Silent Lucidity: Josh Larson on Creating 'That Dragon, Cancer'

In Josh Larson's empathetic indie game, the real enemy is feeling disconnected. 


Josh Larson’s game isn’t supposed to be fun. It’s supposed to invoke pain, sorrow, joy, hope, and helplessness—anything but a passing feeling of amusement. Amidst the blood-curdling adventure games and cartoony mobile apps at South By Southwest, Larson’s small booth is nearly silent as players with headphones hang on every word of the game’s quiet dialogue and somber themes. Silence really is the only option here. How else can you play a game about childhood cancer?

Larson is the co-creator of That Dragon, Cancer, a game that chronicles a family’s real experience with pediatric cancer. Centering on Ryan and Amy Green, a couple in Loveland, Colorado whose five year-old son, Joel, was diagnosed with a terminal atypical teratoid rhabdoid tumor in 2010 and passed away in March, the game places players in hospital rooms as they try in vain to care for an inconsolable child, in doctors offices reeling from news that their child will die, in Ryan’s brain as he grapples to understand why. Written and voiced by the Greens, That Dragon is, at times, uncomfortably personal and undoubtedly a breakthrough in empathetic gaming.

But it’s not about fun. Larson insists it’s about hope, and on a larger level, about helping one gamer understand the emotionally complex experiences of another.

Get In Media: Can you tell us about the process of turning a very intimate and painful true-life story into a game?

Josh Larson: There are definitely moments when it’s hard, emotionally difficult, especially trying to decide certain aspects of their story to include. There was one case where I had an idea to include MRI imagery in the game at a certain point. Ryan sent me over the files [and] it just really hit me again, even late in the project, that it was real. We ended up deciding not to include it because it seemed like too much. It seemed too intimate, almost like an invasion of privacy. It was a very weird feeling.

Overall, I just love [Ryan’s] family, so I am passionate about sharing their story. We also share the same faith; we’re both Christians, so that plays in a lot, too. … I think in our faith, close intimate relationships are kind of an ideal that we strive toward. We get together in small groups with people in our church and talk about very difficult things or personal things, so both of us are used to people sharing personal things with each other. I think because of that, we kind of have, I don’t know if “training” is the right word, but, you know, experience with it. I think that helps as well in this project.

That Dragon, Cancer (concept art)

GIM: Besides Joel’s actual MRI test results, what else was off the table for this project? And how did you decide where to draw that line?

JL: In the scene where you’re in the hospital room trying to care for Joel, having the real Joel’s crying was too much for Ryan. That was off the table. We ended up using other stock footage. That was one other thing that was a little too close. … Overall, the intention is to be very aware of creating something that’s in good taste, so to speak, and is in no way exploitative. That’s our intention.

GIM: That hospital room level is gut-wrenching. Do you have any fear that players may not be ready to have a gut-wrenching game experience?

JL: I think some players definitely aren’t ready. It’s been very encouraging how a lot of people really are able to go there and willing, from young kids all the way up to 70-year-olds. … I think being younger, it’s a little bit easier to maintain some distance because you don’t understand all of the themes of parenting or what it means on a more fundamental level to care for someone and to not be able to succeed at it. I think because of that, it may be easier for young kids to play. It really depends on the person’s life experience, how emotionally intense it would be for them.

GIM: Have you had a lot of interest from young players? There’s poetry in the game. There’s surrealism. The subject is somber. There might be a lot of themes and game mechanics that could be above young players’ heads.

JL: We’ve been surprised about how many kids will come up and sit very patiently in a slow-paced adult game and play the demo all the way through. Just a little bit ago, there was one kid playing it and he was resetting the demo and starting over. He must have done it like ten times. He kept staying there in the seat and listening to different characters, their inner monologues, and jumping between them and then he would reset it again for some reason. It was very odd, but he was willing to be there and to experience that. I think for the younger kids, they seem to be really into the fact that it’s an immersive video game. It’s that kind of experience but at the same time they’re getting a story. I think that’s really what engages them, the fact that it’s this immersive storytelling experience.

GIM: There seems to be a certain level of spirituality in That Dragon as well as in your previous projects. [Larson has also worked on interactive projects that use Wii remotes to bring live visual effects to church worship services.] Is it a conscious decision to incorporate spirituality into your work?

JL: I feel very passionately that when you design a game, you include your worldview in it, and sometimes if you’re not aware of that, it will be unintentionally. I guess I feel passionate about being intentional about it. In fact, I’ve been reading a book recently, Phantasmal Media, and that’s part of the idea that the book’s communicating, that when you’re designing computer-based media that you include your worldview in it. One example was the icon of the women’s bathroom. Talking about how that has a certain worldview wrapped up in it because of how a woman should look. Things like that, sometimes you’re aware of it, sometimes you aren’t. I try to be intentional with that and including that when it comes to communicating themes. It will be themes of how I see the world and, in this case, how Ryan and Amy see the world.

GIM: This game is so personally exposing, much more so than any other game I’ve ever seen. Was there any fear from you or from the Greens about that?

JL: They’re definitely concerned about it. The way they process things is to just create stuff. They made a children’s book about this, a short film about this, and now we’re making a video game. I think it’s Ryan’s desire and Amy’s to share their heart with people and to share Joel’s story. They just do that in a specific way. They make these things, but then when it comes to sharing the they’re so vulnerable with what they’re sharing that it can definitely be a concern and something that they want to be very careful about. When it comes to doing interviews, taking press, what we share with people on the blog, on the That Dragon, Cancer website specifically, Ryan wants to be very intentional and careful about how we do that, specifically because it’s such an intimate and personal story.

GIM: What is your goal in creating this game?

JL: Ultimately, just to share the Green’s story and to honor Joel. What we hope is that people will discover what it means to have hope in the face of death and to kind of conquer their fear of death in a way, or at least confront it and acknowledge it, to just realize that when they’re going through hard moments that they don’t have to give up, that there’s still hope to be found. We also hope that when someone sits down to play the game, afterwards they are more open to talking with other people and about things that have impacted them that might be hard to talk about otherwise. We are trying to create this space where you can talk about difficult subjects.

That Dragon, Cancer will be released on the Ouya console later this year. A site to raise funds to assist with funeral and associated expenses is currently up right here.

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