Arts video game review

That Dragon, Cancer: a powerful story about loss and its emotional baggage

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Joel giggles and feeds a duck in a scene at the start of That Dragon, Cancer.
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The changing relationship between Ryan and Amy is one of the main focuses of That Dragon, Cancer.
Numinous games
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In That Dragon, Cancer, the ordeal of chemotherapy is depicted with glowing, toxic drugs.
Numinous Games

That Dragon, Cancer

Numinous Games

Released January 12, 2016

Ouya, Microsoft Windows, Mac OS (Available through Steam and the Humble Store)

“I’m sorry guys, it’s not good,” says a man in glasses and a button-down shirt, hesitance in his voice. He’s seated next to a woman holding a clipboard, her head tilted in sympathy at the receivers of this ‘not-good’ news. They are addressing our main characters, arranged on a couch facing them: a husband, a wife, and a small child who happens to be the unwitting subject of the conversation.

I, the player, am a ghostly observer, floating above the couch on the baby’s left. In front of me is a toy reminiscent of a “See N Say,” only instead of farm animals depicted around it, there are pictures of the four adults in the room: the two doctors, and the husband and wife. I click on the husband, and an arrow in the center spins until it’s pointed at his face. I press a play button on the toy’s top right.

I fly towards him and straight into his head, rotating to see the room through his eyes. The conversation begins again. “Sorry guys, it’s not good.” The doctor tells us the tumor is back. This means the treatment has failed, he says. “How big is it?” I ask, and the conversation tunes itself out as I hear what I, the father, am thinking. “No, no, no, this can’t be happening. How big is it? If I know how big it is I can wrap my head around it.” And back to the conversation. The doctor says it isn’t about the size of the tumor, but the location. “This is a tragedy,” he says. I fly back to the strange toy, where I notice a rewind button. I click it, select the wife, and hit play, flying into her point of view. Her reaction to the news is wildly different from the panic and frenzy her husband felt. “Oh, so this is that talk,” I think as her, with a strange calmness. I start to worry, “aren’t I supposed to be crying, or vomiting, or something?”

I start to realize how many ways this scene can be played. I could go through each conversation segment as every single person in the room, constantly rewinding and flying to a different spot. Or, if I want, I could experience the conversation entirely from one person’s viewpoint. But no matter what, as the conversation goes on, it begins to rain. The water level in the hospital room gradually rises until it reaches the necks of these people so oblivious to their imminent metaphorical drowning. And suddenly the water becomes an open sea in a violent storm, and the game transitions to a completely different scene.

This segment in That Dragon, Cancer, a new video game by Numinous Games, showcases what lies at the game’s core. It lets you empathize with others, understand feelings that may seem alien. In that moment, I truly felt like I was inhabiting these characters, empathizing not just with the family but also the doctors who are forced to deliver the bad news and see people’s lives change forever.

Ryan and Amy Green, who created That Dragon, Cancer along with a small team of developers, lost their son, Joel, to a series of brain tumors in early 2014 at five years old. The game is a recreation of their experience, in both realistic and abstract ways, of a family harrowed by illness. It was already in development before Joel’s death, but after his passing, they resolved to devote all their time and resources to finishing the game. After almost two more years of development and a Kickstarter campaign, it was finally released this January.

From David Bowie and Alan Rickman’s death from cancer within a few days of the game coming out, to the State of the Union address on its release date, in which President Obama vowed that the US would cure it, it seemed that the week of the game’s release was dominated by talk of cancer. But That Dragon, Cancer isn’t too concerned with the disease itself. Rather, it focuses on how it affects the people it touches. While its story may be specific, the themes of tragedy, shock, inevitability, faith, hope, love, and despair that it addresses are universal.

