As we’ve already seen in our initial exploration of the common route and Nao’s ending, Nurse Love Addiction is a visual novel that goes in some interesting and unexpected directions.
Rather unusually for a visual novel where the routes are themed around the protagonist developing romantic and/or sexual feelings for one of the heroines, the game features quite a few examples of relationships that can be quite reasonably regarded as unhealthy — even in that route’s supposedly “good” ending.
A great example is that of Itsuki, a character who you know pretty much from the outset is going to be trouble — and how. Let’s take a closer look. As always, there will be major spoilers ahead.
A quick recap first. Throughout the common route of Nurse Love Addiction, we meet protagonist Asuka Osachi, and discover that she was inspired to become a nursing student after rediscovering a picture book, apparently from her childhood, that contained a scrawled promise that she was “gonna become a nurse”.
Asuka is very taken with this picture book and its theme of a youngster trying to chase and capture the stars, and believes that her attempts to establish a career — and, subsequently, perhaps grow close to someone — are her own efforts to chase down a star she can keep for herself.
Over the course of her initial studies, Asuka learns some tough lessons about the realities of both life after high school and the things a nurse has to deal with — including the reason why nurses absolutely, positively, definitely shouldn’t find themselves getting attached to specific patients, however much they might like them, or however inspirational they might find them. She learns that the immediate, instinctive response that seemingly benefits an individual might not be the best choice when considering the big picture, and she also learns that life, unfortunately, does not wait for anyone, often throwing unexpected curveballs in your direction.
A core mystery at the heart of much of Nurse Love Addiction is Asuka’s missing memories from her early life. As we explored when we looked at Nao’s route, the truth behind this is that Asuka, along with her sister Nao and her classmates Sakuya and Itsuki, suffered a traumatic childhood as test subjects.
Orphaned at a young age, Asuka, Sakuya and Itsuki all displayed potential for the manifestation of mysterious “powers” and were thus subjected to all manner of invasive tests in an attempt to fully understand and take full advantage of Nao’s capabilities. The lab eventually burned down under circumstances not made completely clear in either Nao or Itsuki’s routes, and Asuka was believed dead along with the apparent mastermind behind the whole situation. In reality, Asuka survived, and Nao manipulated events in such a way that both she and Asuka were adopted into the same foster family as “sisters”.
In Nao’s route, we learn that Nao had been using her powers to ensure Asuka’s memories from that time remained locked away, never to be accessed and traumatise her again. Nao initially did this for Asuka’s own good, but over time became addicted to the power and control this gave her over her sister’s life. Her route reaches a climax as she realises that she will no longer be able to do this after draining her power in its entirety in saving Asuka from a fatal stabbing, and the question subsequently arises as to how Asuka will deal with the gradual, natural re-emergence of her memories now that Nao will no longer be able to maintain the veil of secrecy over them.
In Itsuki’s route, meanwhile, we look at the situation from a slightly different perspective. Many of the events leading up to her unique story remain the same: Asuka still gets stabbed, Nao still heals her — though if you were to play this route first, you wouldn’t know this, perhaps leading us to question Asuka’s perception of reality, as it’s strongly implied that she hallucinated the experience due to exhaustion — and Itsuki still reveals the truth of Asuka’s past by playing her a video recorded back when they were still prisoners of the laboratory.
A crucial piece of information revealed throughout all this is that both Asuka and Itsuki were very different people back when they were children. Asuka was much louder, more brash and confident — Itsuki describes her as “selfish, violent and with a terrible personality; the most annoying damn girl there ever was” — while Itsuki was extremely timid. On top of all this, supposedly Asuka and Sakuya had romantic feelings for one another back during their time in the lab, yet at the time we join the story in Nurse Love Addiction, it is Itsuki and Sakuya who are the couple — and apparently a well-established one.
Before we continue, let’s look at the impression Itsuki puts across throughout the early hours of the story. One of the interesting things about her is that you’re never quite sure what is real and what is not; she is a character that is shrouded in mystery right from the moment she first meets Asuka.
