CA-1 Resident John Tokle Publishes Reflective Op-Ed in, "Anesthesiology"
As physicians, we spend years learning how to read images, interpret data, and synthesize findings. In a recent op-ed published in Anesthesiology, John Tokle, MD, turns that diagnostic lens inward—offering a creative, deeply human reflection on the transition from intern to resident physician.
Titled “Pan-scan of an Intern,” the piece is written in the style of a radiology report, using anatomy and imaging language to explore the cognitive, emotional, and physical realities of internship. From the exhaustion of night float and the pressure of clinical decision-making to moments of levity, loss, growth, and gratitude, Tokle captures the paradoxes of early medical training with clarity, honesty, and wit.
The essay originated as a creative writing project at the end of Tokle’s preliminary medicine year and was later accepted for publication in Anesthesiology—a testament to the value of reflection and storytelling alongside scientific inquiry. Through humor and vulnerability, “Pan-scan of an Intern” reminds readers that becoming a physician is not just an accumulation of knowledge, but a process of personal transformation. Read the op-ed below!
Pan-scan of an Intern
By: John Tokle, MD
History: 28-year-old male concluding a prelim medicine year and about to start residency.
Technique: Unspecified cross-sectional imaging was obtained from head to toe.
Findings:
Frontal cortex: Paradoxically knows enough and not enough simultaneously.
Hippocampus: Evidence-based medical esoterica and the lyrics of Bob Dylan vie for memory consolidation. The answer regarding the required washout period for an ACEI prior to starting Entresto is unfortunately not “Blowin’ in the Wind.”
Amygdala: Aglow with waxing confidence and waning inadequacy.
Internal auditory canals: Ring with regular rates and rhythms, murmurs, rubs, and gallops. Ache with stethoscopic silence at times of death in family-filled rooms.
Optic discs: Double exposed with mistakes. The levity of erroneously ordering a quad marker screen rather than a quad viral panel. The sorrow of failing to order a time-sensitive critical troponin and missing an NSTEMI.
Brainstem: The reticular activating system is saturated with coffee and Red Bull.
Sinoatrial node: Hums with an unbounded supply of P waves opposing the expansive hours and early am fatigue of unending night float shifts. Accelerates against an artillery of crosscover pages.
Chordae tendineae: Strained by the emotional vectors that push, pull, and shape goals of care conversations—the melancholy of memory, brilliance of biography, dignity of defiance, comfort of community, victory of volition.
Lungs: Inflated after performing a champagne tap on the first lumbar puncture attempt of the year. Deflated after whiffing the second.
Carpal tunnels: Entrapped with the QWERTY keystrokes of a thousand histories, hopes, fears, confessions, confabulations, and veracities.
Right hand: Obscured by motion artifact. Fidgets a four-color prerounding pen. High-fives a teammate. Braces a shoulder for bad news. Greets a new admission with a cordial handshake.
Vertebrae: Outnumbered by active medications on said new admission’s med rec.
Quadratus lumborum: Long forgotten from MS1 anatomy lab and unwittingly injured during a lively pickleball match with competitive cointerns.
Spleen: Churns with constructive criticism, imposter syndrome, and self-comparison to peers, which are all recycled via the reticuloendothelial system, whatever that is.
Skin: Diffusely thickened.
Impression:
- Growth from incipient intern into resident physician.
- Gratitude for this past year. Excitement for the future.
We’re proud to see our residents contributing to the specialty in diverse and meaningful ways—and to celebrate the voices that help tell the story of medicine from the inside out! Congratulations, Dr. Tokle!