Cancer, The Video Game

Before I sit, Josh Larson is careful to make one thing clear: “This is a game about Ryan and his wife’s four-year-old son, who was diagnosed with terminal cancer two and a half years ago,” he explains. And then this: “He’s still alive.”

I look around; Ryan Green has already slipped out of the room. I hesitate, then nod. I take my seat at the rickety desk and put on a pair of expensive noise-cancelling headphones.

The game is called That Dragon, Cancer. The desk — I wish we’d had a better desk for them, actually — is located on the first floor of Unwinnable’s furnished, three-story mansion, which we’ve rented for this year’s Game Developers Conference. Tonight every room is full of developers and their games. We’ve given That Dragon, Cancer its own entire bedroom. It’s the largest bedroom on the first floor; it even has its own couch. I am surprised. I didn’t have much to do with organising this event (I’m not much of an organiser), so everything surprises me.

More than one colleague has told me to come to this room. One told me to come to this room first, another told me to visit it last. I am about to become very, very surprised.


I am searching the screen with my cursor when I remember the demo is supposed to end with the words “thank you.” And I realise I’ve just heard these words, and I take my hand away from the mouse and squirm out of the expensive noise-canceling headphones, and now I am staring at Josh Larson.

Josh is here — was he always here? — with a clipboard and pen. He’s going to take my feedback. I think he’s been taking my feedback.

How long have I been sitting here?

“OK,” I tell him. I wrack my brain. “I… don’t think I’ve ever played a video game that takes place in the ICU before.”

I give Josh Larson my design notes. I am clinical with my thoughts and suggestions. I answer Josh’s questions.

Now Josh has another question for me. “Did you understand that the game is supposed to be hopeful?”

I answer yes, and I am explaining why, and this is when it finally catches up with me. I burst into tears.

I don’t think I’ve ever played a video game that takes place in an ICU before. Actually, do you know, for a few years and right up until six months ago, I spent a lot of meaningful time in the ICU.

And wow, you really got every detail right! I can’t believe it! There’s the armchair. And it is! It is always too small! And rubbery. Here’s the phone right next to it, of course. The bed is over there. The bathroom is a room attached to this one, and then there’s another sink counter way over here, where you religiously wash and sanitize your hands. There’s the salmon-pink, kidney-shaped basin sitting on the counter just to the sink’s left: maybe it’s supposed to be a bedpan, but we always used it for vomit instead. Everything is just right, just the way I remember it.

And then there are those great big windows — there are always those great big windows — and if it weren’t for those big picture windows, you’d never know the time of day, since the ICU is always so dark. That moment really struck me, seeing out those windows and realising it’s still daylight.

Oh. Have you ever heard of something called “ICU psychosis”? Write that down, look it up later. But OK, it happens to not only the patients themselves, but also to their loved ones. You not only lose track of what time of day it is, but also what day it is, what week it is. Time doesn’t work right anymore. There are audio and visual hallucinations, too, sometimes. You know that whiteboard, where they write down what day it is and the nurses’ hours? That isn’t really for the nurses, you know. It’s for you. Oh, that’s something you left out, the whiteboard.

And then, and only then, I remember I am supposed to be Ryan.

Something else struck me — sorry, I’m kind of harping on this one moment. OK. So when I’d click on the windows, the camera would whirl, and suddenly it leaves the first-person vantage, and the camera swoops around outside the window to stare into the building back at me, and I’m standing there looking out the window, and it’s a real Portal moment, you know, where you see yourself for the first time? So when I look in at myself, I see Ryan Green standing there instead — Ryan, the man who was only just here in the room with us — and I can see his shape and form and his glasses and his beard.

And then, and only then, I remember I am supposed to be Ryan.


Later I was describing that Portal moment to Ryan Green — this convergence of game and cinema and prose and autobiography — and just how meaningful that moment really was, and I said something like “it proves there really are some stories that can only be told through the medium of games.” Then I added, “I think you’ve really achieved something here,” and I said that last thing out loud and I felt so, so sick.


In the game, you click through the ICU, feeling around with your cursor for any sort of narrative relief. Sometimes relief does arrive, in the form of a white scrawl, an almost-handwritten prose-poem scribbling itself against the ICU. Sometimes, though, it seems you’ve finally run out of options.

Your son is crying out in pain. There is nothing you can do.

