In praise of connections
I love Connections. Four words times four, meanings torn asunder, waiting for an enterprising mind to bake them into a semantic layer cake. The game’s boards are written by Wyna Liu, a seasoned New York Times crossword editor and lattice-inspired sculptural artist. Inspired by the “playfulness and use of free association” of the brain teaser books she grew up with, Connections is a game about grouping words that share some common thread. Each puzzle consists of a grid of 16 seemingly random words. For example, take the particularly distressing puzzle on October 22nd: PICKLE, BOP, LOAF, GROOVE, SPOT, ROAST, BIND, MASH, SCONE, CHILL, BANGER, TRIFLE, SCRAPE, HANG, JAM, LOUNGE. I stare at my phone. There were no giveaways, no words so isolated from the others such that the category would be obvious. A PICKLE could be food, like a ROAST, LOAF, or JAM, but it could also be a difficult situation, more like a JAM, BIND, or SPOT. Wait, do people say that last one? I take a leap of faith and submit my guess, causing the tiles to deselect themselves and shiver with disgust. A small pop-up taunts me: One away…
Look, you’re not better than me. You’re not. I fumble around with my thumbs and impatiently tap MASH a couple of times before inputting my next guess: BOP, JAM, GROOVE, BANGER — and the words coalesce before my eyes into the category “CATCHY SONG.” Nice.
I nail down the four words belonging to “RELAX,” and then panic sets in. I only have two mistakes remaining to guess the final two categories. I think for a moment, and swiftly tap out my guess. BIND, PICKLE, SPOT, MASH. One away. BIND, PICKLE, SPOT, TRIFLE. One away. A sympathetic pop-up appears to tell me “Next Time,” and my heart sinks. As if to prove how dense I am, the tiles easily glide into their correct places, revealing the remaining two categories with a cutesy flourish: “STICKY SITUATION” and “BRITISH CUISINE.” My morning is ruined.
Of course, I do not always have the luxury of playing Connections on a lazy Sunday morning. Sometimes, I am forced to squeeze in a guess while a friend struggles to sign into Canvas. Other times, I put it off until sundown and gaze languidly at the screen, too paralyzed by my pride to hazard a mistake. The game is downright addictive — my girlfriend and sister are as hooked as I am. It wouldn’t be too hard to spot a Connections-clad laptop screen in the JMEC atrium either, at least until it’s replaced by the daily crossword.
Regrettably, the game has begun to leak into my academic life. I even feel like I’ve been playing during team exams. This is how it goes: we all flip to the next question and discuss. It’s about an obscure detail that none of us would ever think to memorize. But wait — there is hope: someone remembers the general layout of the slide they’re asking about, someone else swears they can recall a couple of words, and someone can even recite the axis labels on the figure! We write down all the content we know, context-free, and then go silent. It is now time to look inward and search desperately for that golden thread, that one, true answer that will connect our hazy memories from that one Friday 8 am lecture. O Lord, let our intuitions be true! Our ExamSoft grades depend on it.
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I realize that the sterile bay beeps and whirs at a couple distinct frequencies. First and foremost, the frequency of life, ranging between one and two hertz. Then, the rushes of machine-driven air, which sound out at a slower pace, about once every four seconds. The remaining atmosphere is filled with free improvisation: various monitors, panels, and warnings, the movement of machinery, the clicks of doors and chairs, the ever-present hum of HVAC. I am just here to observe. I see a sign on the wall which reads “NO RECORDINGS ALLOWED,” and I can’t help but be disappointed. My gowned preceptor quickly ushers me into a room.
In 1980, the experimental, at-the-time-teenaged band Negativland released a peculiar record. One owner recalls the cover as a 10-person family portrait with “The Maytag Corporation” pasted underneath, the name of the band was crudely spray-painted on. Another describes cut-out advertisements for a Norelco-brand shaver and a General Electric TV stand. In fact, each copy of their self-titled debut (out of an initial pressing of 500) boasted handmade cover art, quite the feat for a couple of high schoolers from San Francisco. The content of the record itself is decidedly electronic: primitive synthesizers bleakly squeal over decontextualized radio broadcasts and distorted advertisements — the ethos of suburban 1970s America viciously dissected and lampooned. A nurse explains on track 16 as garbled voices and atonal signals drown her out: “these poor people were completely cut off from the person who knew them the best — their own doctor. There was no personal relationship…”
What would it be like to be a patient in the ward, listening to the clinical ambience as the days go by? To be listening to something that is not quite music, but also not just sounds? To me, the hospital is pure music. I mean this in the most academic sense of the word. The ward represents the collision of the sounds of society and sickness, a rare space where conversations about lunch, the weather, and the kids mingle with square waves, harrowing buzzers, and the coupling of mechanical systems. The well mentally detach themselves from the sounds of the sick, momentarily denying their own mortality for the sake of sanity, whereas the sick can only really make their presence known through these very sounds. Perhaps there is a tired worker who hears tides of respiration and closes their eyes to remember the sunny beach. Perhaps there is a patient who feels bad for setting off an ear-piercing alarm every time their O2 sat dips slightly below 94%. It all depends on how you choose to string together and interpret the sounds in this dark satire.
