Note: The following article contains major spoilers for That Dragon, Cancer.

Autobiographical games aren't anything new. Games like Mattie Brice's Mainichi, Anna Anthropy's Dys4ia, and a number of Nina Freeman's titles have received well-deserved recognition for being ultra-indie experiences that have us walking a mile in the author's shoes. That Dragon, Cancer, however, is an autobiographical game unparalleled in elaborateness and popularity. Ryan and Amy Green based this point-and-click adventure on their experiences with their five-year-old son Joel who passed away from cancer in 2014, and while That Dragon may occupy a niche, it still peeks beyond the horizon of that niche. It's a game that people frequenting the sites that cover games may not have played, but have at least heard of, and there's even a RadioLab episode on it.

The Greens' passion project cracks that old chestnut of telling a story full of tragedy in a medium where the traditional goal is to triumph. That Dragon uses the standard method of not employing play for most of its runtime and the slightly more unconventional trick of including gameplay that is unwinnable by design. For example, there is the cathedral scene in which we can keep trying to light the candles on an altar opposite Joel but where eventually, the candles will all extinguish. The message here is that you can't just repeat grand gestures of hope forever to keep a person alive, and the scene emulates the Greens witnessing their son's life slip away. The other notable scene in which the game uses this design technique is when the Greens are telling the story of Tim fighting the dragon of cancer, a story which we play as a boss fight. Here, there is no winning against the dragon; you can't wear its health down all the way, you can only choose to die. The game conflates the win and loss state here to make the point that succumbing to his illness was Tim's victory; he's lifted up to heaven as soon as the dragon deals its final blow.

That Dragon, Cancer also accounts for another complication of the game format: Play is usually playful. It's often pleasant or even silly by nature, and this could make it a bad fit for a piece of media in which a child dies from cancer. Designer Ryan Green goes to great lengths to not just address this characteristic of play, but also incorporate it in a way that makes sense for his personal story. The game is full of lively, innocent play which is incongruous with the thoughts and feelings of a family knowing their child is dying, but in a way that is highly relevant to the Greens' experience.

You end up with minigames like the cart racer where the trinkets you collect turn out to be drugs for the treatment, and you have the fairy tale platformer which is an analogue for Joel's fight against cancer. Then there's the "Farmer Bill" toy in the fatal diagnosis scene. The different panels of the toy reveal the parents' and councillors' perspectives on the news. This approach also gives us the dragon as the banner character for the game. The dragon is an otherwise harmless fairy tale monster made real and given teeth by embodying a fatal medical condition. This gap between Joel's innocent play and the family's gravely serious tragedy paints this humbling portrait of parents trying to keep the spirits of their son up and maintain a normal childhood for them amidst emotional devastation.

However, the other reason that the experience includes toys and minigames is that it earnestly wants us to feel the uplifting quality of play. There's been widespread applause for how That Dragon settles this feeling of upset deep inside your ribcage and cements it there, but as a game that comes from people who loved Joel, it's also celebratory of Joel and the cheerful times that the Greens had with him. You play at the park with Joel and let him ride animals through the cosmos, and the ending is hopeful, with us blowing bubbles for him as he's surrounded by the food he loves and accompanied by a pet he's affectionate towards. Ryan's final speech in the game talks about this duality, implying that the family's story is one we shouldn't just view as "sad" but understand as a combination of joy and sorrow:

"We know love and longing, empty and full, all in one moment. And I am grateful that we loved him well. And that we miss him well".

We might interpret this positivity as a reaction to the emotions talked about at the start of the game. During the speech in the opening scene, Ryan says:

"Fear is cancer's preservative. Cancer's embalming oil".

Hope is frequently taken to be the antidote to fear and so what better way to fight the hell that cancer creates than through hope? For considering play as constructive towards a hope that can beat back even the fear of a terminal disease, the game shows a staggeringly high regard for it. That Dragon, Cancer portrays play as a source of glee even in monumentally trying times, and it allows Amy and Ryan to connect with Joel even when Joel has severely impaired hearing.

Another idea that That Dragon really puts to work is visual metaphor. The game retells a true story but with entirely imagined elements acting as the voice for many scenes. For example, we're shown a dark cityscape of hospitals as a metaphor for how the Greens' lives was an exhausting series of medical visits. At another point, we find Joel standing on an operating theatre bed and speaking fluently which tells us about the dream future that the Greens speculated over before they knew that Joel's cancer was terminal. It's a shame that there aren't more games reaching for this elaborate, poetic use of sets when it's more practical for animated media like video games to incorporate it than for the majority of other audio-visual media like live-action films or theatre. It's something video games have an edge at but rarely act as though they do.

While That Dragon, Cancer uses a range of symbols, the one it returns to most is the imagery of the sea, and this is where we have to talk about the elephant in the room. In accounts of the game, one of the most commonly recounted scenes is the one in which we take on the role of Ryan and spend a night in the hospital with Joel, unable to stop his crying. Players sometimes present this scene as another example of That Dragon's use of the "unwinnable game" model, but that retelling leaves off the end of the interaction because Joel does eventually stop crying and he stops crying after a prayer Ryan makes. People have been keen to discuss That Dragon, Cancer as a story of loss but it's equally a story of religion, and that's how we get to the image of the ocean.

The game opens with Ryan and Joel sitting by a pond in the park, and here the water is peaceful and contained, but the metaphor is cruelly turned against the Greens the moment we discover Joel's condition. Joel is strapped to a hospital bed with an ocean stretching out before him, full of these pulsing black tangles that represent his cancer. Ryan gives his initial speech on the disease as the "dragon" of cancer flies over the ocean. Later, when doctors tell the family that Joel won't survive, the room they're in fills with water that becomes an ocean Joel floats atop in a rowboat. The scene in which Amy sits in a dinghy while Ryan bobs in the sea further clarifies the metaphor. Amy tells Ryan about her hope for the future, then Ryan talks about his despair, refuses to get into the boat, and drops below the waves.