That Dragon, Cancer positions itself as an adventure game, which by design implies all the flaws and failings built into a point-and-click adventure game. You fall into these cyclic, helpless loops of action, clicking on this hotspot and that one, fumbling for anything to alleviate your, Ryan’s, son’s cries — cries that start out gut-wrenching, then quickly turn into something more persistently awful, something you’ve got to quell as quickly as possible. It hurts on every level.

To get to all the hotspots on one side of the room, you have to repeatedly seat yourself in the too-small armchair near your — Ryan’s — son’s bed. And, ah, that’s how it actually goes. You keep sitting down and surveying the room, looking for just one new thing to try to do. That’s how it really, really went.

And at some point the game stops cold. Now there is only one parser command on the screen.


This is how it really, really went.

Ryan tells us, in an early in-game voice over, how at first this whole medical odyssey was “an adventure”. He was, he imagined, “a hero”. I heard him say that, and I thought how brave it was to just come right out and say that, and my stomach folded in on itself.

The very first time, my mother was supposed to die. She was supposed to die, and we succeeded instead. She survived several times after. For just under a year I was needlessly cavalier. I do remember what it felt like to be the hero. I also remember what it felt like to get so, so tired, which was a long time after I’d stopped being afraid.

Ryan Green told me he’d wanted to include some sort of prose refrain. The game, in many ways, is a hymn, a song of praise, but I told him a refrain might be overkill. I told him players will always fumble at the same couple of objects in the room, and those objects can always respond with the same piece of text, and in a way, that could become the refrain, if you could just anticipate what the player will reach for. No, I told him, you don’t need to artificially include a refrain. Maybe. I don’t know.

I told Ryan I have limited experience with cancer. I told him about my mother, who died of something else, but it, you know, it took a long time. Then Ryan asked me what my favourite thing about my mother was.

“Oh,” I said to him. And then I told him something. It was a pretty big something.

And I concluded, “I’ve never told anyone that before,” and that was true, and it is still true.


Josh Larson is holding a clipboard. He has a question for me. “Did you… understand that the game itself is supposed to be hopeful?”

“Yes,” I tell him reluctantly. “Yes, because even when you’re trapped on certain narrative circuits — ”

He’s still alive.

” — there’s this perpetual forward motion, a momentum, where you aren’t really trapped, there’s always, uh — ”

He’s still alive.

I tell Josh I tried to make a game once, in Twine, and I only ever showed it to a few people, but in it there is no narrative direction; the player just circles hopelessly. There is no narrative hope.

“But with something like this,” I tell Josh Larson, “you dedicate years of your life, and the person, ah — ”

He’s still alive.

I sob.

” — the person still dies, no matter how long you take, no matter what you do.” I barely manage to work these words out.

This isn’t constructive criticism at all. It is hopelessness, hopelessness in the face of Josh Larson and Ryan Green’s hope.


Still, I keep thinking about my favourite thing about my mother — a weird thing to love, just some human failing, a secret I kept for her — and I suddenly remember I had two or three extra years with her, and

He’s still alive.

and she’s gone, she’s gone, and now I have all this love and no place to put it.

I carefully take the headphones from around my neck and set them in front of me.

“Well,” Josh Larson says to me, sighing deeply but smiling, “I’m glad we could give you 20 minutes of peace.”

I look at him, and then I stare down at my lap, and I realise he’s right. For 20 minutes I’ve been in another place — in its own fucked way it was safe there — and now I’m back. I nod.


This is admittedly a pretty audacious effort, to invent an entire game narrative about this one event that — how can I say this in a gracious way — hasn’t transpired yet. Yet.

This is an ugly truth, but look. This is probably coming. I’m sorry. This is a game about something that is only inevitably coming.

But it’s coming for all of us.

And that is the loveliest thing about That Dragon, Cancer: we will all meet this thing, or have already met it. Maybe that should be scary, but That Dragon, Cancer is about sustaining the hope and joy of life for just as long as we can.

I like poetry. That Dragon, Cancer is entirely made up of poetry. An old poetry professor of mine is waiting to die of some rare blood cancer. The wonderful thing about his certain-death cancer is, he could die tomorrow, or he could die at 90. “Certain death” is incredibly silly that way.

What was it e.e. cummings said? It was some line of poetry. How did it go? It went something like, “for life’s not a paragraph. And death I think is no parenthesis.” I have no idea what it means; I just like it.


I was confused. Wasn’t there anything else to do? I scanned my cursor across the ICU.

I wasn’t sure I’d found the demo’s end, and then I remembered those strange words: “Thank you.”

