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Visual Novel / Open Heart Choices

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(Not to be confused with the TV series of the same name.)

Open Heart is one of the many Visual Novels from Pixelberry's Choices: Stories You Play collection. A Medical Drama, this story stars you, a new intern at Boston's Edenbrook Hospital, serving under the renowned and demanding Dr. Ethan Ramsey. Can you save your patients' lives?

Contains examples of:

  • Actually, I Am Him: Book 1, Chapter 9 has Nigel Platt demand to see Dr. Ramsey’s manager when he tells him to stop being a rude jerk. That’s when Ramsey tells him he is the manager.
  • Aluminum Christmas Trees: 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.
  • And Now for Someone Completely Different: In Book 2, Chapter 11, you get to play as Bryce and Ethan for the first time, since Casey has become infected and been put under quarantine.
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  • At the Opera Tonight: A premium date with Ethan in Book 1, Chapter 12 has him take Casey out to the opera for them to get over Mrs. Martinez's death.
  • Baseball Episode: Book 1, Chapter 5 has Casey and the interns go out to a baseball game where Casey can end up on the kiss cam. Book 2, Chapter 8 is another, with Edenbrook versus Mass Kenmore in a game of baseball.
  • Bedsheet Ladder: A premium scene in Book 1, Chapter 1 with Dr. Ramsey has his patient, Barbara, threatening to do this.
  • Betty and Veronica: The love interests are divided this way. The Bettys are Bryce (charming and easy-going) and Rafael (courageous and selfless). The Veronicas are Ethan (aloof and strict) and Jackie (blunt and competitive).
  • Big Disaster Plot: Book 1, Chapter 14 involves a subway derailment.
  • Birth/Death Juxtaposition: Book 1, Chapter 4 has this with Dolores dying and her son being born.
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  • Book-Ends: Both Casey's first day on the job and first day back has a patient collapsing in the reception lobby.
  • Busman's Holiday: Book 1, Chapter 5 has this with the interns responding to an emergency when the pitcher for the Boston Nighthawks collapses on the mound.
  • Cliffhanger: Book 1, Chapter 15 ends with Casey realizing what's wrong with Dr. Banerji.
  • Color-Coded for Your Convenience: Book 1, Chapter 14 involves this for triage victims. Green for minor injuries, yellow for injuries that are serious but not life-threatening, red for major life-threatening injuries, and black for patients who are dead or too far gone to save.
  • Content Warnings:
    • Book 1, Chapter 4 opens up with a warning that it covers childbirth and trauma.
    • Book 2, Chapter 7 opens with another content warning, this time related to prescription drug abuse, specifically an anxiety sufferer who tried to commit suicide by deliberately overdosing on their anxiety medication.
    • Book 2, Chapter 15 starts with the warning that the chapter contains disscussions regarding medically-assisted suicide.
  • Death by Childbirth: Dolores Hudson, Dr. Ramsey's first patent when he was an intern, dies giving birth to a son in Book 1, Chapter 4.
  • Dr. Jerk:
    • Dr. Ethan Ramsey presents himself as a cold and stern mentor figure, but Casey can make him open up with Premium choices.
    • Dr. Aurora Emery treats all her fellow interns with disdain, only displaying an affable front to her patients and superiors.
    • Landry is completely uninterested in his patients on a personal level and tries his best to avoid interacting with them socially.
  • Fictional Counterpart: The baseball game in Book 1, Chapter 5 features the Boston Nighthawks facing their hated rival, the Manhattan Stingrays, clear stand-ins for the Boston Red Sox and New York Yankees.
  • "Friends" Rent Control: A premium choice apartment in Book 1, Chapter 3 is this, especially with the rent being $10,000 a month. Casey, Elijah, and Sienna do this by either offering their landlord free cookies from Sienna or pointing out the reality that the tech bros would have enough money for the first month and that venture capitalism is another word for communism.
  • Fun with Acronyms: Nigel Platt, the patient of Book 1, Chapter 9, is called a PITA, aka pain in the ass.
  • Hollywood New England: The story takes place in Boston, Massachusetts. A premium choice date with Bryce in Book 1, Chapter 4 is in Somerville. A premium choice date with Rafael has him fly you to Cape Cod.
  • Hospital Hottie: Casey’s first meeting with Jackie and Bryce happens in the lockers, while both of them are still in their underwear.
  • The Intern: The story’s focus is around Casey Valentine (the main character), a medical intern, during their three year residency at Edenbrook Hospital.
  • Ironic Echo: Book 2, chapter 15: When Jackie posts the evidence of Declan's dirty business to the internet, she smugly states "payback's a bitch, ain't it?" to his face. Later on, it's revealed that the partnership between Mass Kenmore and Edenbrook is off. Sure enough, when the doctors go to check Declan's old hospital office, it's empty except for a post it note containing Jackie's words from earlier.
  • It's All My Fault: Casey can feel this way about giving Annie antibiotics that she's deathly allergic to.
  • Labcoat of Science and Medicine: The Premium outfit for Casey is a white doctor coat while the standard option is a plain scrub uniform.
  • Local Hangout: Donahue’s is the bar where the residents from Edenbrook go after work; even Dr. Ramsey drinks there frequently.
