The character Ginger can die of her illness, even if the player is married to her (if not, they will receive a letter in the mail announcing her death). This triggers a questline where the player tries to make a remedy, only to fail, and they spend their last moments together at the beach. According to a developer's statement, there is no way to cure her illness and her death is unavoidable.

However, the storyline quickly proved to be controversial within the fandom, so much so that Palthea decided to change the storyline to allow Ginger's disease to have multiple outcomes. Eventually, in June 2019, new quests were added to allow the player to help stabilize Ginger's disease.