Nurse Love Syndrome: Nearest and Dearest

Although Kogado Studio’s visual novels Nurse Love Addiction and Nurse Love Syndrome are available as a set (known as Nurse Love Obsession), they’re actually very different experiences.

While Nurse Love Addiction primarily unfolds in a nursing school and deals with the shared traumatic past of a small group of students, Nurse Love Syndrome, at least on a first pass, is a rather more down-to-earth affair that concerns the struggles of a rookie nurse during her first year on the job.

For anyone who has ever experienced work-related stress and the mental health challenges that presents one with, it’s a difficult and emotional but rewarding read. And there’s a lot more to discover beyond that first playthrough, too. Let’s take a first look at the package as a whole, and what one of the routes through the narrative has to offer us.

Nurse Love Syndrome originally came out for PSP in 2011, predating Nurse Love Addiction by several years. Nurse Love Addiction was actually first to be localised, though; Nurse Love Syndrome didn’t come to English speakers until the tail end of 2019. Fortunately, while the two novels unfold in the same narrative universe, there are very few connections between them aside from a couple of thematic elements and occasional throwaway mentions of locations from the other title. As such, there isn’t really a “right” order to play them in.

The version of Nurse Love Syndrome we’re primarily concerned with in the coming articles is actually the third version of the game. The initial PSP release in 2011 was followed up a year later by a new version subtitled RE:Therapy, which featured expanded narrative content for the main characters, plus several completely new narrative routes. In April of 2019, RE:Therapy had a PlayStation Vita and Nintendo Switch port with improved character sprites and event scenes, and this forms the basis for the version we got here in the West.

I’m not here to pick technical fault in these games, as the narrative is by far the most interesting thing to talk about, but it is worth noting that the English Switch release of Nurse Love Syndrome has quite a few issues with prose and dialogue overflowing the available space in the on-screen text box. This happens frequently enough to be noticeable, and while reading the overflowing text is a simple matter of pulling up the backlog and reading it there — a single button press — some people may find that to be an issue to their enjoyment.

As far as I’m aware at the time of writing, the other versions of the game do not have this issue, perhaps due to their use of a different font. But I digress. The Switch version got a packaged release courtesy of Limited Run Games, so that’s the version I got, and if I could deal with it I’m sure you can.

In Nurse Love Syndrome, we follow the life of Kaori Sawai as she joins her local hospital for her first full-time job as a nurse. Fresh out of nursing school, Kaori is in two minds about her new life beginning: on the one hand, she’s realising a lifelong dream of giving back to the medical profession after her vague memories of being rescued from an accident as a young child; on the other, she knows she has a lot of work to do, and is extremely short on self-confidence in her own abilities.

Fortunately, she feels like she’s thrown a lifeline almost immediately after arriving for her first day on the job — she discovers that Nagisa, her old senpai from high school, has been working as a nurse at the same hospital for a year now, and, quite understandably, feels an enormous sense of comfort at having a familiar face to rely on.

It doesn’t take long for Kaori to start encountering difficulties though — right from the moment she has her reunion with Nagisa. She learns that, contrary to her own seemingly reasonable assumption that it would be okay to walk from the nearby dorms to the hospital in uniform, she is expected to change at work. This may seem like a small thing, but it’s just the first of many little mistakes that Kaori makes — and over time, all these little things gradually chip away at her self-esteem, which wasn’t all that high in the first place.

Things don’t get much better for poor Kaori when she arrives at the nurse’s station in the internal medicine ward where she will be working. Not only does she fumble her words during her self-introduction, she accidentally calls the chief nurse Hatsumi “onee-chan”, much to her embarrassment. And rather than just laughing it off, Hatsumi, a rather serious woman at the best of times, points out that “even if it’s unconscious, an irresponsible statement can worry your patients.”

Kaori’s first day on the job as depicted in Nurse Love Syndrome will be familiar to anyone who has ever started a new career and has found themselves panicking about all the things they don’t immediately know how to do. It’s easy to get wrapped up in all the things you haven’t learned yet and immediately assume you’re a failure — in extreme cases, this can lead to mental health conditions such as “impostor syndrome”, where you believe you are a fraud, despite there being ample evidence as to your own capabilities and qualifications.

