Note: I took the liberty of re-imagining Tsumiki's execution here.

I'd been planning this fic for 6 months now, but it kept going to the back burner. I'm glad to be able to bring it to you now.

Primum non nocere

Tsumiki stared up at the operating theater window as the remaining students watched, horrified, as the Monokuma mannequins strapped her to the operating table.

She smiled. All eyes were on her.

One of the bear-headed creatures handed a roll of bandage to the other, who quickly set to work. Beginning at the girl's feet, it began wrapping tightly, cutting off circulation.

The bandages were up to her eyes now, she was suffocating.

Then everything was black, and she was falling, falling.

She would soon be reunited with her beloved… She would be so proud…

Instead of the beautiful face of the girl who embodied despair, Mikan Tsumiki awoke to the faces of the Future Foundation looking down at her.

Surely, she had wound up in Hell, she made no mistake there, but she had just assumed that her beloved would have there, most likely having overthrown the devil and remaking the place into the mirror image of her own brand of Hell that she had created during her time on Earth.

So went the delusion that her feverish mind had cooked up under the influence of the despair disease in her final moments, before she awoke in the real world.

Now, she was never quite certain if she was in her right mind, or if the disease had somehow returned with her.

After they had awoken, the former followers of Junko Enoshima were kept in a secure facility under surveillance. They were separated from each other during the first few days, lest anyone chose to act out an encore performance of the island murders. During this time, the students were given books and DVDs to occupy themselves, but Tsumiki took little interest in either. She was eager to be reunited with her friends. They must all despise her now for what she had done. It wouldn't be the same as when they had all looked upon her with that mix of fondness and pity, but there was a modicum of curiosity squirming around somewhere inside of her; a niggling excitement to see how they would all regard her now. She had most certainly made an impact on them. There was no way they had forgotten about her, and that was the important thing, really.

When she lay in bed at night, she expected to be embraced by memories of the one the she had lost, the only person who had ever accepted her. Instead, all that appeared in her midnight theater was an imagine of a boy with white hair, face stricken with pain at her spiteful words.

"Back again so soon, Tsumiki-san?" Komaeda continued to stare out the window. Though he had been offered the same trivial distractions as the others, watching the grass grow seemed to be the only thing he had taken an interest in since waking up.

"They asked me to keep an eye on you. Someone who cut their own hand off shouldn't be left alone for too long at a time… Not only that, you…you killed yourself." The young nurse had been able to control her stuttering much better since the island simulation had ceased. Having a patient to dote on so soon seemed to be a good idea. She was delighted that someone needed her.

Tsumiki set down the tray of pills, bandages, and water she had been holding, and surveyed the room. There was no need for her to do any tiding up, as Komaeda had been fastidious as always.

The students had been a wake for about a week now, and were gradually being allowed to indulge in their particular talents.

Tsumiki had been approached about tending to Komaeda's wrist. A doctor had already removed the deceased girl's hand from his arm, leaving nothing a stump. There was talk about Souda creating a robotic hand for him at some point in the future, but not until after he could create a body to house Nanami's program in, which could take months, even years. The way that Souda disliked Komaeda, it was really a wonder he had agreed to the project at all. Perhaps it was the opportunity to challenge himself with a new project that lured him, or the most likely scenario, he was merely attempting to impress the princess.

"You're wrong, Tsumiki-san," the boy in the bed turned to face her with a polite smile, as if the girl had simply mixed up math problems during a study session. "It was the traitor who killed me. Then hope killed the traitor. It must have been hope, you know, because it was a force so strong, she wasn't able to come back like the rest of us, was she? Hope prevailed in the end," he drawled. Lately, his speeches about hope all sounded uninspired, as if he were reading off a script.

"Er…I'm still not sure that I understand 'hope' in quite the same way you do..," Tsumiki perched lightly on the edge of the bed. "But to me, being 'hopeful' would mean holding onto the belief that Nanami-san will come back to us someday."

Shortly after Tsumiki had woken up, a somewhat twitchy girl called Fukawa had explained to her about the events that had occurred after her execution. She quite liked Fukawa. Somehow or other, her way of speaking put Tsumiki at ease.

Tsumiki had let out a gasp upon hearing of the downfall of Chiaki Nanami. Nanami had been so very kind to her. The time they played games together was the most fun she had ever had. She had even been hoping to start a game collection of her own once they returned home. Though Nanami's end had been Komaeda's fault, she knew she had not right to judge him for it, not after what she had done herself.

