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1* AluminumChristmasTrees: The ability to adopt a Fennec Fox as a pet may seem far fetched and illegal but they actually are sometimes sold as exotic pets.
2* AssPull: Many see Rafael's reason to stay in Book 3 as this, since it took him ''less than a month'' to get a physical therapist license. According to him, this was possible because some of his credits as paramedic overlapped with the required ones for the new job, which is false, as many readers involved with the process pointed out.
3* BaseBreakingCharacter:
4** To his supporters, Dr. Ethan Ramsey is a genius and a JerkWithAHeartOfGold who shows tough love to Casey given that he's their boss. To his detractors, he's a condescending jerk who takes every opportunity to bully and belittle the interns, doesn't understand that they clearly feel stressed and overwhelmed, acts unprofessionally towards patients as well, and throws tantrums every time something doesn't go his way. His romance route is either adored for being a proper slow-burn romance or hated for making him similar to a teacher who abuses his position to get Casey.
5** Dr. Jackie Varma is either viewed as a GloryHound who wants to get ahead, or someone who is showing Casey how to stand up for themselves. She becomes more divisive after Casey decides to enter the competition. She initially states that she won't take the competition personally, [[{{Hypocrite}} but later starts to treat Casey differently after she drops in the rankings]], which turned many readers against her either as a romantic interest or a friend. Her supporters, on the other hand, admire her for taking the competition seriously and point out that it's not her job to help her fellow competitors. They also appreciate that her relationship with Casey is realistic, that competition can strain friendships, and Jackie can fail to live up to her ideals like anyone else. She won back a lot of support when she agreed without hesitation to participate in Casey's plan to help Mrs. Martinez, and then backed them up when they confronted [[spoiler:Landry]] about sabotaging them in the competition and snitching on them to Mrs. Martinez's family, stating that she'd rather win the competition fair and square than resort to cheating.
6** Dr. Aurora Emery. On one hand, many players like her for her determination to step out of her aunt's shadow, strictly professional behavior towards both patients and co-workers, and gradual respect for Casey. On the other hand, there are players who dislike her for her initially cold, aloof behavior towards her co-workers, particularly Casey. Chapter 4 in particular is a controversial moment for her. While everyone agrees that her dismissal of Dolores’ case was unacceptable, given that Dolores was a pregnant woman admitted for “smoke inhalation” and later died from childbirth, the real debate comes from her character and the context surrounding her actions and motivations, especially after it's revealed that her dismissal is part of her plan to no longer be on the top of the list. While a few people think she crossed the MoralEventHorizon, many people view this as proof that she needs CharacterDevelopment, given her complex motivations and interactions with her aunt, co-workers, and patients, while continuing to characterize her as initially aloof, as they've noted her softness towards Annie and Tommy Liu. They also express their anger at being forced to hate her.
7** Rafael Aveiro. One side sees him as a selfless hero who easily gets along with others and is willing to risk his life to save lives even when he's not in the position to do so. Another side sees him as a reckless idiot who needlessly wastes hospital resources, such as using a paramedic helicopter for a joyride if the premium option to fly with him is chosen and disregarding safety protocols during the train derailment accident. Book 2 turns this up even further with the introduction of his NewOldFlame Sora.
8** Even Casey is subject to this during the situation with Mrs. Martinez. Their supporters praise them for being a dedicated intern who cares for their patients, courage and perseverance in the midst of despair-inducing moments, and standing up to a CorruptCorporateExecutive. Their detractors condemn them as a DesignatedHero and think their license should have been revoked for reckless and entitled behavior, deluding themselves into thinking they're serving their patients' best interests, stealing a medication with a mortality rate and then administering it without documenting it, and not informing their senior residents or attending.
9* BestLevelEver: Book 2 is widely considered to be a considerable step down from Book 1. This didn't stop Chapter 10 and especially Chapter 11 to be widely considered not only the best chapters in the series, but among the greatest chapters of any Choices series, due to being an absolute DramaBomb from start to end, featuring some of the most nerve-wracking, heartwrenching scenes in this series.
10* BrokenBase:
11** As a career-based story, the ability to choose Casey's gender has sparked some debate. Some players believe Casey should've been exclusively female because women have a tougher time in STEM careers like the medical field than men do, such as underappreciation and exploitation by men. It would also make certain moments in the plot involving white men more emotional, such as Casey's relationship with Ethan that can cause people to question Casey's credibility even more [[spoiler:and Landry sabotaging Casey]]. Other players think the story is already fine with gender options because they point out that men also suffer from discrimination inside the medical environment, like male nurses or LGBT doctors, and genderlocking the book would needlessly alienate players who are more comfortable playing as a male protagonist, besides that the discrimination point can be refuted by [[https://www.washingtonpost.com/health/the-big-number-women-now-outnumber-men-in-medical-schools/2019/12/20/8b9eddea-2277-11ea-bed5-880264cc91a9_story.html the new statistics that show that now there's more females in the medical field than men]]. They also point out that Male!Casey succeeds not because of prowess, superiority, or other stereotypical masculine traits, but because of the simple desire to help others, which adds a nice touch to his character development.