In That Dragon's vocabulary, the ocean is the strife and hopelessness that the Greens' experience with cancer has the potential to create, while the boats represent the guiding hand of the Christian God. In That Dragon, the ships (the hope in God), are a necessity for traversing this ocean, and while in the room with the crib Ryan is far above the sea, nestled in the cliffs, he later ends up chest-deep in the water. When he comments that Amy's boat has no oars to row forwards with, that is his scepticism towards her religious hope. He doesn't think that her faith will get her anywhere and does not get into Amy's boat; he becomes lost in the suffocating sea of despair. Ryan is only able to achieve peace later when he lifts himself out of the ocean and onto a lighthouse, an almost literal embodiment of God's light. That Dragon aligns its allegory with an allegory in the Bible by having Ryan describe the miracle of Jesus calming the storm. The comparison is easy to understand: The Bible depicts the disciples as wrongly doubting Jesus for thinking he would let them die in a raging storm, and That Dragon shows Ryan as wrongly doubting God by believing God would let him drown in the ocean of despair.

Not only is That Dragon a broad parable about how Christian faith can armour you against even the most horrific of what life could throw at you, but we can also see it as a modern, more personal version of the calming of the storm. The ocean in That Dragon also resembles some other threatening bodies of water in the Bible like the great flood or the sea that Jonah is cast into for trying to escape God. It's interesting to compare That Dragon to ABZÛ which uses the opposite metaphor and equates existing in the ocean to divine enlightenment.

When Ryan and Amy come to see eye to eye again, they sit on a swing on the side of the lighthouse, high above the water and just below the light. Their physical closeness is not just a sign of them reuniting but also of being realigned in terms of religious beliefs. Then there's the tinge of childhood in it being a swing that they're sitting on which reminds us that Joel is lurking in the background of their story. God protects Joel from the start of the plot to the finish. While the scene where he is diagnosed with cancer is dire, in retrospect, him floating atop the sea in a dingy means we know he is safeguarded by God, and we see the same reassurance at the end when he sails to an idyllic island paradise. The island is unambiguously heaven. The symbol of an arcade machine also makes a couple of appearances, representing the possibility of giving up, just as Tim did in the "game" with the dragon. In the scene where Ryan tries to get Joel to sleep in the hospital, the machine lurks in the bathroom, just out of view, the possibility of surrender tempting Ryan. When he gives in to despair, we see him floating underwater with the cabinet.

All of the religious symbols in That Dragon fold together very neatly, but they're also where the story loses me. Religion pops up in a lot of games, but it's usually either dangerous cultism (e.g. Bioshock Infinite, Silent Hill), viewed within a historical context (e.g. Assassin's Creed, Crusader Kings), spun off into fantastical empowerment (e.g. God of War, Devil May Cry), or is fictional religion empathised with from a distance (e.g. Dragon Age, Mass Effect). That Dragon, Cancer asks us to take the place of a real person living at the same time as us who believes devoutly in a modern religion. You might see the hope of the Greens in the face of tragedy as inspiring, and there's nothing wrong with that, but that hope is inextricable from their Christianity, and to feel the same breed of optimism as them you have to be religious. The reason they believe Joel survived as long as he did and that everything will be okay is because they believe the Christian God is aiding them and will give their son immortality. That Dragon, Cancer is a brave new advancement in the medium's exploration of religion; the Greens have made the first successful Christian video game, but at the same time it doesn't resonate with me because I don't believe in a religion.

To be fair to the players who've discussed the game, the neglect of its religiosity in some discussions is to do with how the game rolls it out. Besides referring to cancer as a "snake" and a "serpent", the game doesn't display a Christian bone in its body for the first half but makes its whole back half an exploration of where the Greens stand in relation to the Biblical God. So in talking about That Dragon you're forced to choose between spoiling it or not discussing one of its main themes because the game doesn't establish Christianity as a theme, it just bursts onto the scene halfway through in this clumsy manner. It also made it difficult to tell from quick looks and previews whether we would appreciate the story. We can typically look at the content from early in a piece of media and make a pass or choose to engage with it based on our tastes. However, looking at That Dragon's first twenty minutes or so doesn't give you a full picture of what kind of game you're going to get.

The Christianity in That Dragon, Cancer and its lack of smooth introduction aren't my only barriers to fully connecting with this work. The game also manages to dehumanise characters by modelling them without facial features and the ocean as a place of sadness isn't an inspired metaphor. The lack of free movement also hurts the game both when it's trying to make the play between Joel and us spirited and carefree, and when it's trying to let us get lost in the ocean of cancer. It's hard to feel lost when you move between a hard coded set of nodes. But these are aspects I can look beyond to see the universal themes of love and loss in the game. The Christianity loses me because it's not a universal theme, it doesn't represent something I can find within myself. However, I want to be clear: That doesn't mean the experience expressed in the game is any less valid, it doesn't mean that people should empathise with the Greens any less, and it doesn't mean that the Greens don't deserve the awards they've received. On the contrary, the fact that the game forces us to compare our beliefs to the Greens' and that many of us may not see parts of ourselves in their experience is proof of how successful the Greens were at creating a game that's personal to them. One of the signs of the advancement of games as a medium is that they are beginning to depict experiences that are radically different from our own and this is essential if video games, like other art forms, are to be a tool for communicating anyone's perspective on life. Thanks for reading.