Despite chief nurse Hatsumi’s seemingly stern nature, she takes Kaori under her wing and attempts to reassure her about what appear to be some common worries for new nurses. Kaori still isn’t quite sure what to make of things, though; despite having gone through nursing school, she seems to be immediately confronted with unfamiliar terminology, techniques she hasn’t had nearly enough opportunity to practice, and a sense of responsibility that she clearly doesn’t feel entirely ready for.

It’s understandable, then, that she comes to rely somewhat on Nagisa. While Nagisa is only a year her senior — and has plenty of her own struggles, as we see over the course of the narrative as a whole — Kaori has always looked up to her; idolised her, even. It’s clear from the way Kaori turns to her senpai in the early days of her employment that she sees Nagisa as almost infallible; this is, of course, not a particularly healthy way of looking at things, as Nagisa is most certainly fallible in her own right. She drinks too much, there are times she doesn’t take her job seriously enough, and there are times where she lets the emotional challenges of the job get to her a little too much.

Kaori fails to see any of this for a significant portion of the narrative, which is what leads to some pretty severe difficulties in the latter hours of Nagisa’s narrative route. It’s hard to blame her, though; latching on to the only familiar thing in a working environment that can, at times, be absolutely terrifying leads one to wilfully ignore the things that don’t fit your own “needs” at the time.

As Kaori continues to make mistakes in her early days on the job, she becomes increasingly scared of what the possible consequences might be — not helped by the combination of Chief Hatsumi and senior nurse Yasuko Yamanouchi continually emphasising the fact that mistakes can indeed be fatal. She finds herself in a position where it’s difficult to recognise or accept praise; she’s so used to messing things up that she becomes fixated on the negative side of things, and feels guilt about burdening her coworkers with her incompetence.

“When you’re new, that’s just what you do,” explains Nagisa, attempting to reassure her. “You make trouble for your coworkers. And if you feel even a little bad about it, then grow into the job fast and make things easier for me, all right? And make sure you help the newbie that comes in after you with a smile, no matter how much trouble they make for you! That’s how the cycle works. That’s part of being an adult. I made so much trouble for everyone last year that I really can’t complain about anything you do, Sawai.”

The whole “being an adult” thing is where Kaori seems to struggle the most. She seems like someone who has always been dependent on receiving clear, concise instructions from others and following through on them. When given a vague order or simply left to her own devices, that’s when she tends to find herself making the most mistakes.

Kaori finds it difficult to adjust to the fact that nursing is a job where you are frequently expected to use your own initiative, and where inaction can have severe consequences — and as such she becomes increasingly dependent on those around her for approval.

Kaori’s most significant troubles begin with the arrival of a patient called Sayuri Sakai. As part of her development, Chief Hatsumi assigns Kaori to be the main nurse responsible for Sakai’s wellbeing during her stay, but things don’t get off to a good start. She inadvertently sets an immediately poor first impression by being late to pick her up and get her settled in the internal medicine ward, but Sakai doesn’t help matters by being extremely rude to Kaori at every opportunity. It’s especially difficult to deal with for Kaori owing to the fact that the things Sakai says, while unpleasant, aren’t actually falsehoods; she’s simply a lot more willing to call out Kaori’s shortcomings than her peers.

Kaori finds dealing with Sakai increasingly difficult, and is often reduced to tears by her patient’s acid tongue. She sees the fact that she is unable to get through to her first “real” patient as a personal failing, and finds it difficult to accept the constant barrage of harsh criticism that comes her way — all the more because so much of it consists of things that, deep down, Kaori knows are absolutely true.

Acknowledging one’s own shortcomings is always a difficult thing to do, particularly when you were lacking in self-confidence in the first place. Kaori knows that she needs to change and improve, but doesn’t really know how to do it herself; whenever she’s confronted with any sort of evidence of her own inadequacy, she tends to retreat into a spiral of self-pity that she can’t get out of on her own. Instead, she tends to rely on the fact that, more often than not, someone will be there to tell her what to do next, and how to improve.