12** Throughout Book 1, players are split on Casey's ShipTease with Kyra Santana until Chapter 11, when a premium scene where the gang goes skydiving pretty much revealed that she is ''[[ShipSinking not]]'' a love interest[[note]]The player is given a chance to share a brief romantic moment with someone during the fall: Bryce, Jackie, and Rafael are included as options but Kyra is not. Once everyone touches down, Kyra is seen making out with the group's instructor[[/note]]. One group approves of this and express their disappointment that she's not an official love interest because they find it refreshing to encounter a cancer patient with a cheerful and optimistic outlook on life, and also because they are upset with the skewed love interest ratio of 3 males to 1 female. Another group disapproves of this because they think it's unethical for a doctor to pursue a relationship with a patient.
13** Rafael's storyline of reconnecting with his NewOldFlame in Book 2 is extremely controversial. Players who romance him (and even some who don't) deride it as a DeusAngstMachina since Sora wasn't mentioned at all in the first book. A second camp is fine with it since it gives him some conflict between him and Casey.
14* CatharsisFactor:
15** The premium choice to help Sienna break up with Wayne is this, primarily because of his dismissal of her job as a doctor and selfishly demanding that she cater to him even after she just saved patients from a subway crash.
16** Chapter 15 has Casey pointing out to Aurora that despite her own issues with her family name and how others try to suck up to her, she has been pushing people away, including Casey when she could've given them a chance. This happens regardless of whether the player chooses to console her or tell her off. Players felt that this is the issue that needs to be addressed to Aurora as part of her character development.
17** Chapter 17 has Casey being able to give Declan Nash a punch in the face after their hearing. The same chapter has Sienna dump Wayne once and for all if the premium scene in Chapter 14 wasn't taken.
18* CreatorsPet: While Book 1 already puts more focus on Ethan Ramsey than other love interests, Book 2 puts even more focus on him to the point that almost every chapter has at least one premium scene involving him. Book 3 is even worse, as he gets so much screen time it comes at the expense of other love interests, especially in the first half of the book. It gets to the point that Ethan is regarded as Pixelberry's most beloved pet.
19* DesignatedHero: Esme Ortega. She's supposedly a great doctor, but she nearly gets a patient killed due to poor diagnosis, and Casey is required to support Esme in the matter. She's also incredibly secretive and abrasive, even if she is sided with [[spoiler:in regards to Levi's death]].
20* DesignatedVillain: Aurora Emery. Much of Book 1 has Casey showing hostility towards her just for minding her own business and trying to avoid sycophants in her own guarded way. In Book 2, the narrative makes Aurora look naïve even though Carrick has been manipulating her all along.
21* DieForOurShip:
22** Harper Emery often receives this from players pursuing Ethan as a love interest since it was revealed that they were in a relationship. They assume Harper is trying to steal Ethan from Casey by having them fired from Edenbrook.
23** Poor Sora. Rafael fans are furious with them for renewing their relationship with him.
24* EnsembleDarkHorse:
25** Dr. Sienna Trinh already has several fans for rescuing Casey from Dr. Ramsey's scolding, standing up to a rude frat boy at a bar, and suggesting that her, Casey, Jackie, Landry, and Elijah all rent an apartment together after they bemoan their current living conditions. She's also beloved for being an absolute sweetheart.
26** Kyra Santana instantly gained fans upon her introduction, both for her cheerfulness and determination in the face of being treated for cancer, as well as her beauty and flirty personality. She gained even more admirers for her determination to go through chemotherapy so she could have a chance to live.
27** Despite their minimal screentime, the fanbase absolutely adore Dr. [[DeadpanSnarker Zaid]] [[DefrostingIceQueen Mirani]] and [[TeamMom Ines Delarosa]] for their dynamic together and concern for the interns.
28** Dr. Elijah Greene is popular among players for his witty comments, friendliness, loyalty to his friends, and dedication to saving lives previously thought hopeless.
29** Among the Book 2 interns, Jackie's intern Gary Garrison is the most popular because he's the only intern that doesn't get into serious trouble in the hospital and unconditionally develops into a capable doctor without getting into trouble.
