That Dragon, Cancer is a personal game, one that is obviously very important to the husband-wife design duo of Amy and Ryan Green.  The story of the Green’s son being diagnosed with cancer at twelve months and battling the disease for four years is heartbreaking from the get-go.  It’s a game without a lot of player agency because it isn’t a story about the player: it’s a story about Amy, Ryan, and their family.  But while the narrative so closely follows Green family, at times our perspective is pushed away from these brave parents and their young son and shifted into the third-person.  The leap between perspective, the surreal nature that the Greens have chose to present the material is certainly ambitious, but manages to work in the favor of the game.  Sometimes we see the story through Joel’s eyes, sometimes we are Amy or Ryan, sometimes we’re a bird, sometime we’re an omnipresent being.  That Dragon, Cancer is a dreamlike (or nightmarish) journey through the mental state and emotional trials the Green family faces and like a dream it sometimes feels fragmented or disjointed, but still is honest and emotional.

With the limited gameplay, players mostly spend their time searching environments for the next icon to select in order to trigger the next action in the scene.  It’s likely that for some, That Dragon, Cancer will fall into the “is it even a game” argument.  But this kind of question is ignorantly reductive.  Of course it is a game.  It’s a game because the Greens don’t relegate the player to a viewer in their story, without the player’s actions the story doesn’t move forward and large swaths of the aesthetics which inform the mood and tone of the game go unheard.  But we’ll get back to the gameplay later.


At the core of That Dragon, Cancer is the story it is telling.  While the leaps between perspective and narrative distance should be jolting, the game finds narrative conventions in surprising ways.  Instead of beginning the game in the shoes of Amy, Ryan, or Joel, we start the game as a duck eating the bread crumbs that Joel is throwing in the water, overhearing the conversation of the Green family describing their son.  It can be hard to tell how much of the game’s narrative is being read in a studio and how much is audio comes from natural conversations, such as home video recordings or voicemails – which is a testament to the voice-over work in the game.  There are rare moments when a line won’t strike with the intended force, but they are few and far between.

What is most impressive, is the game’s intelligent choice of when to tell and when to show.  One of the most impactful moments is when Joel sits by a hospital window and plays with a dog, a moment when Joel’s irregular life melts away and he becomes as enamoured with the four-legged friend as any toddler.  When the game focuses on dialogue or narration, it is usually in service of emotions that can’t be translated through the faceless figures that populate the game.  But a surprising amount of the mood is set by visuals.  The power of get well cards, the statement of children’s painted hand prints on a hospital wall, the joy of riding in a go-kart, and the sinking feeling of drowning are all communicated without words and made that much more impactful.

It’s also surprising when the game finds it most touching moments.  The times when Joel’s disease rears it’s ugly head are painful, but the scenes when Ryan and Amy show the joy of raising Joel are much more heartfelt.  The beauty of the game is how even in the most difficult challenges facing the Green family there are constantly moments of the simple treasures of a child.  Ryan’s opening monologue asks what Joel is good at, giving us a character not defined by cancer, but defined by his likes and dislikes – which are not that dissimilar to any other child.  The game isn’t about heartbreak or pain, it is about the precious moments which make up a life.

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While the Greens spend a large amount of time telling their story, the good and the bad, they also make a poignant attempt to acknowledge how many people share their experience.  The game uses a couple of significant sequences to pay homage to those who have lost loved ones to cancer, a powerful statement considering how unique Joel’s story seems.  While the Greens keep the story definitively personal, they manage to tap into a feeling of universal humanity.  We all likely know someone who had passed due to cancer or who has cancer and the Green’s recognize this in splendid fashion.

The simplicity of That Dragon, Cancer is essential.  There’s a temptation to game-ify the story Amy and Ryan are trying to tell and sometimes they get dangerously close to stepping into that trap or the gameplay hits the metaphoric nail a little too directly on the head.  At one point you actually are young Joel, battling the titular dragon.  These moments don’t distract from the message and story being told, but it flirts with being a little too on the nose.  But more than anything, these moments aren’t my favorite because they took me away from a family I always wanted to spend more time with.  Simple moments like pushing Joel on a swing, or hearing the Greens celebrate as they reach California are wonderful and the highlight of the game.  When the gameplay turns its focus to surreal images, such as Joel flying through space, riding on the back of constellations, it’s beautiful and striking, but it can overstay it’s welcome.  This was especially true when I couldn’t figure out how to get out of certain sequences.  But again, these moments aren’t overwhelming and the game usually moves with a quick pace.


