My Game of Life
How video games washed away my suicidal thoughts after my cancer diagnosis.
The author, post-surgery. Photo: Jagger Gravning
The video games I played were generally fairly silly in a pop-culture sort of way. Batman: Arkham Knight, The Witcher 3, the God of War series. In one way or another all of them deal with suicide.
It was a housebound, post-surgery period and I wasn't working. I'd wake up around 9 AM and play video games until noon, breaking only to eat, be driven to a doctor's appointment by a family member or let in my home care nurses. These morning gaming hours were the best part of my days and the only waking hours I wasn't making detailed plans on the various ways I could kill myself.
I was diagnosed with stage II colon cancer in May. Months of debilitating stomach pains had worsened until one night I was left screaming in my bed. My mother took me to the emergency room and a mass was discovered by a C-T scan. I was admitted into the hospital, and within 48 hours a biopsy had confirmed it as cancer, thus replacing eight months of misdiagnosis with the prospect of a yawning grave. Two days later I underwent emergency surgery to hew the cancer out of my guts and, because of complications, I was in the hospital for the better part of a month.
Around the time of my discharge, my oncologist told me of a second suspected cancerous mass spotted on the C-T scan. We would need to investigate that further with another biopsy and a PET scan. The oncologist called the second mass "a red flag," indicating that my cancer might have spread to other organs, in which case it would likely be terminal. Unfortunately, because the needed doctors were booked solid, and partially due to the interference of summer vacation, I had to wait several weeks to have these procedures done.
Planning suicide became my secret.
These weeks gave me plenty of time to take stock of my situation. I had already had a taste of the demeaning pain on offer from runaway cancer. As it kills you, colon cancer spreads to your liver and lungs. So a fair number of my organs would be rotting inside me all at once as everything that I am grew less and less every day.
I began to mentally plan out a swifter, cleaner, less agonizing death for myself in the event that the cancer was terminal. Admittedly it was odd to be planning out my own suicide when I very much did not want to die; I simply needed to prep an exit strategy from the slow horrors of this disease. Whenever I tried to discuss my thoughts of suicide with family members, they chastised me for my negative thinking, which is reasonable, and so I stopped broaching the subject to them. From that point, planning suicide became my secret.
The practical concerns of suicide weighed heavily on me. Though it seems straightforward in films and TV, when you actually have to plan out, say, hanging yourself, the idea of securely attaching a rope to the ceiling becomes strangely untenable—at least in my little apartment. I don't possess any flying buttresses, after all. Was I supposed to go buy hooks or something to attach to the rope? A bunch of little hooks? How does one even tie a noose? Also, I didn't want my wife to discover the body, which ruled out home suicide altogether.
I thought about plummeting off Seattle's Aurora Bridge, famed for its legacy of jumpers. (It even has a suicide fence now, that I would have to clamber over.) But being aware of my immediate death as terror-induced adrenaline shot through my veins on the way down didn't seem like a pleasant last few moments. I considered that I might tie a noose—if I could figure out how to tie one—to a bridge railing before jumping so the fall would be very short and my neck would simply break.
Washington State is a Death with Dignity state and when I related some of my concerns over the slow process of dying cancer brings, my general practitioner made clear that I could legally request from him a lethal dose of meds that would surely solve all my problems. He was pretty philosophical about the whole matter of death. "Everybody dies," he reminded me.
But there seemed something ghastly about the slow onset of the pills clawing me down into the cold depths of eternity. It seemed that sliding a gun barrel up against my hard palate and pulling the trigger was the best way to go. It was the only death that wouldn't allow me time to think between the final action and the death itself. Since gunplay was my preference, I had to be careful not to say anything to my health care professionals because if they thought I was a danger to myself—that is, if they thought I might take it upon myself to commit suicide in a way that was not officially sanctioned—I might be reported to the authorities and rendered unable to purchase the necessary firearm. Another reason to keep my plans a secret.
These are the Dantean circles in which my mind was imprisoned.
I believe taking one's own life is reasonable under certain circumstances, however these obsessive thoughts were now trespassing over whatever amount of life I had remaining.
Working out the minutia of these plans was the first thing I thought about when I woke up in the morning and the last thing I thought of as I lay in bed attempting to fall asleep at night. During a screening of Terminator: Genesys I found myself phasing out into mental imagery of locations around Seattle I might choose for my final moments. Watching Ingmar Bergman's The Silence of God trilogy I—well. Perhaps everybody thinks about killing themselves during Bergman's films. Books were out, too. Reading the same page repeatedly was about as far as I got.
