Hektoen International

A Journal of Medical Humanities

Life is a game: visual metaphors in Brian Fies’s Mom’s Cancer

Sathyaraj Venkatesan
Anu Mary Peter
Tiruchirapalli, India

Figure 1. Fies, Brian. 2006.
Mom’s Cancer. New York: Abrams Image.

Motivated by a “desire to give meaning to the lives lived in uncertainty”1 and illustrate the experience of enduring an illness, the creators of comics often resort to visual metaphors that render a patient’s physical and psychological experiences tangible.2,3 In Mom’s Cancer (2006) Brian Fies deploys a series of visual metaphors drawn from (board) games to actualize the sufferings of his mother Barbara (hereafter Mom), a victim of lung cancer.

Published by Abrams, Mom’s Cancer records Fies’s mother’s trials and tribulations with metastatic lung cancer. The first Eisner Award winning “Best Digital Comic,”4 Fies uses thought-provoking (board) games such as the ludo board, the jigsaw puzzle, and tightrope walking as metaphors to reflect on Mom’s precarious condition. Taking these cues, this article examines the nature, function, and choice of games as metaphors in Fies’s Mom’s Cancer.

Ludo: the game of dumb luck

In figure 1 Fies introduces a die and a token/pawn in “a stand-alone spot” in order to develop the theme that “life is playing the odds.” In an email interview with the authors, Fies interprets the image thus: “in chess the pawn is the lowest ranked piece, pushed around to protect or benefit the others, and sacrificed if necessary. To me, that small graphic represents a lot of my family’s experience.”

In chapter two, titled “How to Diagnose Lung Cancer, Step Two,” the die and token are reintroduced to form a visual narrative in a tightly fixed panel that takes the guise of a ludo board. A closer look at fig. 2. reveals the double function of the horizontal page. At one level it functions as three vertical panels and at another level, it conjures the features of a ludo board by including the starting square, the game track, the finishing squares, the arrows, and the finish line.

Figure 2. Fies, Brian. 2006. Mom’s Cancer. New York: Abrams Image.

Games based on using dice (or die) depend on absolute luck, of which ludo is an example. It has an implicit resonance with gambling in that the die value determines the movement of each player’s token. To move a token the player should race a die value of six, failing which the turn passes to the next player. Intriguingly, while six is the most desired die value, the die shown in the panel bears two, suggesting the family’s failure in the game of luck. Considering that Mom has already been diagnosed as having cancer, the players/care givers are left with no option but to roll the dice and take another chance. Drawing parallels with the pursuit of luck in the board game, Fies implies the role of fate and random chance. As exhorted by Mom’s osteopath, the siblings scramble for a right physician and end up identifying a chief of neurosurgery at “Impressive University Hospital” (5). Thus the odds of the right doctor are rendered as taking a random chance in the board game. In the context of a confirmed disease, Fies’s creative use of a ludo board records the role of luck or chance in the initial phase of cancer.

Operation luck and skill

In chapter four, titled “A Game of Luck and Skill,” Fies employs the visual iconography of the Operation board game to demonstrate the “Game of Luck and Skill” played upon his mother by the physicians. Divided into two parts on a page, the visual “naturally divides Mom’s tumors, and the treatments she received for them, between her head and her chest” (Fies 2015). Akin to the Operation board game which has two set of cards, namely “the specialist” and “the doctors,” Mom’s diagnostic team is also categorized into two: “the specialist” from the Impressive University Hospital and “the team of local cancer doctors” who exercise their “luck and skill” upon her (Fies 2015). The image which ingeniously demonstrates Mom as a medical entity also provides with an epigrammatic clarity the procedures involved in cancer treatment.

Funambulism: the game of (in)stability

Figure 3. Fies, Brian. 2006. Mom’s Cancer. New York: Abrams Image.

