Tanna Christensen lowered her fingertips onto the knurled flesh and plunged the blade deep into the muscle beneath.

“Still with us?” the instructor asked.

The first-year medical student managed to nod. But it wasn’t the truth. Eight o’clock in the morning was too early for her to peel open a body.

“You have to breathe.”

Tongue clicks and loud snickers rose from Tanna’s so-called peers in her Human Gross Anatomy class. She didn’t look up as they circled her. Scrutinized her. All eyes focused on her.

The floor shifted under Tanna’s feet. She braced herself for what was coming.

“Take a breath,” the instructor reminded her again.

Don’t stop, Tanna thought. Keep moving. But her traitorous muscles hardened. Her limbs cemented themselves in place. She stood there, motionless, until the instructor reached across and pulled her hand away.

“You need to let go,” he said. The scalpel stuck straight out of the cadaver, a ghastly exclamation point to her failure.

Heat stung Tanna’s neck as her face flushed fever red.

If it had been just her and the cadaver, she would have been fine. Probably. But standing in front of all her fellow medical students was different. Their staring eyes and silent judgment drove a frantic pounding through her chest that left her feeling insecure. Powerless. And that infuriated her. She was twenty-four years old; she knew what she was doing. She really did.

Tanna looked around and saw her classmates reveling in her collapse, unable to hide their sadistic smiles.

“Who’s next?” the instructor asked.

She squeezed her hands into tight fists, first left, then right. A trick she learned when she was nine, after she mangled the Pledge of Allegiance in front of the entire school. Left. Right. Inhale. She would never forget opening her mouth with confidence, only to hear her words come out wrong. All wrong. She then melted into a puddle on the cafeteria stage. Watched the room spin. Detached from herself. Unable to hide.

Left. Right. Exhale.

She ached to grab her lucky exam pen, currently tucked away in her pocket. To run her fingers over it while she mentally reviewed the photo flipbook of human organs she had created to prepare her for the real thing.

She had done the work. She just needed to trust it. No matter how many people were watching.

“I can do this,” Tanna said.

She reached for the scalpel. But Nick grabbed it first. Nick and his neon-white teeth. Nick, who wore too much cologne and was a close-talker. There’s such a thing as personal space, Nick. Nick, the ambitious gunner whom all the students openly wished would crumble under the pressure of medical school. Except everybody knew he would finish at the top of the class and get whatever job he wanted.

“The incision needs to follow the outside edge of the trapezius muscle,” Nick said as he cut into the layers of tissue.

Tanna’s shoulders wilted. She might have been just a first-year student, but even she knew that medical school was not a place to expect coddling. Sink or swim, do or die. All the clichés were true.

“Here,” Nick pointed out. “Infraspinatus muscle, identified.”

She stepped back into the crowd of student spectators as Nick droned on, nauseating the class with his cloying honeysuckle scent. And when he’d passed the oral exposition, he flashed Tanna a condescending smirk that leveled her as if she’d been hit with a crippling gut punch.

The instructor split the students into teams of four and assigned each group a fresh cadaver for practice dissection later on. Tanna’s team named their corpse George, even though they were told not to personalize their relationship with the non-person.

Tanna smiled, she joked. She pretended.

Afterward, as the others departed, the instructor approached her.

“Lots of students struggle in here,” he said, filling the hard silence. “Some find out they can’t cut it. Or don’t want it.”

“I just needed more time.”

“Doctors don’t get the luxury of more time. And they don’t get second chances.”

“I know.” Tanna fought the urge to leave. She didn’t need a lecture. Nothing he said could be worse than what she was already telling herself.

“And this year, you need to pass two forty-minute oral expositions. Or fail the class.”

Except that.

“Do you know why I picked you to go first?”

Tanna shook her head. She didn’t want to hear any more.

“I remember your admission essay. It stood out. So I thought you’d be ready. Because it’s not the cadaver that stops people. Maybe you don’t believe what you wrote.”

