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A Way With Words: David Steensma, MD

December 30, 2021
David Steensma, MD
Edward P. Evans Chair in MDS Research and Institute Physician at the Dana-Farber Cancer Institute; Associate Professor of Medicine at Harvard Medical School; Editor-in-chief of ASH Clinical News

When did your interest in crossword puzzles start? Did you enjoy puzzles growing up?

My mother has long been an avid "cruciverbalist" – a crossword puzzle aficionado. In 1977, when I was in elementary school, Mom subscribed to a new magazine called Games, which included a workable newsprint puzzle section called, "Pencilwise." As my own puzzling interest and ability grew, we began squabbling over who would get first crack at the magazine whenever a new issue was delivered each month. For a time, we even had two subscriptions, so we could each do all of the puzzles. In recent years, Mom's proudest non–grandchild-related moment was winning a copy of a puzzle book signed by The New York Times puzzlemaster Will Shortz for finishing a crossword before any of the other attendees at a seminar he led.

So, puzzle-solving is in your blood?

My father was a radio engineer for a defense contractor, and, for most of his career, he designed encrypted communication devices for the military that would allow U.S. and NATO forces to talk without the Soviets or other enemies listening in. So, I grew up with a strong interest in codes, languages, and puzzles. My favorite non-baseball extracurricular activity was fiddling with computers, and I taught myself to program in languages like Pascal, Fortran, and C++, which were all popular programming tools in the early 1980s.

When did you start creating them, and when did you start incorporating hematology into creating them?

As a student, I wrote a few basic word puzzles that were published in school newspapers, but when it comes to crosswords, I have always been much more of a consumer than a creator.

I first created a hematology-themed crossword puzzle for ASH News Daily at the 2008 ASH annual meeting. During the planning session prior to the annual meeting, Ruben Mesa, MD, the newspaper's editor-in-chief that year, asked for creative suggestions, and I brought up the idea of making a crossword puzzle – just like a "real newspaper." The ASH staff coordinating the newspaper that year was enthusiastic (my proposal for an ASH-related comics page was met with less enthusiasm). It was fun to see attendees at the annual meeting working on the puzzle while waiting for an educational or scientific presentation to start.

The following year, I was the editor-in-chief for ASH News Daily, and I included another puzzle. Since then, I've been asked by the ASH staff to create a new puzzle each December for the newspaper.

The first few ASH News Daily puzzles I made weren't so good – I am no Will Shortz! But enough colleagues told me they enjoyed them that I was encouraged to keep creating them. Hopefully, the puzzles have improved a little over the years. Since 2008, the puzzle style has evolved, and I have switched from the British/South African-style to American-style grids, which are denser and have tighter rotational symmetry – and are correspondingly more difficult to construct.

Can you walk us through the process of creating one – where do you start?

I use the "Crossword Compiler" computer program, which is a major advance from the dark days of creating puzzles by hand using graph paper. For the ASH News Daily puzzle, I usually pick a few hematology-related terms to seed the grid at the start, and then the computer calculates whether it is still possible to create a puzzle using those terms; if not, I pick new seed terms. Then comes the more tedious work of filling in all the blanks and making sure not to paint myself into a corner where no conceivable word fits.

The success of a puzzle depends greatly on the clues: If they are too simple, the puzzle is boring, and if they are too difficult or obscure, players get frustrated and lose interest. Most clues I create are "straight," but metaphors and other wordplay that requires some form of lateral thinking is especially fun.

What do you enjoy most about solving crosswords?

What I enjoy most about solving crosswords and other word puzzles is learning new facts and new words, and those A-ha! moments that come with deciphering a well-crafted clue. Some puzzles in major newspapers or in Games are also secretly themed, and I am sure there is a heady neural dopamine rush that occurs when discerning what the linking pattern is. The wordplay aspect can be fantastically clever (or evil). Completing a crossword is similar to the thrill of solving a detective mystery; it is not surprising that Colin Dexter's Inspector Morse was a crossword fanatic.

I am a big fan of the quiz website Sporcle.com, and, when I was a post-doc in a molecular hematology lab at Oxford University, I was a regular at weekly pub quizzes. One of my other avocations is collecting stamps of the Netherlands and former colonies (Suriname, Curacao, and the Dutch East Indies), so I apparently also just like to fill in empty rectangles.

Do you still do puzzles every day – and do you do them in pencil or pen?

In pencil, definitely. I am highly fallible. The exception is on airplanes: Airline magazines publish on glossy paper, so ink is essential.

A grinding commute into Boston, a busy family life, and an active hematology practice mean that I don't get to do a crossword each day anymore, but I often play a few Sporcle quizzes in the late evening, once my brain begins to develop decision fatigue and shut down for the night.

My Mom and I still battle for the puzzle page; whenever I visit my parents, I have to wake up early to get at The New York Times daily crossword puzzle, as my mother inevitably finishes it within 15 minutes of the paper arriving on the stoop.

With The New York Times puzzles, which increase in difficulty throughout the week, I can get through Thursday. Friday is tough, but often doable. Saturday puzzles are usually monsters. Mom can do that one, but it might take her a few extra minutes. Given the frequency with which obscure pop groups from the 1950s or opera singers from the 1920s appear, I usually need an assist from Google or the clever "Rex Parker Does the NYT Crossword Puzzle" blog.

A couple of years ago, Timothy Ley, MD, from Washington University School of Medicine in St. Louis, Missouri, published a top-notch leukemia genomics study in the New England Journal of Medicine, and a reporter from The New York Times called me for some context on it. One of my quotes ended up on the front page of the paper the next day. When my mother opened the paper that morning and glanced at the top stories, she was so startled to see my name that she spilled some of her coffee on the paper. She was torn between pride at seeing her kid quoted on the front page of The New York Times and irritation at having spoiled that day's crossword.

What skills do you use in your "pASHion" that you also use in your hematology career? Is there any overlap?

Word puzzles are an enjoyable diversion from professional life, and while there is probably not much direct applicability, I think the wordplay and metaphorical clues might help prepare one mentally for the banter that is so much a part of academic life. Also, I'm told that doing crossword puzzles and word games helps slow the descent into dementia. So, on the days when I don't get to the gym, I can convince myself that puzzle solving counts as a form of exercise.

Feeling Cross?

Try your hand at a "vintage" ASH News Daily puzzle from the 2012 annual meeting.


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