Asuka first encounters Itsuki and Sakuya as they are descending the stairs in the nursing school. Sakuya immediately gives off the impression of the spoiled, haughty princess, while Itsuki combines an effortlessly fashionable sense of style with a distinct sense of mischief.
Some of Itsuki’s first words to Asuka are “I’ve finally found you” and “it’s not what it seems”. She absolutely refuses to explain what she means by these things at first, and also takes to referring to Asuka as “Dummy Girl” (in Japanese, 模型子 mokei-ko, literally “model child” or “dummy child”, both of which have quite different meanings in English) without any real context — aside from Asuka’s obvious airheadedness, of course, which is more than enough justification at this point.
As time goes on, Sakuya and Itsuki appear to be a couple very much in love with one another, though one might question exactly how they got together in the first place, given their seemingly polar opposite personalities. We’ll come back to that in a moment.
The first supposed answer we get from Itsuki is what her initial words, “I’ve finally found you,” supposedly mean. We learn that Itsuki is a member of a doujin circle that is developing a game called Wizard Nurse Prima, and that Itsuki believes Asuka would make an ideal official cosplayer for the title character. Regardless of the choices you make in the early part of the narrative, Asuka finds herself roped into playing the role of Prima at a local doujin fair, where she makes quite the impression.
More significantly, as she takes Asuka home after the event, Itsuki tells Asuka the story of how she and Sakuya supposedly got together — though if you’ve previously played through any of the routes, you’ll know at least some of this is complete hogwash.
“We’re childhood friends, Sakuya and I,” Itsuki lies. “Our parents knew each other from a long time ago. My parents first took me to see Sakuya when she was in the hospital, I think. That’s where it all began. After she left the hospital, we met often. Not that our houses were that close.
“I was the one that started developing feelings for her,” she continues. “After we entered junior high, I told her my feelings and she turned me down flat. At one point, I couldn’t take it any more and even tried to force myself on her. I thought if we actually consummated the act, things would work out. But she resisted a lot. She stabbed me in the shoulder with a pair of sewing scissors beside the bed. I think I still have the scar. And then we ended up dating. The end.”
It doesn’t take much to understand that there are a lot of suspect things about that story, both in terms of whether or not it is actually true and if so, what sort of person Itsuki really is. But there’s more.
“Anyway, Sakuya,” Itsuki continues. “She had someone she used to love. No wonder she turned me down. But she’s gotten over it and now she tells me that she has feelings for me.”
Asuka isn’t quite sure what to make of all this, but Itsuki will likely be setting off vast quantities of red flags in most readers’ minds at this point. Particularly if they’ve already played another route and know that the very foundation of this story — Itsuki and Sakuya being childhood friends thanks to their parents knowing one another — is a fabrication.
But at the same time, there are still some questions, even given the truths we subsequently uncover. Itsuki and Sakuya did know one another in their childhood, and it’s clear they’ve been together for a while; it just wasn’t under the circumstances Itsuki described. Does that mean other parts of the story contain half-truths, too? Is Itsuki really someone willing to stoop to sexual assault in order to get what — or who — she wants? And is Sakuya — a character who has, up to this point, regardless of route, shown herself to be the very picture of cool, calm refinement, even under incredibly challenging circumstances — really the sort of person who would stab someone with a pair of scissors hard enough to leave a permanent scar, even with her virginity on the line?
There’s also a particularly glaring issue that comes up once Asuka has seen the video of her former life in the lab with Itsuki and Sakuya: how did Itsuki go from being a timid, terrified little girl to the person she is today? And why? Modern Itsuki is not a particularly nice person, and indeed she’s so mean to Asuka on such a regular basis that, as Itsuki’s route proper starts establishing itself after the common route, Asuka convinces herself that she “hates” her.
