Birth is a point-and-click puzzle game about loneliness. In it, you explore a surreal metropolis full of beautiful, broken things. The goal is to find spare bones and organs so that you can build yourself a companion.
You start with the spine and work from there, visiting apothecaries, apartments, and antique shops—spaces grounded in reality but tinged with a dissociative atmosphere. A disembodied fish is taped to a bookcase. There are bones in the washing machine, and entire worlds grow like mould on small plates and mason jars.
You drift through this dream like a ghost, tinkering and collecting your tools, watching on as its wordless inhabitants live their lives around you but not with you.
I played Birth on my Steam Deck a few weeks ago, and the experience was profound and unsettling. It made me reflect on some of the darkest periods of my life. It is still living with me now. I’m sure it will for a long time.
Like any good piece of art, trying to uncover its ultimate meaning would be a foolish endeavour — Birth is more like a mirror, letting you see what you’re looking for in it, no matter how uncomfortable that may be.
I contacted Birth’s creator, solo developer Madison Karrh, to dissect it a little.
People often ask about games, but do you take inspiration from books, movies, albums, or other cultural artefacts when building your worlds?
MK: The Field Museum in Chicago is one of my favourite places in the world. All of the care that went into preserving dead creatures makes my heart genuinely swell. The House on the Rock is also a very inspiring place – the thought of someone spending their whole life making such huge things is so humbling.
Oh! Also, The Lord of the Rings – specifically the Making Of videos that come with the movies. It is just HOURS and HOURS of footage of how much love and work, and care that went into making the movies. It is maybe one of the most motivational things I’ve ever watched. I just love being reminded of the incredible things humans will do to create art & entertainment for other humans.
When you were making Birth, was there a point in the early stages where something clicked together, and you were like, ‘Oh, I’ve got something here’?
MK: The jar-of-seeds puzzle in the Apothecary was one of the first puzzles I ever made, and I was smitten with the clumsiness of the physics. I think that inspired a lot of other puzzles and toys in Birth – I think making a mess in the game world is really fun.
Was there a direction for the game you planned to follow that didn’t work out?
MK: Yea, I originally had planned to have you not only collect bones and organs but also “personality traits” for your partner (curiosity, gentleness, wit, etc.). But when I realised how much of the story could be told without words, I let that idea go in order to keep the words to a minimum.
When you finish Birth, you see a message. ‘Thank you for taking a small amount of your allotted time on this earth to play this game’. It made me ponder the ‘backlog death march’ mindset I’m usually in. Do you think we need to think more about what we give our time to?
MK: Thank you, I am so happy that you resonated with that! I probably think about my fleeting time on this Earth a little too much, but it definitely makes me more intentional. I think being able to relish in both the junk food and the extravagant dishes is important.
I find delight in every single day and every bit of progress I make because of my knowledge that I will die at some point, and I know that sounds morbid, but it is genuine motivation for me.
Birth made me think a lot about the loneliness I’ve experienced as an adult. When I was at university living with other people, there’d be long stretches where the shared areas would be dormant. We’d live our lives in this house we’re all renting, not interacting. I felt like my room was my entire world. I’d spend all my time in there, wishing I had a reason to be out in the city living.
Going out and interacting with the world in such circumstances can feel like solving a bunch of phantasmagorical puzzles. Sometimes, a lollipop is an eyeball on a stick… It’s tough to summon the courage to solve your problems, but in the end, it’s worth it to find new connections that help you not feel so alone and misunderstood. This game is absolutely something that’s going to mean different things to everyone, but do you see anything in that from your perspective?
MK: Your description of loneliness in university is very relatable. I am sure that as a fellow creative, you also understand the fact that you have to be comfortable spending a huge amount of your time alone in order to make things. I have spent most of my twenties living alone, eating most of my meals alone, playing games alone, making things alone. I had similar feelings to the ones you’ve described. I struggled with thinking that I was wasting my life by staying inside and making things, but luckily I am a lot more confident in my alone time now.
I actually fell in love for the first time when I was working on Birth, so I think a lot of the surreal, phantasmagorical puzzles are probably inspired by the head-high of learning another human and melding into their life. The restaurants they like, the games they played when they were young, the trinkets in their home.
Where did you find inspiration for the puzzle paraphernalia of Birth? I particularly loved shucking the pomegranate and the repurposed GameBoy Advance, which functioned like one of those little water games you’d get in a Happy Meal, lol!
MK: Yes! “Puzzle paraphernalia” is a wonderful phrase! A lot of the objects in the game are inspired by little things that I see in the city (sans the bones & organs, of course). There is a “Lost Necklace” sign in Birth which was inspired directly from a “Lost Necklace” sign that I saw on a signpost that day.
Sometimes I get pomegranates on sale, and sometimes I see a snail in the park or a mass of ants swirling around a peach slice and just have to draw it. I think it is a fun way to document extremely mundane moments. I think most of life is made up of mundane moments, so maybe those are the most important pieces to document.
What do you think about the state of storytelling in modern games? Do you play much AAA stuff? It can feel like we’re pushing a bit too far towards the safe cinematic playbook with celebs and blockbuster stories. Birth was a massive refresh of ‘here is a story without words’ or any of the typical tools that the big games often use.
MK: I agree with you. I really cherish the human feeling in any media that I consume – I do not like when I can feel the lack of vulnerability. Tell me your secrets, show me your insides.
I don’t play many recent AAA games, but I do love the Resident Evil series. For the past year, I have been playing a lot of old survival horror games, and they are just delicious. The characters in Silent Hill 2 are specifically memorable to me.
How do you feel about the general response to Birth? Have you had any unexpected insights from players now that something so personal is available for everyone to play?
MK: I am so surprised by how well Birth has been received. It is such a personal game that it feels like everyone that has said nice things is taking my hand in theirs and saying, “I understand you,” which just makes me cry. I think showing your soft underbelly allows others to show theirs too. It makes me feel so much more connected with people.