30** Tobias Carrick became this after becoming a regular character in Book 3. Many fans who were disappointed by Ethan's character arc wished Tobias could take over the love interest spot from him, and by the end of Book 3, many players chose to stay at Edenbrook just to make Tobias the new leader of the diagnostics team.
31* FanNickname:
32** Landry Olsen is often nicknamed "Laundry", especially after [[spoiler:players correctly suspected him of sabotaging Casey.]] This evolves to "Dirty Laundry" [[spoiler:when he's confirmed to be the saboteur out of petty jealousy.]]
33** The female faces for Casey, which are reused in several books in 2019, have come to be known as the Meredith Grey faces, after the protagonist of ''Series/GreysAnatomy'', the inspiration for this series.
34** The BDSM scene with Ethan in Book 3, Chapter 8 has come to be known as "Fifty Shades of Ramsey".
35* FanPreferredCouple:
36** Zaid/Ines is universally supported by the fandom due to their individual popularity and interaction together when they counsel Casey regarding Mrs. Martinez's situation and when they celebrate [[spoiler:after Casey wins their ethics hearing]]. Because of this, many fans have expressed disappointment when it is revealed in Book 3 that Ines has a girlfriend (who she later marries).
37** Fans have been very vocal about wanting to romance Aurora, Elijah, Sienna, and (after the reveal that she is not a Love Interest) Kyra. Book 2 adds Esme and June into the mix.
38** A lot of people want to be able to romance or hook up with Harper Emery due to her attractive character design, though some are creeped out by the age and power difference, and/or the fact that there have been hints that her niece Aurora is being set up as a Love Interest in Book 2.
39** Quite a number of fans want to have a choice to flirt / hook up with Tobias Carrick (and / or having a threesome with him and Ethan) due to the sheer amount of tension he expressed toward Casey. Chapter 11 [[spoiler:where he rushed to Edenbrook and lending Mass Kenmore staff and resource to synthesize a cure for the maitotoxin]] has won over a lot people into this camp. The support for this got bigger in Book 3, where Tobias character is shown in a better light, with many wishing to drop Ethan and take him instead.
40* FirstInstallmentWins: Players consider the first book as the best in the series because of the development among the characters before many of them were sidelined in subsequent books.
41* FranchiseOriginalSin: Not for this story, but for Choices in general. The female faces for Casey have been used in several subsequent books (most of which were released in the same year as this one) which some people consider lazy, to the point of labelling a book as subpar in quality if it has these reused faces.
42* IKnewIt: Many players correctly guessed that [[spoiler:Landry Olsen was the one who told Mrs. Martinez's family that Casey indirectly contributed to her death, and that he's also the one who's been sabotaging Casey in the competition.]]
43* JerkassWoobie: Mitch Keller, Sienna's intern, eventually became this. While he never respected Sienna and always got her to do his work for him out of laziness, his co-workers bullied him after Sienna snapped at him and revealed that he wet himself during a difficult case, causing him to quit.
44* MemeticMutation:
45** Before the story premiered, many fans were making jokes along the lines of "Well I guess all my patients are going to die because I'm not going to spend diamonds to save them," referring to Choices' tendency to put favorable outcomes behind paywalls (and [[VisualNovel/TheCrownAndTheFlame other]] [[VisualNovel/VeilOfSecrets Choices]] [[VisualNovel/AcrossTheVoid stories]] ''have'' forced the player to spend diamonds to save someone's life). The jokes gradually died down once it became apparent that saving lives was not going to be paywalled.
46** “Dr. (Name). I like the sound of that.” It involves people abusing the HelloInsertNameHere feature and giving their character names of other famous or fictional doctors or scientists, such as Dr. Pepper, Literature/{{Frankenstein}}, [[ComicBook/DoctorDoom Doom]], [[Music/MotleyCrue Feelgood]], and [[WesternAnimation/PhineasAndFerb Heinz Doofenshmirtz]].
47** "Dr. Ramsey has no diamonds." - The joke is mostly about how the romantic moments between Casey and Dr. Ramsey seem to be separated from the rest of your friends, as well as the fact that his romance proceeds much more slowly than the other love interests even when you pick the premium scenes, which led many to joke that he has no diamonds to spend time with Casey.
48** Many players compare Ethan to a giraffe because his neck looks longer than those of other characters.
49* SugarWiki/MomentOfAwesome:
50** The premium choice in Book 1, Chapter 14 for both Casey and Sienna to lay a TheReasonYouSuckSpeech to Wayne as she finally breaks up with him.
51** The very free choice in Book 1, Chapter 17 to punch Declan Nash in the face after the hearing.
52* MoralEventHorizon: Landry crosses this by [[spoiler:sabotaging Casey's pager and messing with their charts out of petty jealousy, disrupting their ability to treat patients in the process.]]
