The Carlton Club (14 page)

The senior surgical resident was the trauma chief. During his six-month rotation as trauma chief, he never left the hospital. Dr. Ed Moore was already in the emergency room when Mark was shot, caring for a patient who had been stabbed in the thigh. Ed wanted to get the other patient stabilized so that he could devote his full attention to Mark when he reached the trauma room.

Ed Moore quickly moved beside Leslie.

“OK, Les,” he said brusquely. Meaning, I’ve got him now.

Leslie looked at Ed and said calmly, firmly, “I have my finger on the severed artery.”

Ed drew in a breath when he saw Leslie’s bloodied face.

“Hold onto it, Les. I’ll get a clamp.”

Ed eased the long silver clamp beside Leslie’s finger. They couldn’t see anything. It had to be done by feel. Leslie had to direct Ed.

“There,” she said when she felt the cold clamp near the tip of her finger.

Ed opened and closed the clamp, taking a blind bite at the artery.

“OK. Let go.”

As soon as Leslie released the pressure exerted by her finger, the blood, Mark’s blood, spurted out at them.

“Damn,” Ed sputtered.

Quickly Leslie pressed her fingers against the artery again. It was getting harder to maintain the seal. Her fingers cramped. The pain from the cuts in her own hand, cuts from Mark’s broken, shattered ribs, throbbed in her palm. The new hot burst of blood made the artery even more slippery, more difficult to compress.

They tried again.

And again.

On the fourth try the clamp closed over the artery. When Leslie removed her fingers, there was no bleeding.

“Operating room in two minutes,” Ed barked. “Where’s the blood? I want two units
in
him
before we operate. And we’re operating in two minutes.”

With the endotracheal tube, oxygen and an attentive anesthesiologist managing Mark’s breathing for him, Mark had regained consciousness.

Leslie saw Mark beckon to Ed. She had withdrawn to a corner of the trauma room as soon as the artery was successfully clamped. The energy and emotion that had enabled Leslie to act as quickly as she had now gave way to exhaustion and fear. Now that she was no longer an active participant, preoccupied with her task, she had time to think. And worry.

But Mark was in good hands. The best.

And he was talking! Leslie stood up straight as she watched Mark. Awake, alert, trying to communicate with Ed. Mark couldn’t speak because of the endotracheal tube, but he clearly had a message. Leslie saw him gesture, saw them give him a pen and paper and saw him write something which he handed to Ed.

Leslie watched Ed’s expression as he read what Mark had written. She watched Ed frown, then scowl. He began to speak animatedly, then angrily, at Mark.

Leslie couldn’t hear what they said. The room was too full of other noises. It was filled with the sound of nurses and doctors and technicians making certain that Mark was stable, finalizing arrangements for the imminent transfer to the operating room and calling out laboratory results done on Mark’s blood.

“The pO
2
on the last gas is
280
.”

“Thanks. What’s the pH?” the anesthesiologist asked.

“Seven point four.”

“Great.”

“His crit is twenty-eight.”

A brief silence ensued, a break in the general hubbub.

“Did you hear that, Mark? Your crit is twenty-eight. And that’s before rehydration. You’ve lost a helluva lot of blood,” Ed Moore shouted, his voice especially loud because of the momentary silence in the trauma room.

Ed looked across the room at Leslie, at her bloodstained face and clothes. It gave him a rough idea, a grim idea, of Mark’s blood loss, and he hadn’t even seen the pool of blood in the ICU laboratory.

Leslie saw Mark’s head move slightly from side to side. A clear negative message.

“OK, Mark, old buddy, I’ll give it my best damned shot.”

Ed walked toward Leslie and snapped to whoever was listening, “Where’s Dr. T?”

Everyone was listening. Everyone had overheard Ed’s last remarks to Mark. Everyone was wondering what had happened.

“Scrubbing,” the head nurse answered, remembering that Dr. Moore had just asked a rather specific question.

“Good.”