I nodded and took the headphones off, and then I looked for Josh.

Jenn Frank is Unwinnable's editorial director. Her writing has also appeared at 1UP, Vice Motherboard, GameSetWatch, Jezebel, the New York Times and in Kill Screen Magazine. She lives with a miniature schnauzer. Follow her on Twitter @Jennatar. This post was republished with permission.

Learn more about That Dragon, Cancer at its development blog.


    Godammit, I made it to the forth last sentence and then my eyes welled up and my throat started burning.

    Did Jenn Frank know what the game was before they started? Now that I know what this game is, I don't want to play it.


    But not for me. I play games to escape. I like to be the cyber-ninja warrior.

    I'm not playing to be confronted with my deepest fears in an unwinnable situation. That would be depressing.

    I've got 2 kids under 4. This is my worst nightmare. Sounds like a powerful unique game, but it's not one that I'll be playing.

    I'll be hitting my 5th run through of Mass Effect 2. Or Deus Ex. Or Skyrim. Or Street Fighter 4. But not this.

    I really feel for the guy who made it though. So much pain and sadness. My heart breaks.

      You sound like my mother and the theatre. I took her once to see a very sad and moving musical about a woman who's son is dead but she schizophrenically believes he's still alive. Afterwards she told me "I don't go to the theatre to be challenged, I do it to enjoy myself."

      And all I can think is, you're missing out on so much of this beautiful art form because you don't want to be confronted with something difficult. And I think that's really unfortunate.

        Games are meant to be fun dude.

          They're not "meant" to be fun. Games are defined by how they function, not the emotional outcome. Games are OFTEN fun. But games can also evoke strong emotions and explore uncomfortable or confronting subject matter. And it's like I said above - you can ignore those kinds of games if you like, but you're missing out on a whole world of thought provocation and even self discovery by doing so.

          It's like only watching comedic TV shows or only reading light-hearted books. Media can do more than just simply entertain.

            "you can ignore those kinds of games if you like, but you're missing out on a whole world of thought provocation and even self discovery by doing so."

            Computer games have been around for less than 40 years. Human civilisation has been around for thousands. The vast majority of humans who've ever existed have missed out on the "world of thought provocation and discovery". So I think I'll be okay if I stick to the games I enjoy. I'm in good company after all.

            There's plenty of thoughts being provoked by my experiences in real life, I don't look for game to do that. I may be missing out on an experience that you feel is valuable, but I have no problem with that.

            As I stated earlier, I feel for the guy who made it, he's gone through a lot of pain in his lifetime. It's amazing that he's created this.

            But I won't be playing.

            One piece of advice though. Don't worry so much about what other people may or may not be getting from experiences. It's what it means to you, that matters. You're actually patronising your mother by thinking about it in the way that you do. She's probably gone through a lot in her lifetime. If she wants to go to the theatre to enjoy herself, then there's absolutely nothing wrong with that. We're lucky we live in a society where we can make these choices in how to live our lives.

            Last edited 11/04/13 12:34 am
    For those who want to learn more. Doesn't look like it's out yet.


    Article was a powerful piece of writing. Potentially facing cancer in the family right now, and every paragraph kind of hit hard. Will be checking this out for sure.

    Last edited 10/04/13 1:45 pm

    For a game that positions itself as an adventure game, where is the adventure in watching someone you love slowly dying with no way of changing the ending? If you're going to make a 'game' about dying of cancer, why just focus on the ICU - why not look at palliative care as a whole?

    I play games for a source of enjoyment - there is no enjoyment in this at all.

    Last edited 10/04/13 2:16 pm

    Cancer took my grandfather from us a few years back, its a horrible demon. Fortunately pa was in his eighties, but to see him wither away from the strong, statuesque man he was, to a frail near toothpick of a man in a very short time of under a year, was harrowing to me, worse on my mother. I look forward to experiencing this, I truly do, but at the same time I fear it, I don't know if I could handle bringing up any of those feelings again. But I at the same time applaud someone for approaching this topic with such dignity and respect, well done, and by the way, amazing article, absolutely fantastic.

    Really great article Jenn. I also get why people are against the idea of playing something like this, but then again, I don't get the attitude of playing games solely for escapism. If there's films and music made to explore life in all it's variations, why shouldn't games?

    Then again, most people just watch films and listen to music for escapism these days anyway, so yeah. Not sure where I'm going with this now. What's that over there!