“No. I mean, yes. Medicine is fascinating.” The words rushed out. “Everything it can do, the endless possibilities, the people it can help. That’s why I came here.”

“You’re tired of not making a difference in the world.”

Tanna had written and rewritten her essay so many times that she still knew it by heart. But hearing someone else speak her words gave them a gravity she’d never expected.

“I am,” she said.

The instructor led her out of the room, the door closing behind them, and started down the hall. “We’ll be back here in a couple of days,” he said over his shoulder as she heard the door’s latch catch against the jamb, missing the final click. “Then, maybe, I’ll let you try again. If you’re sure about that.”

Normally, the Los Angeles campus of Southern California Science and Medicine reminded Tanna of a resort, not a university. Precise rows of towering palm trees lined manicured lawns, and birds of paradise sprang from the soil, fanning vivid orange and blue petals high into the open air. Sun-drenched days warmed the cream exteriors of the Romanesque buildings dotting the campus. Every Tuesday and Thursday the dining hall held outside barbecues and students hung out in the sunken gardens. Add an infinity pool with a swim-up bar, and SCSM could have been the Four Seasons.

Today Tanna saw none of that. Today she saw buckled asphalt and rust-streaked windows. Today she wandered the grounds in crisscrossing arcs for more than an hour before settling at the top of the bluff near the old dormitories. There she focused on the Pacific Ocean stretching out in the distance until it fell off into nothingness.

Go check the door, her mind told her. It didn’t close all the way. You can go back in and get it right this time.

Tanna paged through her Medical Biochemistry workbook, but the thought played over and over on repeat. The morning’s humiliating events had sent her emotions ping-ponging between anger and regret. She didn’t know if she could complete one oral exposition, let alone two. Who was to say the same thing wouldn’t happen again? Then not only would she fail the class, she could flunk out of the university altogether.

A janitor or security guard might have closed it. But if not . . .

She remembered how excited she’d been after receiving her SCSM acceptance letter. For six months before taking her Medical College Admission Test, she had devoured every textbook she could find while working double shifts for a shady carpet distributor. Then came formal applications, personal interviews, secondary interviews. Sleepless nights and zombie-eyed days. But when the email showed up in her inbox, and as she read the opening lines, she knew it had all been worth it. Several weeks later she had given up her studio apartment, having sold everything that wouldn’t fit in her rusted blue Mazda with the mismatched wiper blades, and was driving the two thousand miles from Chicago.

All that seemed like a lifetime ago.

What are you waiting for? To blow another opportunity?

Somewhere inside her, a decision was made.

She tried to dismiss it, but her mind was already playing out the details. She envisioned herself going through her incisions, building up her muscle memory. If she practiced on her own with a real cadaver, she’d be able to pass the oral expositions. She was sure of it. And she had to be. If she choked again, that label would follow her around forever. Not only through school but on into her residency.

If she even made it that far.

To get after-hours lab admittance, students had to apply for dedicated security access and work under strict instructor supervision. But all of that took time to arrange. Time she didn’t have; there were only two days before the next lab. Besides, she only needed a few minutes. Just enough to prepare her for anything the instructor threw at her. Enough to stick it to Nick for stealing her chance. Enough to prove she could do it.

Even if that meant violating the pledge she had signed at the bottom of a very official-looking piece of paper.

Go check the door.

As Tanna stood in the empty hallway outside the gross anatomy lab, the anxious thumping in her chest returned. The afternoon sun pushed thin rods of light through the building’s punch-block windows while casting threatening shadows everywhere else.

The door was in fact ajar—if just barely. But it was so close to closed and locked that one wrong breath could clap it shut, and ruin any chance of redemption. Then again, walking through could also seal her medical-school fate.

Or save it for another day.

She dismissed that thought as quickly as it came. Because if not now, when? When would it ever stop?

“Here we go,” she whispered, pushing the door open and slipping inside.