The simplicity of That Dragon, Cancer also seeps into its art style.  The faceless models of Ryan, Amy, Joel, and the supporting cast are off-putting at first, but it quickly settles as you assign features to the characters.  The voices and actions inform you of the the details of the characters and quickly you’ll have your own mental image of Joel and his family.  This serves as a small example of a large element of the game that works well, the ability for the game to offer up something that is deeply personal to the developer and the player at the same time.  The beauty of the art can only be suggested, but I found it easy to mentally construct environments, and characters with what the game provided.  

That Dragon, Cancer does so much with its material.  It connects to players while being personal and unique.  It is rich with characters and personality, but sparse in what it actually presents to the player.  It’s a game about tragedy, but spends most of its time rejoicing in life.  The very nature of the game screams contradiction, but feels so honest and heartfelt it’s difficult to find deep faults in the design.  But more than anything That Dragon, Cancer is a game that must have been difficult to make.  Amy and Ryan Green deserve our praise for the amount of bravery and perseverance it must have taken to share such a personal story.  And our thanks, because without this game we would have never known Joel, and that would have been unfortunate.  The Green’s have made a game about their brave and wonderful son, and it’s filled with all the love you would expect, and that kind of love is something all too rare in game development.

About The Author

The Glorious Predecessor

As I write this, I am listening to Striking Matches and eating a blueberry muffin. The music is good, the muffin is even better. I dance when I drink and have been known to occasionally free-style rap, none of which benefits society.

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  • This visual style is very effective. It’s used by my personal favorite 3D game so far, King’s Field 2 (or just King’s Field) from 1995 and it holds up incredibly well. The trouble is people don’t know the first thing about esthetics, they don’t realize that abstract art, or even randomly scattered objects have esthetic value, based merely on chance composition and arrangements, across many varying dimensions. They just have gut emotional reactions, based on what they are already primed for.

    Put faces on these characters and you will have a completely different experience, as if the tablecloth was pulled out from under it, and not in that way where everything slips right back onto the table unscathed, like on television!

    This is the first “game” that has felt real to me in a long time, and I’ve only watched about 20 minutes of it in video. I mean at least a decade long time. And by real, I mean like actual art that deserves to exist, and not forgotten. I’ve been realizing lately that every single video game I’ve seen in motion for years and years now looks like absolute cheap crap, just something about the technology, and either the lack of mastery of it, or care for what it is capable of. This is a combination of massive corporation making a mockery of art, as they are often wont to do, and really amateurs being let go with technology that is too far gone beyond the fundamentals for them to grasp,,,

    This offering fairs remarkably well. Its scenes are solid and developed far beyond what anyone should expect given the present state of affairs. The writing, sound, and delivery is better than convincing, within a field that seems to pay people to produce aural firebombs nonstop.

    It dares to be artful, and thoughtful, visionary, you know, like books and film, and even pop music. It dares to call itself a game, even with Cancer in the title. I mean if there was ever a clear sign that the word “game” had outworn its welcome, it’s when you juxtapose it next to Cancer I think, that everyone will surely finally come to their senses (I do work in the service of this medium. My advice is instead of game we just begin calling this medium “3D”, two syllables, short and sweet, rhymes with movie, transcends language. If these VR headsets ever get into peoples hands with favorable reviews, the default meaning of 3D will be forever “real-time 3D experiences”.)

    My only reservation, is this feels like the real deal. The first real game of the new century (I can think of a few predecessors) and I worry that it sets the bar too high, that others will hesitate to experiment with this format (which I believe is the true historical form that 3D will take) because they will stop and compare themself to That Dragon, Cancer and feel like they cannot bear being compared to that. I mean this in a very laudable way. I just thought we get here more gradually and slowly over time, with lots of very understated experimentation, and I worry because people are very self conscious creatures they’ll feel like they cannot compare, and so not even try and see what happens. It’s these impossible standards we set for ourselves, that I think impedes progress more than anything.