Skin Deep (Graduates of Love #2)

Finding Her Way

Isa Moreno had entered college with a fire in her heart and a singular goal: to become a doctor. 

Medicine had always been her dream, the ultimate blend of intellect and compassion that she'd admired in the caregivers of her childhood. She'd grown up in a bustling neighborhood where her grandmother, a retired midwife, was the go-to healer. Isa spent countless afternoons watching her grandmother stitch wounds, check fevers, and soothe fears, all while sharing stories of the doctors she'd worked alongside. Isa wanted to be one of them, someone who could change lives, one patient at a time.

But by the end of her first semester in college, Isa was struggling in a way she hadn't anticipated. Honors chemistry felt like a foreign language, honors anatomy lectures overwhelmed her, and every exam seemed like a test of her self-worth. What hurt more than the academic challenges, though, was the culture surrounding her. Her premed cohort was cutthroat, with classmates constantly competing to outshine one another. Study groups turned into strategy sessions for who could dominate the curve. Every interaction seemed to remind her of how much farther she had to go.

One night, during a particularly grueling study session, Isa sat in the corner of a library study room with her group consisting of all premeds. She had joined them early in the semester, hoping to bolster her understanding and build connections. But then, as Brian, Kelly, and Marcus debated the finer points of cellular respiration, Isa felt more like an observer than a participant.

"Okay, so glycolysis happens in the cytoplasm," Brian said, his pen flying across the whiteboard. "Then it's the Krebs cycle, right? Pyruvate becomes acetyl-CoA—"

"And we can't skip the link reaction," Kelly interrupted, her tone clipped but confident. "That's where NADH production starts."

Isa's eyes darted between her notebook and the whiteboard. She tried to keep up, her pen poised over her paper, but the discussion moved faster than she could process.

"Wait, could we—" she started to say, her voice barely above a whisper.

"What about the ATP yield?" Marcus jumped in, his question steamrolling over hers. "I think it's 36, but didn't the professor mention variations depending on the shuttle?"

The others quickly picked up the thread, debating shuttle systems and ATP yields as if they were speaking in code. Isa felt her face flush as she glanced at her notes, which suddenly seemed woefully inadequate. She wanted to ask for clarification, to request they slow down, but the thought of interrupting their flow filled her with dread.

By the time they paused for a breath, Isa had fallen hopelessly behind. "Isa, do you have that chart?" Kelly asked, glancing her way briefly.

"Oh, um... I think so," Isa mumbled, fumbling through her textbook. But before she could find the page, they'd already moved on.

The worst part wasn't their speed. It was that they didn't even notice she wasn't keeping up. They weren't mean or dismissive; they were simply too focused to wait for her. She was just a shadow on the periphery of their conversation, a silent presence that didn't alter their rhythm.

As the session wound down, Isa packed her things in silence, her stomach twisting in knots. The group laughed and chatted about weekend plans as they left, their camaraderie a stark contrast to her lingering sense of isolation. She walked out of the library feeling smaller than she ever had before.

It wasn't that they had excluded her intentionally. But their indifference, their unrelenting pace, only highlighted her own inadequacies.

By winter break, Isa was doubting everything. She dreaded the thought of returning to the competitive grind, but she couldn't bring herself to admit it outright. Instead, she signed up to shadow Dr. Howard, a family medicine physician who worked at a local clinic. Isa thought of shadowing as a way to reconnect with the core of why she wanted to pursue medicine in the first place.

Dr. Howard wasn't what Isa had expected. He was in his late sixties, with a head of silver hair that seemed permanently tousled and a laugh that came easily, even in the busiest moments. His office walls were covered in framed photos of his patients, many of them children, who had scrawled notes of thanks in crayon. He wasn't flashy or intimidating. He was kind, unhurried, and deeply connected to the people he served.

For weeks, Isa followed him through his day, observing how he treated every patient with the same level of respect and care, whether they were a young mother worried about her baby's rash or an elderly man managing diabetes. Dr. Howard always seemed to know the right thing to say, his calm presence making even the toughest conversations bearable.

One afternoon, after a long day at the clinic, Isa lingered as Dr. Howard finished typing up his notes. The clinic was quiet, the hum of the HVAC system the only sound in the room. Dr. Howard glanced at her and smiled. "You've got something on your mind, Isa?"

She hesitated, her hands twisting nervously in her lap. "I don't think I can do it," she admitted finally, her voice barely above a whisper.

"Do what?" he asked, leaning back in his chair and giving her his full attention.

"Medical school. Becoming a doctor. This whole path," she said, her words tumbling out in a rush now that she'd started. "It's not just the classes. It's everything. The competition, the way everyone's trying to one-up each other. It's like... like I have to prove I deserve to be there every second, and I don't think I can keep up. And honestly? I'm not sure I want to anymore. It's all so cutthroat. I thought medicine was supposed to be about helping people."

Dr. Howard leaned forward, resting his elbows on the desk. His expression was serious but kind. "You're not wrong, Isa. The road to becoming a doctor is tough, brutal even. It weeds out a lot of good people, not because they're not capable, but because the system is built to test endurance, not compassion. But let me ask you something. What is it you really want out of a career in medicine?"

Isa blinked, caught off guard by the question. "Obviously, I want to help people," she said after a moment. "I want to work with patients, build relationships, make a difference in their lives. But I also want balance. I want to have a life outside of work. I don't want to lose myself in the process."

Dr. Howard smiled knowingly. "That's a pretty honest answer. You know, there are other ways to be in medicine without going through the meat grinder of medical school. Have you ever considered being a physician assistant?"

Isa frowned. "Not really. Isn't that like a step down?"

"Not at all," Dr. Howard said firmly. "PAs do a lot of what doctors do. They diagnose, treat, prescribe medication, but they have more flexibility. They're a vital part of patient care, and in many ways, they get to spend more time doing what really matters: connecting with people. And you strike me as someone who values that."

Isa hesitated. "But wouldn't people see me as less than?"

Dr. Howard chuckled. "Less than what? A title? Let me tell you something, Isa. Patients don't care about the letters after your name. They care about how you make them feel, how you treat them, how you listen. Titles don't heal people, people heal people."

His words settled over her like a balm, soothing the insecurities she hadn't even realized were weighing her down. "So you think I could be good at it?" she asked, her voice softer now.

"I think you'd be great at it," he said. "You've got the heart for this work, Isa. The rest is just finding the right path to let it shine."

That night, Isa went home and stayed up researching the PA profession. The more she learned, the more it resonated with her. It was exactly what she wanted: meaningful patient care, collaboration with doctors, and the ability to build a fulfilling life both inside and outside the clinic.

By the end of freshman year, Isa had shifted her academic focus, her sights set on becoming a PA. It wasn't a compromise. It was a revelation. Years later, she would look back on that conversation with Dr. Howard as the moment everything changed. He hadn't just pointed her toward a new career. He'd given her permission to redefine success on her own terms.