Instead, I lopped the limbs from helmeted, flaming cockneys in The Witcher 3. (They were flaming because I had just set them on fire.) In Batman: Arkham Knight, I enhanced-interrogated a thug by backing a Batmobile tire against his head and revving the engine. It was toxic masculinity, and yet it was bringing me an inner calm that nothing else approached. My mind was given over to these worlds in a wholesale manner that did not occur with any other medium of aesthetic engagement. Gaming wrapped me in serenity, despite the fact that the primary action in these games was heartlessly smiting monsters and people and making everything blow up. I'd found the Zen of killing men.
Then again, it wasn't all blood and guts. I also completed every last task and mission in casual (mass audience) family-oriented games like LEGO Marvel Super Heroes and New Super Mario Bros. Wii U. Regardless, if meditation is meant to unshackle the mind from extraneous cognition and calibrate consciousness to the present moment, gaming was doing that for me.
Maybe there were footprints already on my newfound island of inner peace. "I view video games as something of an emotional therapy," said the Karmapa Lama, a senior Buddhist leader, speaking specifically of his love of war games. "Whether we're Buddhist practitioners or not, all of us have emotions. [W]e need to figure out a way to deal with them when they arise…. If I'm having some negative thoughts or negative feelings, video games are one way in which I can release that energy in the context of the illusion of the game. I feel better afterwards."
I began poring over research at the intersection of gaming and mental well-being.
In 2010, the American Psychological Association's Review of General Psychology published a study that tested commercial video games for use in the management of patients' anxiety in a hospital setting, noting that, "the impact of the video games on anxiety was as effective as a pharmacological intervention for anxiety."
The article also references a theory of play going back to Freud, who saw play as a means of catharsis—"a release of tension and fears in a safe context. Play," the RGP study continues, "is therefore often conceptualized as a means of stress management."
Dr. Carmen Russoniello, director of the Psychophysiology Lab and Biofeedback Clinic at East Carolina University, is also interested in the use of video games to treat anxiety and depression. He told me about a study in which researchers literally prescribed non-violent games to patients: 30 minutes of video games, four times a week.
"These were patients who were screened for depression and then randomized," Russoniello said, "and what we found was a significant decrease in symptoms of depression in the video game group that was prescribed over that month time."
Different types of games seem to help in different ways. Casual games seem to work, at least in part, by constantly rewarding and praising the player with positive messaging, Russoniello explained. Casual developer PopCap Game's Bejeweled 3, a tile-matching puzzler, even included an endless Zen mode, which has a breathing pattern for the player to follow for relaxation purposes. In Russoniello's 2011 study on the ability of casual games to quell depression and anxiety subjects played Bejeweled 2, which has a similar Zen mode.
My morning video games excursions into these fantasy dimensions were cramming more life into me by making my present existence more varied, more densely packed.
From my own perspective, video games might be a particularly enrapturing manifestation of recreation because they fuse this fundamental instinct to play, with art. The player is an active participant in phantasmagoric, but diligently-authored worlds. Writer Tom Bissell punningly titled his book of video game journalism Extra Lives, which is precisely what my convalescent morning gaming sessions represented to me. I didn't feel as though I were squandering precious hours, as many might have viewed my daily ritual. I felt my morning video games excursions into these fantasy dimensions were cramming more life into me by making my present existence more varied, more densely packed. The video game worlds were make believe, but the emotional experiences derived from them were not.
Afterwards, I was able to carry on my day of pills, chemotherapy decisions and doctor appointments with hugely magnified moxie. I was reminded of Oscar Wilde, who once wrote: "It is through art, and through art only that we can shield ourselves from the sordid perils of actual existence."
The second suspected cancer mass turned out to be nothing—a mere shadow on the C-T scan. I am fine, at least for the short term.
Later, my oncologist handed me a printout showing the results of a patented genetic oncotype test that had been applied to my cancer tumor, which was meant to gauge the likelihood of recurrence in my individual case. I was informed that a recurrence in my case would mean that the cancer had metastasized, and would likely be discovered not in the colon but in my liver or lungs and would be terminal. The printout indicated that I have a one-in-four chance of recurrence at some point in my life.
It could be worse. But a one-in-four chance of a death sentence will still be a fairly sharp Sword of Damocles hanging over my head every time I go in for an exam. While I am no longer wracked with unremitting suicidal ideation, I must find a long-term strategy to form a truce with this constant background noise of anxiety. It is alright, though. I own a lot of video games.
If you want to speak with someone, the National Suicide Prevention Hotline is toll-free in the US and available 24/7 at 1-800-273-8255, while suicide.org has a list of international suicide hotlines, including Canada and the UK. Crisis Text Line also provides free and confidential emotional support 24/7 via text.