(reposting my review from toxic yuri server)
wow this story hit really close for me. you mention it being a very personal work and i can see that, and i related to elke way too much, because of the creative insecurities, and a lot of other things.
this story taps into some very deeply ingrained anxieties - the lunch scene was particularly painful for me, the crushing feeling of being out of place and unneeded, and also elke finding out how abi made her, as her mommy, a funny bit to post online about... also the way elke would constantly avoid being honest to abi, and always had it in their mind that abigail could leave them at any moment when they find someone easier and more fun to be with. elke and abi's relationship had such a frustrating lack of communication and that felt very realistic and painful to read about.
the ending was unexpected - while i can see where it came from, it didn't really feel like a resolution, for example how abigail probably cheating on elke never came up again? abigail turns out to actually be kind of a shitty person, not just inconsiderate, and the way she presents her relationship to her online friends without elke's knowledge really was pretty gross. and elke giving up their personhood to be a doll doesn't really do anything to fix the relationship problems here, even if it gives them relief? kinda anticlimactic ending but i can respect the choice
also i gotta mention it as a side note: it was kinda surreal for me personally reading a vn with a protag who had so many insecurities similar to my own vn's main character and even used some of the same music tracks. medicine is just a really good album...