Dr. T., as they fondly referred to Dr. Jon Thomas, was the attending trauma surgeon. Dr. T. didn’t scrub in on every case. It wasn’t necessary. His trauma chief and the other surgery residents were highly trained. But Dr. T. came in for the critical cases. For cases like Mark.

Leslie was glad he would be there.

Ed stopped when he reached Leslie.

“If he’s not a Jehovah’s Witness, what is he?” Ed demanded.

“What do you mean?” Leslie asked, worried.

Ed shoved the crumpled piece of paper he held in his hand at her.

It read: No Blood Tx. It meant: No blood transfusions. It was written by Mark.

“He says he’s not a JW, so what’s his problem with receiving blood?”

Leslie shrugged. Then she remembered.

“AIDS,” she whispered, almost to herself.

“AIDS? What’s the evidence for that?”

“Not much, but apparently data is beginning to accumulate.”

“Typical internist worrying, what if-ing. I have plenty of hard data about the mortality of Mark’s type of chest wound, even given optimal management, such as blood transfusions. Leslie, this could cost Mark his life.”

“Why don’t you transfuse him anyway?” Leslie asked anxiously, knowing the answer.

“Because we have this in writing. Clear evidence that Mark does not want blood. Mark is conscious and sane, legally anyway. If he had whispered it to me, I might have misunderstood, or not heard it at all. But in writing, lots of witnesses. No can do. You know that.”

“I know,” she said weakly. Then she asked, “Can I talk to him? I could offer to give him my blood. Our blood has already intermingled. If I have AIDS, or if he does, the exposure has already happened.”

As she spoke, Leslie held up her hand with her palm facing Ed. He knew that she had already been exposed to Mark’s blood; it was all over her, but he hadn’t realized until then how Mark could have been exposed to her blood. Reflexively, Ed reached for Leslie’s badly cut hand and looked at it closely

“These are bad lacerations, Leslie,” he said quietly.

Leslie shrugged. She would worry about her cuts later.

“So, you see, Mark’s gotten some of my blood already,” she said. “So could I talk to him?”

“Be my guest. He seems determined. What a fool!”

“Ed,” Leslie pleaded gently, “please don’t be angry with him.”

“Hey, whoa, Les. I’m angry as hell at the guy. I also happen to like him. He’s a friend. We go back two years and a lot of long, hard, on call nights. I’ll try my best to save him,” Ed said. Then he added sternly, “Even if I’d never met the bastard I would try my best to save him.”

“Now you’re angry with me,” Leslie said grimly, realizing she had insulted him.

“No. I’m just angry. But don’t worry. Being angry just pumps me up. I do my best operating when I’m a little mad,” Ed said, briefly touching her shoulder on a rare patch of her coat that was white not red. “Hey, haven’t you ever seen John McEnroe play tennis when he’s angry? He always wins.”

You have to win this one, Ed, Leslie thought as she watched him leave to go to the OR to scrub. You have to.

Then she walked over to Mark. His eyes were closed.

“Mark?”

The brown eyes opened. So much pain.

“Mark, it’s Leslie. You need blood.”

Pain and fear. Mark shook his head slowly, definitively.

“Because of AIDS?”

A slight nod, eyes closed.

“Mark, that is nonsense!”

Eyes opened, a trace of anger. But, mostly, pain and determination.

“Mark, what if I give you my blood? You’ve already been exposed.”

Mark’s head moved swiftly to the side. No.

Ed was right. Mark had made his decision.

It’s as if he wants to be allowed to die, Leslie thought suddenly. Mark had lunged at the assassin and into the gun. Now he was refusing livesaving, essential blood. Stop it, she told herself. It was just her own morbid imagination at work.

“Mark,” Leslie said gently. “Shall I call Kathleen?”

Mark’s eyes brightened for a moment, then faded. Joy then worry. He nodded.

“And Janet?”

A slight nod.

“Your parents?”

A strong no. Almost as strong as his refusal of blood.

“Gotta go, Leslie. OR’s ready,” the anesthesiologist said.

“Oh. OK. See you soon, Mark,” she said.

“Are you going to scrub in, Leslie?” someone asked

“What? No,” she said.
No
.

