That Dragon, Cancer is a stepping stone in video games as a medium exploring personal stories, and it’s interesting to align its criticisms with mainstream perception of that exploration.

It’s been over 18 months since the release of That Dragon, Cancer, an interactive story about a father coping with his young son’s cancer. We hear Ryan Green talk about the game to press, but rarely have we seen Amy Green from Numinous Games discuss the game and its development in great detail, likely due to the quite personally emotional nature of the game for her.

But last December, shortly after That Dragon, Cancer received the Geoff Keighley Game Award for ‘Games with Impact,’ I managed to get in contact with Amy to talk about what it was like balancing the game’s emotive subject matter and the gamification of the experience from a perspective of very intense involvement.

“I think, because the subject matter was so personal and important to us, it was simple to navigate the ethical lines of ‘gamification.’” Amy’s chief aim was always to honour their son Joel through the game, and “we were never tempted to forget that, so our design choices always kept Joel in mind.”

“Video games offer an opportunity that other mediums do not, because they give us a chance to share a created reality”

Some critics of That Dragon, Cancer felt that elements of the game broke the immersion and lessened the emotional impact of the experience. One scene especially prominent in this criticism is a kart racing mini-game, the player character sat in a wooden cart with his son, connected to an IV drip, as they sped around the transformed hallways of a hospital.

Amy says that there was a very good reason for elements like this existing in the game. “For Joel, we made everything in his life a game as much as possible. Children’s hospitals are full of doctors and nurses trying to find ways to add amusement to what are otherwise very grim circumstances.” More so than this very true reflection of what she and Ryan tried to do for their son, they wanted to experiment with using some of these cliche game mechanics to convey different ideas.

“We also used moments of levity within the game to show how quickly and dramatically circumstances can change for families of cancer patients. We tried to use game mechanics as metaphors of the experience.”

There were some who found these gamified elements present in That Dragon, Cancer insensitive considering the nature of the narrative; that there shouldn’t be stages inspired by Mario Kart present in a game about cancer, some saying there shouldn’t be a game about cancer outright.

“I suspect that the people who cringe a little when they hear about our game and tell us or others that “cancer isn’t a game” don’t think of games as having genres like films or books have.” Amy suspects this is down to the limited exposure that a lot of people have to the diverse nature of games. “If you think of a game as sheerly existing for “fun” or “entertainment” then certainly there is reason to be concerned about a game that memorializes a child lost to cancer.  However, if you think of games as a medium that supports contemplation and storytelling, like other mediums do, then our game makes sense.”

“I would argue that you experience games more personally than you experience any other form of entertainment or art”

For Amy, it’s all about the varying degrees of involvement and awareness that different video game players have with the movement of the medium as a whole. “If someone has played enough games to get a sense for the many different styles of games being created and consumed today than they are more likely to be okay with thinking about game experiences that are inspired by difficult circumstances.”

She thinks it might also be an issue with the way we categorize games. “Part of the struggle may also be based in the categorizing of games based on their mechanic and not their subject matter. Films tend to be categorized by subject matter instead of filmmaking technique.”

This disconnect that seems to be present for some between video games as a medium and personal, expressive, and emotionally-impactful narratives sometimes holds the industry back from making use of what Amy considers to be some of the most effective tools to tell such stories. “Video games offer an opportunity that other mediums do not, because they give us a chance to share a created reality.”

“I believe that video games have huge potential as an expressive medium, because games let you experience a story in a multi-faceted way that plays with the chronological sequence of events and invites a player to more fully participate with the story.”

She argues, furthermore, that perhaps video games are inherently ideal for telling these stories, more-so than other mediums. “I would argue that you experience games more personally than you experience any other form of entertainment or art.  So, it makes sense to tell personal stories in a personal medium.”

Fine art, film, and literature have all been allowed to explore personally-expressive stories, and Amy feels that video games shouldn’t be excluded from this opportunity. “Each of these mediums have developed these forms until the artists felt free to bend the form and blur the lines between fiction and reality.  Video games begin in that mixed reality space and the potential to move on from there is really exciting for me as a storyteller.”

Video games are a relatively new medium, and Amy thinks this plays a part in the mainstream reluctance to explore more personal stories. “Video games are still emerging and we haven’t experimented with the form as much as we will in the next 10 or 20 years.  When the barrier of entry for creating video games is high and it takes a lot of money and experience to create a game, developers will only create games that are low-risk and high-profit.

“That Dragon, Cancer is an effort to process the tragedy in our family and share the experience because it changed us in profound ways.”

But as games become generally easier to make for individuals and smaller studios, we’re seeing more experimentation like this, and Amy sees it as a stepping stone on the path to a more widespread experimentation with the medium to tell stories like this, much in the same way as literature or filmmaking. “I think as less technical people can create games for less money the medium will mature with a greater diversity of content.

“Once the general public becomes accustomed to seeing really diverse content in games, the perception of games about personal stories will shift. I think we’re right on the cusp of this happening.”

Amy sees potential in video games as a medium for expressing one’s feelings for the sake of that expression. We keep diaries and make family movies already, why not use video games as a medium to do the same thing? A tool for both the professional who seeks a career, and the amateur who seeks a personal outlet? “I think we’re just beginning to see people create small experimental games as a form of self-expression, just for the sake of doing it. Up until fairly recently, creating a game was too gargantuan of a task for someone to take it up as a purely creative endeavor.”

This is, in fact, where That Dragon, Cancer began as a project. “we started out just making That Dragon, Cancer for ourselves and for Joel. We were pretty surprised when the demo scene garnered the attention it did.” Soon, it became much more than that; as the game garnered a greater following and more support, it transformed into letting the world meet their son. “We wanted them to love it and to love Joel.

“It felt like our final attempt to introduce people to Joel, but we never lost the sense that it was for us. We weren’t trying to design a hit, we just had things we wanted to convey, feelings that no one we knew could share with us fully.”

Looking back, Amy sees the game almost as a product of therapy. “I think That Dragon, Cancer is an effort to process the tragedy in our family and share the experience because it changed us in profound ways.” She doesn’t go back to the game to remember Joel, because while it tells a very personal story for her and her family, it doesn’t convey some of the deeper nuances of what their son was to them. “If I want to remember the joy and love that Joel brought to us, I tend to watch home videos and talk with my kids about our memories of Joel.

“I never describe books to another person using the pronoun ‘I.’”

“Playing the game reminds me more of the way love mixes with sorrow and how difficult circumstances made our joy more full because that joy felt precious and fleeting.”

In making this experience reflective, people really felt almost as actively involved in Joel’s life as Ryan and Amy did. “We watched people play with Joel in the game and say “I pushed Joel on the swing.” Which is pretty remarkable when you think about the fact that our game offered players very little agency.”

And the power that video games have over other films or books, that active and immersive involvement with the narrative regardless of the degree of agency. “Despite being offered almost no significant choices, players still personalized the experience. I love books. I get lost in them but I never describe books to another person using the pronoun ‘I.’” Other mediums can absorb you into their worlds, but at the end of the day they’re quite passive experiences. The interactivity of video games completely changes a person’s perspective on what it has to say, to share.

Probably one of the most beautiful parts of That Dragon, Cancer is the huge, shared appreciation of this one boy’s story, and the impact it had on everyone who played it. I never met Joel, and neither did a lot of people who played it. But in experiencing the game, perhaps we all know Joel, even if just a bit.