  • Magical Defibrillator: Subverted as it's played out like a proper one does to get a proper heart rate going instead of just outright reviving Annie. She still needs to be intubated and given epinephrine.
  • Medical Drama: The story as a whole.
  • Nerves of Steel: Casey has choices to have these. In a premium choice with Bryce in Book 1, Chapter 2, he shows his by nailing the bullseye on the dartboard if Casey chooses to sing an annoying song.
  • Nice Job Fixing It, Villain!: Declan invites Mrs. Martinez's son, Luis, to Casey's hearing in hopes of getting them fired. However, Dr. Ramsey had showed Luis the photo of his mother in Paris and he realized how much Casey made her happy. This made Luis announce to the panel that's he dropping the lawsuit entirely, improving Casey's chances of a fair hearing greatly.
  • Parlor Games: Book 1, Chapter 13 has the group play Charades with Casey pairing up with Jackie, Sienna or Landry. A premium choice can allow Elijah and Phoebe to get closer.
  • Plot Allergy: Book 1, Chapter 2 reveals that Annie is allergic to the antibiotics used to treat her.
  • Reassigned to Antarctica: Zaid threatens to do this to anyone who misbehaves during the governor's visit in Book 2, Chapter 2. Elijah thinks it sounds like fun.
  • The Reveal: Book 1, Chapter 14 reveals Landry was the one who tipped off the Martinez family and was the one sabotaging Casey.
  • Rewatch Bonus: Landry's scenes are seen in new light before he's revealed to have sabotaged Casey.
  • Shout-Out:
  • Sleep Cute: Book 1, Chapter 6 has this with Sienna and a nurse, Danny, having fell asleep next to each other after the party.
  • Stag Party: A premium date with Bryce in Book 1, Chapter 8 has Casey and Bryce joining one in an act of spontaneity.
  • Stern Teacher: Dr. Ramsey mixes this with Secret Test. He gives Casey plenty of time to figure out what happened to Annie on their own, instead of just giving the solution. Casey can reprimand him for this or thank him for giving them the chance to learn.
  • Successful Sibling Syndrome: Aurora feels this way about her aunt Dr. Harper Emery, a doctor with almost the same level of renown as Dr. Ethan Ramsey.
  • Symbol Swearing: A premium choice allows Sienna to break up with Wayne in Book 1, Chapter 14. One of Casey’s options is just a long string of these.
  • Team Pet: Book 1, Chapter 12 allows you to buy either a pet turtle named Mitch, a chinchilla named Andi, a fennec fox named Furball, or buy all of them.
  • Tonight, Someone Dies: The start of Book 2 has a Flash Forward, showing Casey attending a funeral of someone close to them, It's not stated who it will be, all we know is that someone will kick the bucket before the end of the book. It's revealed to be Nurse Danny Cardinal and a security guard, Bob Gunderson, who were caught in an assassination plot against Senator Ed Farrugia.
  • Urgent Medical Alert: The very first case for Casey is a woman who suffers a hemothorax in the reception lobby. Some other patients offscreen get this as well. When Annie gets an allergic reaction to the antibiotics, the only doctor around to help is Jackie.
  • Wham Episode:
    • Book 1 Chapter 7. Casey discovers that Patient X is Dr. Banerji and that he's dying.
    • Book 1 Chapter 12. Mrs. Martinez is cured of her Rhodes disease with an experimental serum that has a 40% chance to kill her, a chance she'll gladly take than stay cooped up in the hospital. A few days later, she dies in Buenos Aires. Ethan finds out that Dr. Banerji only has a month to live, and Casey is brought before Harper to learn that Mrs. Martinez's family is demanding an autopsy of her and if they discover anything went wrong, they will sue.
    • Book 2, Chapter 11 is a big one. An attempted assassination on the senator via biological warfare leads to multiple characters being Killed Off for Real, the hospital being quarantined, Casey and Rafael almost dying and Rafael's partner breaking up with him after realizing that he will never stop sacrificing himself without hesitation, meaning that Casey is finally free to rekindle their relationship with him (if they had one in Book 1). This chapter also marks the first time in the series where you get to play as someone other than Casey.
    • Book 2, Chapter 13. At the end of the chapter, Esme makes a Tragic Mistake that kills one of her patients (one that she had Ship Tease with, at that). Because of this, the patient's family are suing the hospital, echoing what happened in the last book.
    • Book 2, Chapter 15 suggests that Esme intentionally put her patient out of his misery, despite medically-assisted suicide being illegal in Boston. While this is neither confirmed, nor denied, it does mean that if this was true, only Esme would be in legal trouble and the hospital would be safe. Also, Declan Nash's crimes are revealed and Mass Kenmore pulls out of a potential partnership with Edenbrook, leaving them in serious financial trouble.
    • Book 2, Chapter 17. Despite everything, Edenbrook only has a month left before it closes its doors, due to lack of funding. This is also the chapter where Casey has to make a decision on what to tell the administration board; did Esme really Mercy Kill her patient, or did she make an honest mistake? What Casey tells them will affect their relationship with Esme for the rest of the series.
  • Writing Around Trademarks: A premium date with Bryce in Book 1, Chapter 14 has him and Casey playing Barrio Kart. Bryce actually name drops Donkey Kong before the proprietor asks if they want the company to get sued.

Alternative Title(s): Open Heart


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