Sometimes this involves being on the receiving end of a scolding from the Chief; sometimes this means being joshed by the easygoing yet highly capable Yamanouchi; sometimes this just means cutting loose with Nagisa, drowning her sorrows and remembering that tomorrow is another day that you can — hopefully, anyway — approach fresh.

An important turning point for Kaori comes when she accepts an offer from Chief Hatsumi to engage in some after-work study sessions. Much to her surprise, she discovers that the seemingly unflappable, always perfect Hatsumi is, in fact, a complete sloven in her private life — and this helps to remind her that however perfect people might seem under certain circumstances, there are always situations that they, personally, find themselves having difficulty with.

Kaori actually finds herself in a peculiar position of “power” over the Chief when she helps her tidy up a bit, and the effect on her self-confidence is immediately noticeable. She opens up a lot more, she’s a lot more animated and she’s much more willing to make light-hearted comments. It’s certainly a far cry from the anxious, tearful Kaori we tend to see around the hospital, and it’s a valuable experience for her; it shows her that there is a lot more to someone than simply their professional performance.

One area where Kaori does manage to recognise her own strength is in emotionally engaging with patients. She knows from her own nursing training that she shouldn’t get too attached to individual patients, but at the same time she comes to recognise quite quickly that being a good nurse is not just about providing solid medical care; it’s also about taking care of a patient’s emotional needs.

As we’ve already seen, she struggles somewhat even with this side of things when it comes to Sakai, but it’s another matter when we look at her relationship with Ami Asada, a somewhat sickly high school girl who we get the distinct impression has been in and out of hospital quite a bit over the course of the last few years. Ami is the sort of person who seems perpetually overflowing with positive energy and Kaori immediately recognises that this makes the people around her feel better — but she’s also quick to notice when something isn’t quite right.

Upon realising that this is something she has a talent for, Kaori finds herself able to approach her work with a certain amount of renewed vigour. While she recognises that she still has shortcomings — some of which she probably “should” have overcome by now in some people’s eyes — she knows that she does have at least part of what it takes to be a good nurse. Or so she believes, at least; a conversation with Sakai shakes her belief in this a little.

“Do something for someone and that just makes them dependent on you,” says Sakai. “They lean in on you and devour everything you’ve got. Not giving people something for nothing is true kindness. When people think someone will always be there to help them out, they stop putting in effort on their own. People fall pretty easily, don’t they? And the charity of others is nothing but poison. Not that I’d expect someone who thinks herself as kind as you do would understand that.”

There are a few layers to this worth considering. Firstly, Sakai is effectively arguing that the relationship between nurse and patient is not simply the patient sitting back while the nurse does everything to help them. This is, in fact, true; at numerous points in the narrative, we see instances of patients ending up coming back to the hospital because they took their nurses’ advice for granted, failed to follow clear medical instructions after being discharged, and ended up coming back in a worse state than when they left.

Secondly, though, it’s pretty easy to see how this applies to Kaori. While Kaori believes she’s been doing a good thing by being kind to her patients, in Sakai’s eyes she’s also been taking advantage of the kindness of people like Yamanouchi, the chief and Nagisa. While it’s good to have people you can rely on in a pinch, it can be dangerous to depend on others too much. Because dependency can leave you very vulnerable.

We start to see this first-hand as Kaori, seemingly out of nowhere, starts to receive a series of phone calls, text messages and emails that appear to be threatening her. What makes it all the more terrifying to her is the fact that she doesn’t know why this is happening — and of course, this drives her into the arms of the person she trusts the most in the world, Nagisa.

Not only that, it starts leading her to believe that she somehow “deserves” abuse for her failings. When a furious Sakai bites her on the arm in retribution for a botched needle insertion, Kaori’s reflection after the fact is not that she has just gone through something completely unreasonable and unacceptable — but that she deserves it, as it “just might be what helps me understand our patients’ pain, especially hers.”

It doesn’t help that from this point on, everything Kaori does seems to end in failure. Most notably, she attempts to apologise to Sakai and reconnect with her through a heartfelt letter, but ends up violently rebuffed. And this only causes her to spiral further and further out of control, focusing on the negatives and discounting the positives entirely. And all the while this is going on, the harassment is getting worse and worse. It affects Kaori’s mental state so severely that she reaches a point where she believes simply opening her front door means she will die.

