Unlike other Saga titles, MGS4 offers little overt exposition upon its theme, Sense. The word Sense likely comes from Hideo Kojima's idiolect of wasei-eigo words, Japanese words derived from contact with English. As with many wasei-eigo words, the term's meaning likely does not align with most native English speakers' semantics, and its meaning must be inferred from the context of MGS4.

From the game's form, we may infer that Sense describes the habits and routines that inform a person's behavior. However, the word "habit" does not carry the full negative connotation that MGS4 seems to assign to Sense. The game enforces a negative understanding of Sense through the motifs of addiction and cancer.

Snake's smoking itself is a Saga trope, and the addictive nature of smoking falls in line with the motifs previously explained – sets of behaviors that culminate to destructive degrees. MGS4 parallels its own reconfiguration of Saga tropes with images of Snake's smoking and decay during the game's load screens. Characters in the game berate Snake (at length) for his smoking and, to a lesser extent, his use of the nanomachine suppression syringe. The tropes that constitute the Saga's own habits are implied to be equivalent to acts of addiction. MGS4 imagistically associates this addiction with the iterations that have created the Saga itself when it shows Sunny serving Snake a cigarette with his burned eggs, as if to say, "These are the same."

Appropriately, MGS4 maintains cancer as a motif as doggedly as it does addiction. Two "cancers," one literal and the other abstract, emerge over the course of the game. Most literal is Naomi's cancer, which she keeps at bay via nanomachines. The mutation of MGS1's Foxdie virus within Snake's body forms a more abstract collage of cancer associations. When Naomi explains how Foxdie mutates in Act II, the audience sees the virus associated with three aspects of the cancer motif: Snake's smoking, his decay, and the image of a mutated cell.

These motifs reflect the narrative development of the Patriots' AI, characterizing them as a kind of digital cancer. Big Boss describes SOP as having resulted from the Patriot AIs' taking on a will of their own, mutating, and tainting the world with iterations of the Saga's circumscribed tropes. He identifies them in the same terms that MGS4 uses to define Sense: repetitive behaviors bordering on addiction that result in self-reflexive overflow and collapse.
 

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