    I find stories like this hard to read these days, my son was diagnosed with cancer 2 days before his first birthday, we went to the Emergency Department with gastro and didn't walk out of the hospital until 3 weeks later with a diagnosis Neuroblastoma stage 3. That was 7 months ago, lucky for Ryan(my sons name also) 4 rounds of chemo later he is in remission. We got lucky it was found early before it did any damage to other parts of his body but we will have 5 years of testing to making sure it stays away. I love him so much and often wonder how I would be if he wasn’t around, but I try not to think about it too much because life is for living and there are no certainties so be thankfully for what you have.

      Amen to that. Recently I've been telling myself that every moment I pass with my family is precious, because you don't know if you'll be looking back at the moment as the last one you had. Put in perspective, arguing and fighting and feeling resentful is just not worth it.

      That's great mate. There's a little dude just north of where I live, he's only 2 and he's so sick. Brain tumours. It's been removed twice.

      It's just devastating. The poor little guy. He's so young and most of his life has been in a hospital, in pain. I really feel for everyone involved.

    I read this story around lunch time, and yeah, just can't quite get over it.
    My 3rd daughter was born with an inoperable brain tumour. She wasn't meant to survive her birth, but we had nearly 2 beautiful years with her.
    I'm with @single_malt, why just ICU? Yes we spent much of Lilah's life in ICUs and HDUs, but our main aim was to be with her at home as much as possible, through the help and support of Pal care.
    I guess that was the journey Ryan went through. We put less of an emphasis on waiting for our baby to die, and more about what could we do day to day to live in the moment. Every day we had with her was a bonus, so we chose to live in the moment. Again, everyone's journey is different, as obviously it was for Ryan.
    I guess looking at a game drawing you in and becoming emotionally attached, this certainly fits the bill, but it wouldn't be one that I would be able to play.

      Hi @nicb_205 and @single_malt,

      What wasn't entirely clear is that we gave Jenn only an early demo of the game. The piece she played was one of the darkest moments for me in our journey fighting cancer.

      My family has been in the palliative stages of treatment for over 2 years. We're still fighting with Joel, and even though we're on our 8th tumor, we've had a beautiful 3 years in the midst of such trials. That Dragon, Cancer will have moments of despair, but I will never leave the player there. Our journey has been characterized by hope and many small miracles, a community of faith and a set of amazing physicians. And even in the event we lose him, our desire is that our hope remains. Of course, we're just in the middle of it. We don't know the ending.

      I hope you'll take a moment to learn about the project and our family, here:

      I'm deeply sorry for your loss. Lilah is such a beautiful name. I'm sure she was as incredible as we think our Joel is.

        Thanks for replying @ryangreen8
        That certainly does add some context for me.
        I'll have a closer look at the website.

        If you would like, have a look at my daughter's Facebook fan page - where my wife is devoted to spreading the story about living in the moment and appreciating what we normally take as granted:

        And what a great tribute for Joel. From the families we have met, they are indeed incredibly special kids.

    Very Interesting read.

    I'm reminded of the movie "Wit" about a woman dying of cancer. Great movie, but confrontational. Not something I'd want to watch twice.

    I may be able to relate to this article. My grandmother was taken by brain cancer a few years ago and while I was growing up, I never really had time for family. When I found out that she was diagnosed with the cancer, I flew over to Vietnam I and spent a week with her at the hospital. We spoke about anything and everything as much as possible before I had to fly back for my year 12 mid year exams. It was two days after I got back that the phone call came. I broke down when it came, and even though I had spent so much of my time I could talking to her, there was so much I missed out on.

    The article tells us about the inevitable and what we, as humans, could do to fight against it, hit home hard. The cancer my grandmother had was genetic, so the next person may be my mother, my younger sister, or even me. It was a beautifully written piece and I welled upin the library at uni when I read it.

    I think nurses & doctors could make for some interesting NPCs to add to the game... or even antagonists like thin shadows that flit & mist in & out of the periphery of the screen - and either dart away when you try to approach them directly - or solidify into blocky shapes that spew out a cacophony of too-loud assurances and instructions before disappearing again.
    My experience with a family member who died of cancer reminds me more of horror games (that I watched my friend play) like Resident Evil, and Phantasmagoria 2: A puzzle of flesh. It's not the gore, mind you, but that overwhelming feeling of helplessness and dread and that feeling that everything has suddenly gone wrong somehow.

Join the discussion!

Trending Stories Right Now