@bishop113: I'll play devil's advocate to you and ask, who says Ellie believed Joel's lie? Just because she says "OK" doesn't mean she can't be lying too. In fact as you pointed out, after all their time together it's very probable she knows he's lying. Furthermore, the game has proven her shrewd enough to know that if Joel says it didn't work out at the hospital, SOMETHING must have been wrong with the fireflies, even if he lied about the specifics. She would have to know that he was trying to protect her, regardless of if he tells her the truth. She woke up in a surgery gown so hopefully she has reached some conclusions on her own (but maybe I'm giving her too much credit).
In addition, Ellie has just confessed her guilt over her friend dying from a bite while she (Ellie) survived. This late game revelation is there for a reason, and I think it's trying to suggest how guilty she could be knowing she could have cured humanity but it didn't happen. A previous poster in this thread said it best that Joel lying to her COULD, COULD be his way of telling her that it's not her fault if no cure is ever found and that they don't ever need to talk about what happened again. Joel does not lay humanities fate at her feet and say "Yeah I lied sorry you really could have been the cure but I fucking shot all those doctors so..." =D
Ellie saying "OK" doesn't have to mean that she believes Joel when he said there were dozens of others and the cure didn't work out...it could simply mean she is acknowledging that some shit went down and that the past is the past. Just a thought, I hope you get what I was saying as I think it makes a much more plausible (and thoughtful) end to believe that there is a mutual understanding between Joel and Ellie rather than Ellie blindly accepting his lie (which as you said is kinda hard to accept!)
From reading many (not all) of the posts in the thread it's great how everyone really seems to enjoy the game as a whole and the ending is really challenging people's expectations for what they hoped for and wanted from the ending! Halfway through the game I told myself that if both these characters survived I would be shocked and consider it a happy ending, and like so many others I'm not sure I feel that is what I got by the end! Great game :)
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