53* NoYay: When the series debuted, there were a fair amount of people turned off by Kyra Santana's nature, because it was believed she might be a romantic option, and a doctor having a relationship with a patient was deemed inappropriate. However, once it was revealed she was just flirty and the relationship was chaste, fans gravitated to her.
54* TheScrappy:
55** Sienna’s boyfriend Wayne instantly became hated due to his condescending and dismissive attitude towards his girlfriend and her co-workers, refusing to acknowledge that doctors have stressful and demanding jobs. Many chose the premium option to help Sienna break up with him, as it allowed them to blow off steam at his callous attitude.
56** Landry Olsen quickly became hated after the reveal that [[spoiler:he sabotaged Casey's job as an intern by turning off their pager, hiding their charts, and spreading malicious rumors about them, all because he was jealous of Casey getting to spend time with Ethan. Even more so when he didn't apologize for his actions. Many players are glad he got PutOnABus at the Book 1 finale.]]
57* ScrappyMechanic: The 3:1 ratio of male to female love interests has been heavily criticized, especially since the book is not gender-locked.
58* SeasonalRot: Book 1 of the series is widely liked for its drama, the heartwarming and funny relationships between the characters, and the fact that many of Casey's choices have lasting outcomes, culminating in the hearing in Chapter 17 where nearly ever choice they made over the course of the book is mentioned in some capacity. The other two books...not so much.
59** Many players consider Book 2 to be weaker than Book 1 because of the excessive focus on Ethan Ramsey over the other love interests and poor plot pacing. Even outside of being love interests, Rafael and Jackie are almost nonexistent, and Bryce only barely more. The new characters introduced - Esme Ortega, June Hirata, and Baz Mirani - are criticized for not being as fully developed as they should be.
60** Book 3 makes Book 2 look like Book 1 by comparison. While Book 2 ''was'' weaker than Book 1 by most accounts, it still introduced several fun characters (even if they were sidelined), the friendship drama was still believable, and the middle chapters (particularly [[WhamEpisode Chapter 11]]) were both heart wrenching and well-written. Book 3 writes several characters out of the series (some of them without much fanfare at all, some of whom have been supporting characters since the beginning) and reduces the screentime of other characters to maybe a couple of scenes in the entire book, the plot is even more disjointed, Casey has become too perfect and Ethan TookALevelInDumbass, especially in Chapter 8 when he pulls a page out of ''Literature/FiftyShadesOfGrey'' and has Casey up for some {{UsefulNotes/BDSM}} (something that turned off people who were even going for him from the start), and the ending is rather anticlimactic.
61* StrawmanHasAPoint:
62** Harper Emery may be a huge stickler for the rules, but she has a point that having Ethan testify on Casey's behalf isn't a smart move because of his bias in Casey's favor, and biased witnesses have clouded judgments that weaken their reasoning and credibility.
63** Declan Nash might be a stereotype about pharmaceutical company greed, but the cure his company is holding for Rhodes is not ready for the market given its mortality rate.
64* TearJerker:
65** Dolores Hudson dying in childbirth, leaving her son, Ethan, without either of his parents. Many agree that it's one of the saddest scenes in all of the Choices stories.
66** Mrs. Martinez dying a week after receiving an experimental treatment for her condition.
67** The deaths of [[spoiler: Danny and Bobby]] in Book 2, Chapter 11, and the resulting funeral in the next chapter. The same chapter also has [[spoiler: the near-deaths of Casey and Rafael, complete with an emotional bonding moment between the two in what could have been their final hours]].
68** Leland Bloom learning that his wife Caroline is deathly allergic to him as a result of his new kidney. Because of this, they had to sleep in different beds and couldn't embrace each other physically without Caroline getting severely sick.
69* TheyWastedAPerfectlyGoodCharacter:
70** Bryce Lahela and Jackie Varma are written as flawed but believable interns implied to have more nuance than meets the eye, but there are no opportunities to explore them because of Pixelberry devoting their efforts on [[CreatorsPet Ethan Ramsey]] at the expense of other characters.
71** A number of players hate Declan Nash's characterization as an over-the-top CorruptCorporateExecutive when his motive for [[StrawmanHasAPoint not releasing the cure for Rhodes also includes its mortality rate, in addition to wanting to make a profit]].
72* UnintentionallyUnsympathetic:
73** In Book 1 Chapter 15, Aurora expresses her frustration at everyone trying to use her because of her connection to Harper Emery, as a means to give her character more depth explaining her cold and overly guarded behavior. However, Casey points out that her decision to behave this way has backfired on her because the treatment she gets is not a justification to push other people away, including towards people who might even want to be genuinely friendly with her.

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