She merely nodded in understanding upon learning Komaeda's ultimate fate within the program. Though his ultimate motivations may have differed from her own, she was no stranger to thoughts of ending things, late at night before coming to the island, when the cigarette burns would sting each time she rolled over in bed. Despite her knowledge of medications, a rope around the neck had always sounded best, an impactful option to be sure.

"Oh, I definitely think she'll come back," Komaeda replied mildly.

The realisation hit her. "You…don't want her to come back, do you? You didn't want any of us to come back…your self included."

"What about you, Tsumiki-san?" he seemed to be changing the subject. "Do you think you'll be joining the others at Mioda-san's concert tonight? She's being kind enough to put on a private performance here at the facility, just for her friends. It seems as if she's not holding a grudge against anyone."

"I had been planning on going…"

"Saionji-san will there, you know. To be honest, I'm a little worried for you. She was already so cruel to you before things happened. Have you thought about what you're going to say to her?"

"I have… but… things are different now. I think that, when you're a quiet person, people project their own imagination onto you. The person that they think they're talking to doesn't even exist… I think it might be time to say good bye to her and Mioda-san. I'm not sure that I'll be seeing them anymore after we leave here."

Though she was curious to see what they thought of her after everything that had happened, that was the extent of it now.

"Very good, Tsumiki-san! I'm proud of you."

"Even though I gave into despair?" She challenged.

Hanamura's trial was the first time that he had really taken notice of the nurse.

Being in the presence of such a large number of Super Highschool Level students had been quite overwhelming to him at first. Hinata Hajime had been the first to truly stand out to him. In Komaeda's eyes, the boy had been the personification of infinite possibility. Hinata had been a paradox, containing both the potential for a marvelous talent, or perhaps even a disappointment like himself. He had been a conundrum. One that had unraveled and fallen apart and left little to interest him now that things were said and done.

During the first trial, Tsumiki had been the first person to doubt Komaeda's guilt, stating that he was too 'clean' to have killed. He knew what she had meant, despite his joke of taking it as a compliment. Still, something about her caught his attention that day.

He remembered that she had been the same girl who had tripped and fallen twice before.

How could a nurse be so uncoordinated? Such sloppiness wouldn't do when administering shots and such. She was an intriguing character, some one to keep an eye on, to be sure.

He had a difficult time recalling much from his stay in the island hospital. He had the distinct impression of opening his eyes and being met with a blurry view of the popcorn-ceiling. Then a girl came into view. His vision blurry as it was, it had been nearly impossible to make out the oddity that was her choppy hair cut; there was nothing but the tempting color of plums. It made him hungry.

Her voice had carried with a melodic confidence, so different than usual.

It was her eyes, though. No matter how blurry his vision, how muddled his thoughts, that look was unmistakable. Despair. Utter despair, the type of which turned people into wild creatures, attempting to claw their way out of the confinement of their situation. Yet... something else lingered under the surface. Their was a glimmer of a smile. He closed his eyes again, leaning back into the pillow. He was going to die, finally useful to someone. He'd never felt more at peace.

Then he woke up, all by himself in the hospital room. She hadn't killed him. How many times had he made it clear to every person entangled in this killing game, that he wished to help them? Why hadn't she excepted his help? Generosity is so rarely appointed among today's youth, he had mused.

She was the murderer this time. She killed two her their classmates, and neither were him. He had been helpless, completely at her mercy, nothing more than one of the ants Saionji delighted in killing. Instead, she had tended him carefully, gently, despite her all-encompassing despair.

Why?

"Well, I suppose so," he finally replied. "Your misdoings allowed the other students' hope to shine brighter after their winning against you. I should really be thanking you, Tsumiki-san. You put up a good fight. One could say that you were akin to one of the bosses in Nanami-san's games. The game wouldn't been any fun without a villain."

She was surprised at his words. "Y-you're saying that I was useful to everyone? I'm so glad…I was certain you'd be upset with me… after the things I said that time..."

"Everything you said to me was true, after all. I really did wish for someone to love me. Even if I don't deserve it, everyone has silly dreams like that. Even you, one of the most talented young people in the world, wished for the same didn't you? I didn't understand then, but I think that I do now."