A big part of this stems from how Asuka starts spending more time with Itsuki in the hope of finding out more about her past — though it’s immediately clear that the one who is primarily concerned with this is Itsuki, not Asuka herself. Asuka simply goes along with it initially as a means of trying to figure out some things for herself; Itsuki is the one who seems to think it is important that those lost memories are recovered.
Her initial explanation for this is that she believes Asuka and Sakuya should get back together — and indeed her talking with Sakuya about this is what caused a raging row between the pair of them. However, something doesn’t quite add up about all this; as Itsuki talks about how Asuka and Sakuya used to be with one another — very much in love, but also quite frequently at one another’s throats, much like Itsuki and Sakuya have, by this point, shown themselves to be — it becomes clear that Itsuki is referring to the past Asuka almost as if she’s an entirely different person.
She talks about the Asuka of the past in the third person, and does not have particularly complimentary words to share about her. She explains how past Asuka treated her poorly over and over again, seemingly making her out to be a terrible person — “the most annoying damn girl there ever was”, as she put it earlier. But despite this, she remains insistent that the current Asuka should try her best to recover her past memories, and return to her true self — the “real” her.
Asuka isn’t convinced at all by this, and in fact finds herself feeling rather hurt. It’s understandable; to be effectively told that your current self doesn’t matter is enough to make anyone sting a bit. But still Itsuki persists.
“The ‘dummy’ in Dummy Girl comes from ‘dummy’, as in a fake copy,” Itsuki explains. “I’m not interested in a fake copy of ‘Asuka’. We have to turn you back into your true self.”
Note the language she’s using here: “we have to”, as if it’s a team effort; a friendly, cooperative affair that will ultimately be for Asuka’s true benefit, when in fact it’s just Itsuki trying to get what she really wants. Because, if you hadn’t figured it out by now, Itsuki herself is the one who actually wants past Asuka back, despite supposedly having had miserable experiences at her hands as a child. And she doesn’t care if that means completely erasing Asuka’s current existence.
What has been happening here is that Itsuki has been “gaslighting” Asuka; if you’re unfamiliar with the term, this refers to the deliberate use of psychological tricks and manipulation to cause someone else to question their own reality. The term originates from British playwright Patrick Hamilton’s 1938 play (and two subsequent movie adaptations) called Gas Light, in which an abusive husband attempts to manipulate his wife into believing she is insane by making subtle changes to her surrounding environment — such as gradually dimming the gas-powered lights in the house, hence the title — and completely denying that anything has changed any time she mentions it.
Itsuki is doing a similar thing here. Asuka only has Itsuki’s word that her past self used to be a completely different person, but Itsuki is trying desperately to convince her that this supposed past self is the “better” Asuka; the “true” Asuka. And in the meantime, she continually denies Asuka’s present existence; Asuka describes the sensation almost as if she is being looked through or past, despite standing right in front of Itsuki, present in the here and now.
Asuka snaps, and, recognising the true reason for Itsuki’s behaviour, calls her on it in no uncertain terms. Yes, Itsuki is suffering her own degree of pain, in that someone who looks like the girl she used to love — but who is not that girl — is standing right in front of her, but her psychological manipulation in an attempt to recapture a lost past is just about the worst way she could try to deal with and resolve that pain.
And we get a possible answer as to that earlier question: is Itsuki someone who would resort to sexual assault in order to get what she wants? The climax of her confrontation with Asuka would certainly seem to suggest this; after being forcefully pinned to the wall after making it clear she knows exactly what’s going on, Asuka challenges Itsuki to “shut her up”, and Itsuki forces a non-consensual kiss on her in response. It’s at this point that Asuka is pretty much completely convinced that she truly hates Itsuki. Understandably so.
Rather than moping around, Asuka chooses to channel her hatred into her studies, since this provides an opportunity not only to better herself, but also to keep herself away from Itsuki — and to stop herself from thinking about Itsuki. And it seems to work; everyone notices Asuka’s marked improvement in all areas of her study, with her teacher even commenting that she might even find herself in the top third of the class at this rate.