The game takes about two hours to play, and is framed as a series of 14 distinct scenes. They take the player, sometimes realistically and sometimes surreally, through the stages of the Green family’s experience with cancer. The scenes range from Joel playing in a playground, to a go-kart style mini-game where you collect chemotherapy drugs, to beautifully strange set pieces like the “Temple of Man,” a vast white atrium with Joel in the center, lying in a humming, rotating scanning machine that exudes menace and power and purity. Joel is at the center of all of these scenes, but at the same time he is vague and ephemeral, like a distant memory. His face is lacking in features, even more so than the other characters, and for the most part his actions consist of clapping and giggling. In one scene, he isn’t even physically present, just an empty crib in a hospital room from which issue inconsolable sobs. It’s a smart choice, and most likely an emotionally cathartic one by the developers, keeping Joel distant in some ways and present in others, and allowing them to project their feelings and experiences with him onto essentially a blank slate.

Throughout the game, That Dragon, Cancer makes consistently smart and effective artistic choices. Its simple, clean presentation gives the story a sense of universality, as well as adding graphical longevity to a fairly low-budget production. All of the living things in the game, from people to ducks, vibrate with some supreme energy in a kind of three-dimensional rotoscoping that feels reminiscent of stop-motion animation. And the physical representations of cancer are spiky and pulsating and feel like black holes, devoid of light and color and poised to consume all that exists around them. They are terrifying, yet oddly captivating and beautiful.

That Dragon, Cancer also tends to make good use of sound design. Much of the story is delivered through speaking, and whether it’s an inner monologue, a voice-over, or a conversation, the dialogue consistently feels genuine, because it is. When you hear the family talking about Joel, you’re hearing an actual conversation that the developers recorded themselves having with their children. The game plays with spoken words, making them abstract and surreal to fit with the scene. The frequent use of spoken word and monologues usually works quite well, but sometimes it feels like the game is just using a monologue to tell me how to feel, rather than making me feel something. I also find the game’s orchestral soundtrack to be a bit much, occasionally forcing or reinforcing emotional beats that don’t need musical cues to evoke feeling.

The game’s controls are simple. This isn’t in itself a bad thing, but in the context of That Dragon, Cancer, my immersion often felt inhibited by the lack of agency the game allows. The controls consist of moving the mouse around and clicking, which is sometimes enough to provide a sense of agency while delivering the story, but at other times, the game felt like a cart on tracks that just asked me to click before feeding me the next segment.

And part of the game’s purpose is to give the player a sense of helplessness. The Green’s want you to feel what it’s like to have a sense of moral responsibility, and a set of tasks you can perform, but be completely unable to comfort or save Joel. When it achieved this, I felt panicked and horrified. I felt morally culpable for not being able to help what I knew was a fake representation of a child. But sometimes, I was more frustrated with the controls for not doing what I was trying to do than with myself for failing.

There is also an occasional sense of information overload. One segment of the game was filled with cards bearing messages from Kickstarter backers, talking about their own losses. I wanted to honor these people’s stories by reading them, but at the same time it felt misplaced, a jarring break from the narrative arc I was trying to follow. At other times, conversations in the background go on for too long, forcing me to decide whether to stand idle and just listen, or continue with the game. This sense of content overload may have been an intentional choice to overwhelm the player, but I felt like it just harmed the overall game experience.

That Dragon, Cancer confronts the player with intensely uncomfortable and universal questions and truths, and this is where the game really shines. The Greens are devout Christians, and the game doesn’t shy away from religious themes (not that it forces ideas about faith on the player). At one point, Ryan confronts his faith and his wife’s certainty that Joel will be healed, asking, “how could the creator of all that is and ever was care about my son?” One doesn’t have to be religious to understand the fear of cosmic insignificance, and part of what is so effective about the game is that while its story may be specific, anybody can identify with what these people feel. It affirms that the human condition is universal.

That Dragon, Cancer, in its final form, is a tribute to Joel’s life. A life that was never lived. A life too short to have gained meaning or purpose, yet too long to be devoid of substance. And that accomplishment, in itself, is beautiful. The game is a compelling, unforgettable step forward in a fascinating direction that small independent games have been taking, of exploring storytelling through gameplay. It certainly could go further in embracing interactivity, to increase the sense of immersion and agency and strengthen the emotional connection it creates. But when the game is at its height, That Dragon, Cancer achieves gloriously, delivering emotional, interactive storytelling on the level of Telltale’s The Walking Dead or Gone Home. The brutal realness and emotional candor that the developers poured into the game is constantly evident and incredibly admirable. This is a game worth experiencing.