Part of Kaori’s issues in this regard stem from the repressed memories of the accident she was in as a child. She can’t remember the details of what happened, but she does remember a few things that people apparently said to her — and her memory of the face of the driver who caused the accident left her with a longstanding fear of men. She comes to associate the harassment with her recurring nightmares of the accident, and comes to believe that “the man in the car” is coming to kill her.

At the same time, Kaori is becoming increasingly conscious of the fact that she probably shouldn’t rely on Nagisa all the time. Nagisa is insistent that Kaori shouldn’t feel bad about this, however — and in fact encourages Kaori to count on her. But, unfortunately, this isn’t something sustainable; Nagisa finds herself transferred out of the internal medicine ward into the surgical ward, thereby fulfilling her own dream but separating her from Kaori.

Neither Kaori nor Nagisa are completely okay with this, since both have conflicting feelings. Kaori knows that she shouldn’t rely on her senpai all the time and, in some respects, feels that being forced to strike out a little more on her own will be good for her; at the same time, though, she is understandably loath to lose her safety net, not just at work, but in her personal life, too.

Nagisa, meanwhile, seems reluctant to leave Kaori behind, for both personal and professional reasons. As Kaori’s immediate senior in the internal medicine ward, Nagisa has found the opportunity to develop her own skills through helping Kaori valuable, and as her friend she has been happy to be the first person Kaori turns to when she is in trouble. It’s obvious that there’s a strong emotional attachment there — but neither Nagisa nor Kaori will admit it outright, with Kaori preferring to put up a front of being strong “for Nagisa” rather than being truly honest about her feelings.

The foundation of any relationship is good communication, and that’s exactly what Nagisa and Kaori are lacking here. From an outside perspective, it’s obvious that Kaori and Nagisa will probably be better off together — although perhaps with a little more equality in their relationship rather than one being dependent on the other. But each of them do what they believe is “best” for the other — without actually consulting said other as to what would really be “best”.

Kaori’s work suffers almost immediately as a result of Nagisa’s absence. She becomes distracted and distant, and flip-flops back and forth between assuring herself in her own internal monologue that she wants to “get on the same level” as her fellow nurses, but the moment doing so starts looking like it might be a bit challenging, she shies away and retreats back into herself.

It’s an accurate depiction of how work-related stress can make one feel, particularly when you have no outlet for that stress. You start to feel like everything you do is for naught, and that you will never reach a point where you can just treat your job as an everyday part of life. Even performing the basic tasks expected of you can feel like an exhausting effort, and actually going above and beyond those fundamentals — as is often required in a profession such as nursing — can feel like an insurmountable challenge. Sometimes you feel like your only option is to go and find a secluded spot and cry your eyes out for a bit, simultaneously hoping that someone finds you so you can tell them all about how you’re feeling… and that no-one ever sees you in such an embarrassing position.

Kaori doesn’t notice this immediately — perhaps because she’s going through it herself, and is thus rather self-absorbed — but this is exactly what Nagisa is dealing with. It’s some typically barbed comments from Sakai that bring things somewhat into focus for her; Sakai notes that Nagisa “just makes excuses for what she can’t do, and doesn’t even try to do what she probably can”. This is all true of Kaori to a certain extent, too — but hearing Sakai talk this way about another person, a person whom Kaori had previously regarded as infallible, is a bit of a wake-up call.

Things only escalate as various characters catch glimpses of what is going on with Nagisa now that she is separated from Kaori and supposedly following her dream of being a surgical nurse. It seems her transfer has not gone all that well, and that the surgical ward’s practice of “hazing” newcomers has been taking a heavy emotional toll on her. It has led to her becoming sullen and uncommunicative — which naturally only attracted further attention from the bullies. On top of that, her desire to see Kaori continue to rely on her even in her absence sees her resorting to increasingly unreasonable behaviour — we as the audience can doubtless reach some conclusions in this regard before the narrative reveals it explicitly.

