During the game, a girl gets hit by a car and paralyzed, and has to have all her limbs amputated to save her life. That's pretty messed up and there's nothing you can do to stop that, but of course it gets worse. She gets kidnapped by some psycho who wants to use her as a living art installation. In one of the bad endings, the killer gets killed by his own father and you recover the girl still alive and return her to the hospital. In all of the Good endings and even the True final end, the killer escapes justice with the girl's corpse and neither are ever found. Oh btw, this girl is basically your canonical girlfriend.
Although you can get close to and have sex with around a dozen women and you're never really officially dating any of them, there are the most scenes with her and her route leads to the true ending. The true ending where she's hit by a car, then murdered, then has her corpse absconded with by an insane murderer.
BTW, although one insane murderer gets away, there are
multiple insane murderers in this game, and the good endings do lead to you do bringing down the "Big Bad" who has haunted you for years. So...yay?