My preceptor points to an overflowing bag, and I toss my gown into the pile. It was time to trek across the Pavilion, ride the elevator up, ride the elevator down, check the map, backtrack, take a different elevator, and see another patient.
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Nerds were worth double — those were the house rules.
Every summer, each boy would stuff their trunk full of extra socks, water bottles, uniforms, sub-zero sleeping bags, carving tools, comic books, and, if you were a particularly bad Scout, a small Nintendo 3DS you could play deep inside your sleeping bag after the last adult had switched off their head lamp. But the true currency at camp wasn’t games, nor copies of the latest X-Men — it was candy.
Pure sugar. Even the meekest boys brought some. No chocolate though — your buy-in would be reduced to a puddle by the end of the week. If you won, you won big. The reigning champions would slam down jars of the addictive substance onto plastic trunks-turned-tables and sit back coolly in their camp chairs, flaunting their Ring Pops and tipping their shades at any boy with the guts to approach them.
I confess; I too was not immune from the seductive allure of Starbursts and Blue Raspberry Jolly Ranchers. We sat around a trunk, stuffing in as many boys as would fit in our tiny, open-face camping shelters, and watched as a boy in the back produced a trusty pack of red Bicycles.
“Pony up,” bellowed one of the younger Scouts, an imposing force who was inseparable from his trusty, custom-whittled wooden staff.
Everyone tossed in what they had — Skittles, Fun Dip, even Swedish Fish — and with a whack of the staff, the game began.
Hold ‘em is a simple game about matching and predicting patterns. I slipped a thumb under my cards and peered underneath: the Jack of Clubs and the Queen of Hearts. I looked back up at the rainbow-colored pot. Easy.
There was always some punk that went all in on the first round. Thankfully, he had already been sent packing, face buried in hat, a couple hands prior. Some of us called, some of us folded. If you were funny, you tossed a merit badge or pocketknife into the pot. One boy bet a Twizzler, eliciting some groans. I stayed in.
The Flop: 10-A-4. More people folded, while probabilities and card combinations flew through my head. No pairs, but a ten and an ace? A king. Come on, I just need a king. “Sure, why not?” I shrugged and tossed in a handful of Dubble Bubbles, and the crowd went wild.
The Turn: 10-A-4-4. With a flip of the card, my heart began to race. I looked up and noticed the only other player that was still in the game: staff-boy.
“Just you n’ me, now,” he chortled malignantly. I thought of the chances that he had another 4, or even pocket aces, and weighed it against my straight, which seemed more like a Hail Mary at this point than a plausible outcome. I stared at the saccharine sum and imagined myself finally being the one to get to lounge, slick back my hair, and haphazardly toss a couple Lifesavers to the uncandied. I glanced back at my cards, and I felt my stomach drop.
“Hey buddy, I’ve got nothing to lose,” I said confidently, relinquishing the last of my Dum-Dums.
The River. Time to sink or swim. Everyone went silent as the boy in the back flipped over the final card: 10-A-4-4-4.
Of course. One away…
We revealed our hands, and the boy, now hollering, cleanly raked in his spoils with his staff. I stepped outside of the shelter for some fresh air and managed to convince one of the senior Scouts to lend me a couple Tootsie Rolls for the next round. A Scout may be trustworthy, loyal, courteous, and kind — but he is also thrifty.
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It wasn’t a migraine. Nor was it a tension headache. Not a cluster headache. Ruptured aneurysm? Good Lord, I would be dead by now.