"Y-you really don't have to try to forgive me, but thank you… I'm really happy to be able to take care of you like this. I know I'm not the best conversationalist, and I'm sure that I'm probably the last person from the island that you wanted to see, but I really am glad that I was able to wake up and be able to talk with you like this," she rambled. She slid off the bed to busy herself with the tray of pills and bandages she had set on the nightstand. She did come here for a reason for after all.

Komaeda took the antibiotics and painkillers he was offered without argument.

"Can you show me your arm?" the nurse asked, her tone firm. Komaeda wondered if this was nothing more than the usual authoritative tone she took when dealing with patients, or something new.

The boy proffered his bandaged stump.

When Fukawa had first told her of the situation with Komaeda's arm, she immediately wondered if the amputation had been her own work- She remembered little from the time directly proceeding the doomed 'field trip'.

However, it was clear upon first inspection that it was the work of an amateur. He truly had lopped the appendage off all by himself.

"You loved her, didn't you? I'm sorry."

"Hm?" Without being conscious of it, she had been running her hand in the air above his wrist, as if attempting to clasp a hand that was no longer there.

Komaeda had been the first person to speak to her on the island. She had been overjoyed that someone would take the time to get to know her, despite their current dire situation.

He had even worried for her the two times she had fallen. He had paid attention to her, shown her kindness…and how had she repaid him?

It was true, she had loved Junko Enoshima's special brand of despair, had wished to emulate it, but she was gone now. She had been striving to impress a dead woman, and for what? She had thrown away the trust of the friends she had made on the island. Even now, though she knew how wonderful it felt to be truly cared for, Tsumiki found herself unable to completely quell the voice in her head that delighted in constantly reminding her that it was still far better to be detested than ignored and forgotten.

"…I loved what she did for me. That much is true, at least, but she's gone now, and you're still here." She smiled ruefully as she began to unwrap the bandaging for the second time in as many days.

For what he had done to it, it appeared to be healing exceptionally well. It would seem that his luck even extended to matters such as this. It led her wonder what the trade off had been this time, perhaps the fact that he cut it off at all?

She gingerly ran her latex-gloved finger tips over the stitching. Her thoughtful expression relaxed into close to reverence, eyes not leaving the wound. "It's really healing beautifully, though. I don't think it's going to become infected at all as long as you keep up with your antibiotics."

Without another word, she leant down, gently pressing her lips to the wound.

"Even if you've forgiven me," she began, eyes finally locking with his, despite his look of confusion. His expression was one of mild surprise, but certainly not disgust or hatred, nothing at all like that time after her trial. "I really am so sorry for everything that I've done…betraying your trust and saying those awful things. I'm sorry for ruining your plan by waking up."

She kissed his wrist once more, warm and open-mouthed this time. A familiar metallic tang met her tongue as she ran it over the rough stitching. It was the essence of a living human, proof that Nagito Komaeda was real, and here, and alive, just as Mikan Tsumiki was also. It was much more pleasant than the flavor of her own blood that had so often flooded her own mouth after a beating.

"It's…um… important to clean it now and then, you know?" she laughed nervously after finishing, hastily grabbing for the fresh roll of bandage and setting to work with it.

"How could I ever stay angry, when I've had the honor being cared for by the world's most talented nurse two times now? I think I was wrong… I feel very lucky that you were able to come back."

Mioda's concert passed without incident, though Tsumiki mostly kept to herself during it.

Komaeda was the last of the students to be released from the facility. On the morning of his last day, he had received a letter from Tsumiki, informing him that his tests for cancer had all come back negative- He had been miraculously cured, probably at some point during his time in stasis. The note went on to explain that she was sorry she couldn't say good bye, but she hoped that his luck would allow them to meet again in the future. She concluded by apologising for her selfishness, but she believed in his talent.

Mikan Tsumiki had been working at a hospital in Tokyo for a year now, though it had been five since the field trip incident. A handful of her patients were in long-term care from injuries they has sustained as a direct result of The Worst, Most Despair-inducing Incident. It was somewhat cathartic to heal people who's problems she likely had a hand in causing. It gave her a sense of righting her wrongs.

"Hey, did you hear about the new intern? He's pretty handsome."

She overheard two of the other nurses gossiping in the hall one day.

"That guy with only one hand? I saw him the other day. He kind of gives me the creeps."

The end

Thank you for reading my first fic of 2015! I'm pretty proud of this one, so hope you enjoyed it :) Please stay tuned to my account for more Komamikis in the future!