be able to remain by Asuka’s side when they eventually ended up adopted by a foster family — the point at which they became sisters.
The memory of all this was, of course, traumatic for Asuka, so Nao attempted to show her appreciation for Asuka’s kindness by erasing the trauma and allowing her to believe a lie. The erasing process became necessary on an annual basis, though; feeling like she shouldn’t suddenly allow Asuka to remember such a horrific past, she continued to use her powers to keep her adoptive sister in the dark, over time becoming addicted to the power she wielded.
There was another side to it too, though; as we saw earlier in the narrative, Nao became jealous of Asuka’s feelings for Sakuya — which, it turns out, were themselves an echo of a memory thought lost. Part of the reason for Nao continually erasing Asuka’s memories lies in the fact she wanted to keep her “sister” for herself; should she become involved with Sakuya again, she would absolutely have to let her go. And it is clear by the time we learn all this that Nao most certainly would not be able to handle life by herself.
Nao becomes desperate and irrational. The reason for her sorrow over Asuka turning down her “magic charm” — and her reason for suggesting they try and move on from it — is that she knew she had drained all of her power, and would be unable to ever get it back. The reason? She was the one who saved Asuka from the fatal stabbing on the roof — which, it appears, did indeed happen. And the amount of power it required to pretty much bring someone back from the brink of death ensured that Nao would never again be able to make use of her other abilities.
This, naturally, would mean that Asuka would eventually recover her memories and, in Nao’s mind, would promptly run straight into Sakuya’s arms, leaving her behind for ever. So she makes one last-ditch effort to keep her sister for herself… but things most certainly do not go quite how she planned.
The two possible conclusions to Nao’s narrative are fascinating. The final choice is between whether Asuka forgives Nao for all the things she’s done or not — and the “correct” choice isn’t what you might think.
Forgiving Nao causes her to become completely overwhelmed with guilt and grief for what she has done, and utterly fixated on the belief that she will never truly be able to make it up to Asuka. Merely being in Asuka’s presence causes her to feel sick as she is reminded of her behaviour, with the only release she feels from her mental pain being consensual physical torture at the hands of her sister. And as such, the “bad” ending for Nao sees the pair entering into a very different sort of codependent relationship; Nao becomes dependent on her daily bondage and beatings as she seeks endless physical punishment for what she believes are unforgivable sins, while Asuka becomes addicted to delivering this punishment as a means of showing what she comes to believe is love for her sister.
While a sadomasochistic sexual relationship is not, in itself, necessarily a sign of total dysfunction when it’s between two consenting adults, in the case of Nao and Asuka it clearly is — particularly for Nao, who drops out of school to effectively become a voluntary “prisoner” in her own bedroom in order to receive her eternal punishment.
This isn’t a matter of pleasure for either of them, even though Nao does reveal towards the end of her narrative that she “doesn’t dislike pain”; for Nao, it’s a need to be continually punished for something she believes she can never make up for, and for Asuka, it’s an attempt to be the “responsible” one in her own strange way by giving Nao what she needs. It’s unhealthy for both of them, however; it’s their codependence taken to a whole other extreme, and the longer it goes on for, the less likely they will ever be able to enjoy a normal life.
Conversely, choosing not to forgive Nao sees Asuka, for once, playing the role of the older sister properly by scolding Nao with a combination of love and fury. This, it turns out, is exactly what Nao has been craving; it’s still punishment for her actions, but in a much healthier, more productive manner than how her “bad” ending unfolds.
“It’s precisely because I don’t forgive you that I have to stay with you,” explains Asuka. “When a little sister does something wrong, it’s the older sister’s job to scold her little sister, and help her fix the problem. I have to be forever by your side, so I can properly scold you, and so I can keep a good eye on you, to make sure you don’t do any more naughty things!”
One can argue that there’s still an element of dependence going on here, but the difference is that Asuka in particular moves on and becomes the responsible older sister, while Nao attempts to do her best to prove she is becoming a better person rather than simply lapsing into completely submissive subservience.
This relationship ultimately blossoms into genuine romantic love between the pair of them — which one can’t help but feel may well get them into trouble someday if they continue getting up to what they do in the ending — and becomes rather heartwarming to see.
While there are most certainly unhealthy aspects to how their relationship began and particularly how it developed, by the time we leave the Osachi “sisters” behind at the end of Nao’s route, we can feel confident that they’re probably going to make it — and that their shared experiences will ensure they go on to be wonderfully kind, caring nurses.
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