HOLDING ON: THE TROUBLED LIFE OF BILLY KERR is Emotional, Powerful, and Unlike Any Other Board Game

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“Do you want to play a board game about a man in the final days of his life? We’ll play nurses who don’t have sufficient resources to provide both palliative and medical care. Also, he might die while we’re playing.” That is a tough sell on board game night. Many of us play board games to escape real life, and I can see why you might not want to play a game that can – and likely will – make you sad. I get it; I also implore everyone to sit down with Holding On: The Troubled Life of Billy Kerr. It’s a challenging and fun cooperative game, but it is also uniquely powerful and settles any debate about the artistic merits of board games.

Billy comes to you and your fellow nurses shortly after suffering a massive heart attack while aboard a flight from Sydney to London. His condition is terminal – no spoiler, this is right in the rulebook – and it’s your job to make his last days comfortable. Part of that involves providing palliative care. This the type of care nurses around the world provide all their patients when the enter with a smile and talk to their patients. It’s as much about making them happy as it is healthy. This is a big oversimplification that I make with apologies to all the nurses and doctors out there, but it’s the main mechanical divide in Holding On.

Billy’s story unfolds over the course of 10 narrative scenarios. You’ve got to succeed at one before moving into the next and a story slowly unfolds. I won’t say much more due to spoilers, but the unfolding narrative does make some tweaks to the core mechanisms and add a few rules. In an effort to keep things as spoiler-free as possible, I’ll limit discussion in this article to just the first scenario.

The first chapter of this story is one of getting to know Billy. The first scenario tasks you with encouraging Billy to reveal moments from his past. By providing continuous, high-quality palliative care you can encourage Billy to open up to you. Performing palliative care will provide you with Partial Memory cards. These cards have a quote or statement from Billy and an accompanying bit of art. In this art Billy is rendered clearly, but his surrounding are fuzzy and you aren’t quite sure about the details. What’s much tougher is sketching in these details. Each memory is part of a timeline. These aren’t individual moments, but are a series of memories from Billy’s life all relating to important elements like family or children.


After providing care you’re often given the opportunity to ask Billy about specific memories a little more deeply. To do so you nominate a specific timeline and begin drawing cards from the deck of Clear Memories until you draw a card from that timeline. At the end of the round, you’ll replace any partial memories with Clear Memories you may have drawn. This represents Billy filling in those details and sharing a memory. If there isn’t a match you must discard the Clear Memories you’ve drawn.

This memory system is a fantastic example of how board game mechanisms can be used to drive and enforce a narrative. Partial memories are fuzzy and invoke a natural curiosity in the players. You may sit and take a guess at what else is going on in the story just like actual nurses may chat in the break room. The mechanical difficulty that comes of finding a specific Clear Memory mirrors the emotional difficulty of getting Billy to open up to you and the rest of the staff. It’s frustrating from a play perspective and an emotional one, but it’s the kind of frustrating that makes success sublimely rewarding. Watching a tapestry of clear memories resolve on the board is exciting.

The act of providing care is another great example of this mechanical/narrative intersection. Each day begins with a pool of available nurses, nursing assistants, and on-call specialists that can be used to provide care. A day is divided into three shifts; for each shift you draw a large tarot-sized card that represents Billy’s needs that shifts. Most cards are split into two halves: a palliative care half and a medical care half. Each card also has a minimum amount of nursing resources that must be allocated. Once you’ve allocated nursing resources you can make the choice of providing palliative or medical care. I discussed the results of providing palliative care already, but it’s important to remember that providing medical care is just as important. Billy’s health is in a critical condition and you must do your best to keep him alive.


By spending Care Tokens on the challenges presented by the card you can manage Billy’s medical state or inquire about his past. These tokens represent the time necessary to treat Billy and the unfortunate reality is that you won’t always have enough available to you. There is a heavily limited pool of nursing resources available to you. Should you find you need more nurses for a late shift than you have available you can try to keep some nurses over for a 2nd back-to-back shift but this comes at the cost of stress. Stress markers are stark red rings that rest around your nurse tokens; the weight of this stress literally hangs around their necks and provides a constant reminder that your staff is being pressed beyond their limits. Again, this is brilliant. Stress literally gets in the way of your ability to manipulate your tokens as it figuratively gets in the way of your ability to provide care. Accumulate too much stress and your nurses must go on leave. If you don’t have enough nurses to provide sufficient care then a faceless hospital administration will give you Negative Marks that can even end the game early as the doors are shuttered.


Everything about this is carefully designed and presented to evoke an emotional response in a frankly brilliant way. I learned on the Beside the Box Podcast that the design team  even involved a screenwriter to sculpt the narrative and flavor text. Back and forth the narrative informs the mechanisms, and the mechanisms reinforce the narrative. Partial memories give rise to real curiosity, the inability to provide care plays on your desire to win to summon real stress in the players, and helping Billy work through his troubles promotes real satisfaction. This is a hard game that is also hard to play, but it’s supremely rewarding. It stands out among a sea of cardboard and plastic and – in my humble opinion – is an absolute must-play.

Read about some of our other favorite games of 2018!

Image Credits: Raf Cordero, Hub Games
In addition to Geek & Sundry, Raf Cordero co-hosts the gaming podcast  Ding & Dent. Chat with him on Twitter  @captainraff

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