You might not be surprised to learn this was not the hardest version of the game :P I had to do a lot of tweaking to take it from "ungodly punishing" to "ungodly punishing... but winnable". Long story short my first draft of the level had far too many enemies that were all far too dang close together xD
In the end after playing through it a few times and *finally* clearing my own damn game in one run, I was torn onto whether I should keep it Nintedohard or dial it back a little... I uh... didn't dial it back much.
As for running through I ended up trying that in playtesting and happily left it in. I think it's a fair way for a player to trade off a little score to balance their own difficulty, especially before at least picking up the shotgun.
(Thank you for playing BTW!)