The differential ran through my mind as I lay in an Airbnb in Manhattan. It was the start of January (Happy New Year!) and I was maybe on my third or fourth Ibuprofen or Tylenol of the day. I gingerly took a sip from the glass of water my girlfriend had brought for me and tried to focus on my breathing. The weekend getaway was not going super well.
The next day, the pain was still there. I spent another day in bed; we ordered takeout that night. I could not think of any exposures, inorganic or otherwise, nor trauma that could have resulted in the excruciating pain currently emanating from a spot on the margin of my neck and my skull. In medical school, we sometimes scoff at the odd or dramatic descriptors for pain — I assure you that pain can indeed be “searing.”
I sat in Moynihan Train Hall waiting for my 10 pm train back to Philadelphia, mostly because I’m a cheapskate. I would reach 30th Street Station around midnight, so I found my seat and tried my best to close my eyes and rest. This proved difficult: even a light touch of my head on the seat behind me was enough to conjure the sensation of a red-hot poker ramming into my skull. I plugged myself into Todd Rundgren and MF DOOM on low volume to distract myself from the pain. My eyes were wide open. It was difficult to focus on anything. Was I dying? Well, “Mm..Food” wouldn’t be a bad album to end on…
Upon arrival at the station, I immediately called an Uber to the emergency department. “Glad ur back in Philly now at least,” my girlfriend typed at 12:28 am. “But yikes 🙁 the pain killers aren’t cutting it…” I told the ED staff my symptoms, and as thanks they gave me a colorful wristband. Over the next few hours, I would become well acquainted with the other people in that room. Around hour two, we lost an elderly couple, and it wasn’t until hour three or four that a limping man was led into the back. At some point, someone came to check my temperature and blood pressure, but my nose had started bleeding, and it was difficult to hold the tissue and adjust the cuff at the same time. The person in scrubs looked at me and seemed to smirk a little. Hey, it’s all good. I too found the whole ordeal rather humorous. It was after seven hours of sleepless awareness, of seeing people shuffle in and out of the glass doors, of nibbling on the granola I had thrown into my bag days prior on a last-minute whim, of listening to reruns of some haughty televangelist on the TV in the corner (no remote control or mute button in sight), that they finally led me to a bed.
I’m not completely sure who saw me. They gave me a pill, and I took it. The person dressed in scrubs came back and pressed on my neck. They told me “migraines,” and offered to hook me up to a line and pump something into my veins to help ease the pain. I declined. I slowly collected my belongings — a jacket, a backpack, a duffel bag — and exited through sliding doors. Strangely lucid, I began to walk home.
I hadn’t realized it from the inside of the triage room, but the sun was already out. I looked up and saw a brilliant and cloudless blue. I took a deep breath, and I felt the air, crisp, alive, and filled with the humming of daily commutes. I could feel the pain in my head ease ever so slightly — was this really the pill? I walk, and I walk, and finally I cross the South Street Bridge. My phone buzzes triumphantly: “Step target reached. Well done!”
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I love connections. I have to. Connections dictate what is logical, and therefore real, and what is contrived. We all engage, consciously or bot-assisted, in this decision making; it’s how we make sense of the world.
What happens when the connections aren’t clear? To me, the tension between interpretations is just as enchanting. Interpretation is what separates migraines and “occipital neuralgia,” which, looking back, was a better fit for my chief complaint: focal, unilateral pain at the base of the skull with allodynia lasting several days. At camp, your own discernment is the crucial difference between predicting a straight and instead preparing yourself for the victorious twirl of a staff in the air. The will to interpret can be used to combat banality; it can convert everyday hospital ambiance into the subtle progressions of a sound collage. It’s what helps us to best another one of Wyna Liu’s dastardly boards with only one mistake remaining. It is the difference between seeing four seemingly unrelated vignettes and realizing that they actually cohere into one greater story.
It’s important to sit with connections. Let them steep. Write them down. Leave them alone in the morning, then come back to them at night. Try to peel back the facade and bare the logical circuitry underneath. Find out what makes someone tick, which concepts impose on their being. Search not just in the clinic, but everywhere you go. Consider all possibilities. Offer your best answer and help someone. Relish, and dig deeper. Do what a large language model can’t do: have fun. Remember that it’s okay to be wrong. What do I know, really? I’m just a med student. And there’s always next time…
Ian Ong is an MS2 at Perelman School of Medicine.
Art by Jasmine Larrick, an MS2 at Perelman School of Medicine.