But the damage is already done; Asuka can’t stop thinking about Itsuki, despite everything she’s put up with by this point. She can’t say for certain that she truly hates Itsuki, because after everything she’s heard, she can’t help but question her own existence, and whether she really is a “dummy” — a fake copy. And with that in mind, she can’t help but wonder if Itsuki is a way that she can recapture her “true” self.
She doesn’t have a lot of time to really process things, though, because she is unceremoniously abducted by a mysterious woman named Sumika Kuraku. Sumika was once a security guard at the facility where the girls were confined in their childhood, and has since been part of an operation to continue the lab’s work in secret — an operation that Itsuki inadvertently got dragged into as a means of protecting Sakuya, helping to establish the doujin circle and the Prima project as a cover story in the process.
Sumika explains that “the others kind of treat me as the extremist of the lab, but actually I’m just a realist” — but it’s clear from her abusive treatment of Asuka that she most certainly does not have the wellbeing of her “subjects” in mind. Instead, while it seems that the original — now deceased — owner of the research facility had some grand plan for her work, just questionable ethics in carrying it out, Sumika and her cronies are now in it for pure profit. Not only are they attempting to continue the research into “powers” — hence the abduction of Asuka, and their manipulation of Itsuki — but they have also been illegally dealing drugs and getting involved in all manner of other criminal activity.
Asuka is rather surprised to find Itsuki coming to rescue her while Sumika’s attention is elsewhere, and, as with the other routes in the story, a final choice is presented to you if you have made all the “correct” decisions up until this point. In this instance, it’s whether to follow Itsuki’s rescue plan to the letter by giving in to Sumika’s provocative behaviour — which looks set to escalate into sexual assault, as something of a running theme in this route — or to resist.
Resisting, which you might think is the logical thing to do, causes Itsuki’s rescue attempt to be botched but ultimately still successful; Sumika does, however, escape. Not resisting, meanwhile, causes Itsuki’s plan to be successful, ending up with Sumika being knocked out and — we’re told — taken away by the police. In keeping with the way the other routes handle the finale sequence, it’s not immediately obvious whether or not either of these are the “correct” thing to do — and indeed, both Itsuki’s “good” and “bad” ending sequences have a lot in common with one another to further add to this sense of confusion.
In both cases, Itsuki returns Asuka to the dormitory, promising that she’ll “make sure this never happens again” and that she’ll “get rid of the lab”. She then promptly disappears for a protracted period of time, leaving Asuka with even more questions than she had before. Why did Itsuki come to rescue her? How does she feel about being rescued by Itsuki? How is she going to “get rid” of the lab? And is Itsuki still obsessed with past Asuka?
In both endings, Asuka acquires a copy of the unfinished Prima game that Itsuki and the lab members had been working on as a cover story for their activities. It seems that Itsuki had made a real effort with the narrative for the game, despite it not being finished — but had also used it as a means of working out some of her own issues. Most notably, Asuka recognises that the character of Prima was very clearly based on what she understands of her “old self”, while the true villain of the piece clearly represents Itsuki.
Prima grows and changes so much over the course of the story that she’s practically a different person by the end of it, while the evil Queen who represents Itsuki ends up destroying herself, her final words being “I just wanted to become one with you, Prima”. Asuka recognises this as Itsuki’s frustration that the Asuka she fell in love with is now too far away to reach — and how Itsuki, supposedly falling for Sakuya, decided she wanted to take past Asuka’s place as some sort of substitute for her lost love.
Asuka, understandably, isn’t quite sure what to do with all this information, and is left well and truly confused as to her true feelings for Itsuki at this point. Asuka hates Itsuki for her manipulative nature and her seeming refusal to accept Asuka as the person she truly is, but she can’t deny her attraction; how she has constantly felt drawn to this frustrating, infuriating, emotionally abusive young woman.