Things come to a head after Nagisa’s frustration with her situation — plus a patient pulling a prank that goes wrong, leaving Kaori with an injured ankle — leads her to contemplate suicide. And the outcome of the situation is determined through a series of choices where Kaori interacts with a young girl she has been seeing in her dreams over the course of the narrative as a whole, but whose presence isn’t fully explained in this particular path.

By picking the options which cause Kaori to reflect properly on the situation and admit the things she needs to do in order to move forward, we reach the “good” ending. By picking the options where Kaori refuses to listen to the truths buried in her heart and effectively “runs away”, meanwhile, things end significantly worse for both her and Nagisa — and perhaps not in the ways you might expect.

I’ll save the details of the three possible conclusions for you to discover, but suffice to say that there are lessons to be learned here — both for the reader, and for Kaori. Since we’ve been following along with Kaori’s narration for the duration of Nurse Love Syndrome, it’s easy to come to the conclusion that she was the only one suffering — but as the latter hours of Nagisa’s narrative path prove, everyone has their own burdens to bear, and everyone deals with those burdens in different ways.

In the worst possible cases, those burdens, if unacknowledged or unshared, can cause us to act irrationally — perhaps with devastating, irreversible consequences. Sometimes, the right thing to do is to admit your own weaknesses and honestly consider what you might be able to do about them — either by yourself, or with the help of others. And asking for help from others is not the same as becoming dependent on them, particularly if you’re willing to grow and change as a result of their assistance.

“It hurts to hide how you truly feel from the person you love, when you do it for their sake,” muses Kaori to herself. Communication and honesty are key; bottling things up helps no-one, and can end up having consequences that affect not only you, but your nearest and dearest around you.

This is a lesson that is repeatedly driven home to Kaori in her professional life throughout the narrative — but it’s something that applies just as much to life in general outside of nursing. No-one, however alone they might feel at any given moment, is completely isolated from the people around them; nothing is truly without consequences; no-one can simply cease to exist without someone shedding a tear for them.

It takes time for both Kaori and Nagisa to realise this, and at the end of the narrative both of them still have a long way to go in terms of accepting and acknowledging their respective pasts and presents. But together they are stronger; together they can overcome the challenges ahead of them. And while there are parts of their relationship we can quite reasonably look at and consider to be a little unhealthy, that, too, is something they can work on in the long term.

By the end of Nagisa’s route, both she and Kaori have been through a lot, and there have been times when each of them looked to be in danger of not “making it”. But as we leave them behind, we can be a little more confident that they are taking their first steps on a whole new journey — and the terrain ahead of them is far less treacherous than the paths they have walked alone up until now.

More about Nurse Love Syndrome

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5 thoughts on “Nurse Love Syndrome: Nearest and Dearest”

  1. It’s interesting to contrast this game with your writing about NL Addiction. In that game the girl’s problems were all melodramatic and exciting, in this one, they all seem to be realistic and depressing.

    I’m sure the realism allows for much more in terms of emotionally nuanced story telling, but I have to admit I don’t think I’d enjoy playing a game like this. If anything, it seems to be a huge dose of the kind of everyday unhappiness that most games exist to offer an escape from.

    Liked by 1 person

    1. The contrast between the two is really interesting; I was expecting two rather similar experiences but so far they couldn’t have been more different.

      For me, a nice dose of relatable misery in a visual novel is actually rather appealing; I enjoy getting my emotions fully engaged with something like this — and to be honest, it’s actually oddly comforting to see someone else going through if not the exact situation you might have been through yourself, then at least something like it.

      I felt for Kaori throughout this because I’ve been there with work-related stress; I’ve been in the “I want to go and cry in a stairwell and I both do and don’t want someone to find me” situation. In my case, it was teaching, not nursing, but it led to a lot of the same feelings — particularly that feeling of questioning whether or not you’d be able to make it through the next day.

      I can completely understand why that might not be for everyone, though! 🙂


      1. I can definitely respect that perspective. I think I had something similar with Evangelion, which was less for me a story about giant robots and alien invaders as it was an exploration of the struggles of the psyche. It was encouraging to be able to relate to those characters, as it helped me understand I wasn’t alone in the way I felt.

        Liked by 1 person

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