Following her diagnosis, Mom underwent severe treatment regimens and lost her mobility, which was “a bigger blow than cancer” (11). To reflect these experiences, Fies’s circus imagery depicts Mom as a funambulist, or tightrope walker (fig. 3.). Tightrope walking is a balancing game of walking along a thin string tensioned at two ends, usually while carrying a pole. Guised as a tightrope walker, Mom displays circus skills and performs several risky tasks, including walking on a burning rope while balancing a vulture and an elephant on either side of the pole in such a way as to not to fall into the pool of crocodiles below.

By introducing an elephant and a vulture, Fies sharpens the scene to signify the intensity of Mom’s agony. The imagery of tightrope walking maps the rigorous medical regimens used in Mom’s battle as well as her struggle to maintain physical and emotional stability. Elsewhere a close-up shot of a helpless funambulist leg, which has to ensure the safety of the whole body, reminds the readers about Mom’s deteriorating and unstable health and about her “trial and error balancing act,” as Fies calls it (60). By imagining Mom as a funambulist, Fies brings into relief both the teetering on the edge state of mind and near-to-death experience of his mother and the compounded physical and emotional demands of cancer.

Jigsaw puzzle: the tussle with tessellation

In chapter 22, titled “Puzzlement,” Fies reproduces a piece of jigsaw puzzle in the hospital lounge. Provided for the patients/carers “to kill time while waiting” (66), jigsaw puzzles demand assembling irregular and interlocking pieces to produce a complete picture. Although a pastime, solving a jigsaw puzzle requires meticulous scrutiny of the prevailing chaos in order to establish a meaningful connection out of it, which as such requires “building a picture, together, one tiny piece at a time” (67). By introducing the jigsaw puzzle, Fies alludes to the indeterminate and puzzling nature of cancer and to Mom’s struggle to make a meaning out of her chaotic illness life. It also suggests the monotonous and grinding tedium of visiting a cancer hospital.

Ian Williams, citing Deborah Lupton in “The Iconography of Illness and Suffering in Graphic Pathographies,” states that “metaphor and visual imagery are two important ways of conceptualizing illness.”5 Particularly, visual metaphors, through an implied comparison, bring together two dissimilar ideas and render complex notions concrete and palpable. Essentially, visual metaphors effectuate the author’s expression as well as aid the reader to understand subjective realities with heightened clarity. In Mom’s Cancer Fies illustrates the role of risk and luck in the different stages of cancer as well as the emotional vicissitudes of the patient. Taken together, these three visual game metaphors convey a state of uncertainty, an absence of coherence and causality, and, as such, echo the absurd and complex nature of cancer itself.


This paper is dedicated to Brian Fies’s mother, Barbara. Special thanks to Brian Fies for his instructive comments and suggestions.


  1. Jurecic, Ann. 2012. Illness as narrative. Pittsburgh: University of Pittsburgh Press.
  2. Deignan, Alice. 2003. “Metaphorical Expressions and Culture: An Indirect Link.” Metaphor and Symbol.18 (4): 255-271.
  3. Dent, Cathy, and Lois Rosenberg. 1990. “Visual and Verbal Metaphors: Developmental Interactions.” Child Development.61 (4): 983-994.
  4. Fies, Brian. 2006. Mom’s Cancer. New York: Abrams Image.
  5. Williams, Ian. 2012. “The Iconography of Illness and Suffering in Graphic Pathographies.” Paper presented at Comics and Medicine: Navigating Medicine, Toronto, 22-24 July.

SATHYARAJ VENKATESAN, PhD, is Assistant Professor of English in the Department of Humanities at the National Institute of Technology, Tiruchirappalli, India. He received his PhD from the Indian Institute of Technology (IIT), Kanpur. He was a Fellow at the School of Criticism and Theory at Cornell University, New York and currently is an International Field Bibliographer with the Publications of Modern Language Association of America (PMLA).

ANU MARY PETER is a research scholar at the National Institute of Technology, Tiruchirapalli. Her area of research is graphic medicine.

Winter 2015