This is a good representation of the dynamics of an abusive relationship. Abusers often work from the shadows, leaving the abused to feel like the problems are all their fault. Gaslighting is part of that process, but there are plenty of other ways to manipulate emotions, too. The end result is, regrettably, often the same, however: a victim of abuse who feels a curious sense of “attachment” to their abuser, and an unwillingness to let them go, even if doing so would absolutely, definitely, obviously be the best thing to do.
The two endings reflect two ways in which this sort of thing can end up, with the “bad” ending being a particularly extreme example that focuses on the long-term mental damage an abusive relationship can have on an individual.
In the “bad” ending, Sumika’s escape from the confrontation means that she is able to fatally wound Itsuki before fleeing once again; Asuka happens to stumble across Itsuki on her way home from a failed attempt to draw her out of hiding using the Prima project. Not realising she is wounded at first, Itsuki crumples to the ground and bleeds out in Asuka’s arms, the scene obviously and intentionally mirroring the final scene of Prima — with the point being further driven home by the fact that Asuka is in Prima cosplay at this point.
Itsuki’s final words are the same as those of the evil queen she wrote to represent her in Prima; an apparently earnest desire to “become one” with Asuka. Asuka, well and truly broken at this point through a combination of Itsuki’s emotional manipulation, grief and shock, isn’t sure how to interpret this at first, but let’s just say she ultimately does so in the worst way possible. The final scene in particular is a masterful example of how a bit of clever pacing and unreliable narration from your first-person protagonist can cause a real rollercoaster of emotions for your audience — in this case, culminating in a rather memorable combination of sickening horror and abject pity that will stay with most players for a long time.
In the “good” ending, meanwhile, Asuka is able to successfully draw Itsuki out of hiding, at which point she screams everything she has been thinking about at Itsuki, while in Prima cosplay and in a very public place. Asuka reaffirms her supposed “hatred” of Itsuki, but as we’ve established pretty well by this point, Itsuki is a masterful manipulator.
“I didn’t feel any of that hate when I kissed you at the karaoke place,” Itsuki responds, referring to the non-consensual, forced kiss the last time Asuka had expressed her anger. “Haven’t you been thinking about me non-stop this entire time? I do love you, Asuka. I came to love you. Is it really true that you hate me, Asuka?”
Itsuki’s deliberate, repeated use of Asuka’s name — in stark contrast of her use of “Dummy Girl” for the majority of the rest of the narrative — is just another example of her emotional manipulation. And Asuka absolutely well and truly falls for it; whether she genuinely believes Itsuki’s words or is just too exhausted to resist any more is a matter of opinion, mind — but remember, the choice that brings you to this particular conclusion of the narrative is “Don’t resist”.
“Unfair, mean, putting on airs, but timid at the same time,” Asuka muses as the pair share what is supposedly their first genuine kiss. “Always trying to hide her true self. That’s Itsuki. Itsuki’s lips are so soft, so sweet. And also, a little bit… the taste of sin.”
From this, we can infer that Asuka recognises what she is doing is not at all healthy for her and a terrible choice in the long run. But she’s in too deep right now, and after everything she’s been through one can perhaps understand — if not forgive or accept — the desire to take the path of least resistance. As such, she ends up becoming something of a submissive partner to Itsuki, despite Itsuki’s insistence that her timid former self is still inside her. Itsuki, of course, takes full advantage of Asuka for her own sexual gratification at every opportunity, and in some of the scenes towards the conclusion of the narrative there is certainly some murkiness over the question of mutual consent.
With all this in mind, it’s hard to think of either of Itsuki’s endings as being truly “good”. And indeed the other cast members would seem to agree.
“What’s your opinion on that?” Nao asks Sakuya, the pair of them apparently inadvertently witnessing the beginning of what Itsuki describes as “naughty nurse practice” during the summer holidays at the school.
“I think they should just go ahead and die,” says Sakuya with uncharacteristic hostility.
“We may be a couple of dummies, but we’re having fun,” says Asuka as the narrative comes to a close. “There, I admit it!”
One can only guess at who she’s trying to convince with those final words — us, or herself.
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