Leslie followed Mark’s stretcher out of the trauma room and into the glaring light of the television cameras. Leslie stared directly into the light, her blue eyes wide, blazing with anger and astonishment at the harsh intrusion. The rest of her face and her hair were covered with blood.

Beyond the cameras she saw her intern Hal. Leslie could not interpret the look on his face, but, remarkably, she felt a sudden closeness to him.

Leslie rushed past them all, down the hall, to the women’s locker room. She removed all her clothes, her white jacket, her blue and white flowered shirt, her bra, her slip, her underpants and her nylons. All were stained red, red-brown, with Mark’s blood. Leslie eyed the clothes helplessly. They were ruined, but she couldn’t throw them away. Not yet. She couldn’t throw away Mark’s precious blood even though it was useless to him.

If only she could give him back some of his own blood!

Leslie couldn’t throw away Mark’s blood. She couldn’t even rinse it out.

Slowly, carefully, Leslie folded the clothes and put them into her overnight bag.

Eventually she convinced herself that she had to wash Mark’s blood off her body. It was even more morbid not to. She stood in the shower and let it wash off, her eyes closed shut so that she couldn’t see how much of his precious blood was flowing down the drain. Leslie didn’t scrub it off. She just let the water wash it away. Finally she dared to look at the water at her feet. It was clear.

Then Leslie got the soap and shampoo she had removed from her overnight bag and took a usual on call shower. It was a quick shower taken at a quiet time with the pager lying next to the shower stall on the tile floor.

The lacerations on Leslie’s palm and fingers stung. As she washed they began to bleed. Her blood.

Momentarily mesmerized, Leslie watched her own blood swirl down the drain. Then she focused on the cuts themselves. Several were deep, but none extended down to tendon. The sensation and motor function in her hand seemed normal. They were probably too deep and narrow—true puncture wounds—to suture, but they needed attention. Sometime she would return to the ER, clean the wounds carefully with sterile solution, and ask one of the orthopedic surgeons to take a look.

Leslie had clean underpants, nylons and a blouse in her overnight bag, but she had no extra bra, no white coat, no skirt. She found a clean surgical scrub dress, a royal blue, cotton dress with a deep V neck and short sleeves. The dress was loose around her narrow hips and waist but snug over her bare breasts.

She would borrow someone’s white coat or find an extra white coat somewhere to cover up her immodest outfit. Not that it mattered. Not that anything mattered except Mark.

Leslie walked out of the women’s locker room and into the glare of the television cameras. They had followed her and waited.

“Dr. Adams,” a reporter said. “Just a word, please.”

Leslie stopped. She was too bewildered not to.

The cameras pointed at her. They focused on the damp chestnut hair combed hurriedly, before she left the locker room, with the trembling fingers of her uninjured hand. They focused on the brilliant blue eyes, and they focused on the ample breasts that strained against the too tight scrub dress.

She looks like an NCAA swimming champion, the reporter thought, damp, healthy, fit. Except, he noted, her breasts seemed large for a swimmer.

“Dr. Adams, could you please tell us what happened?”

Leslie opened her mouth to speak, too stunned not to, but the question unleashed the memories. And her priorities. Her only priority was to find out about Mark.

“No,” she said flatly into the camera. She leveled her gaze at the red light on the camera because the glare was less there. “No, I can’t.”

The cameras continued to roll as she sped away. They didn’t have many words from Dr. Leslie Adams, but they had sensational color footage, before and after: before, the blood-soaked face and clothes; after, the clean, damp young woman, erotic and sensual in the ill-fitting scrub dress. Common to both sequences, captured in vivid color, captured as they delivered clear, eloquent nonverbal messages of astonishment, sadness, worry and anger, were the huge blue eyes.

Channel Five had the best footage, but all the local stations had good shots. Good enough. They all ran the story on the shootings—the murdered would-be informant, the assassin, the wounded police officers and the critically injured resident—featuring the dramatic pictures of Dr. Leslie Adams. The segment was featured on every newscast on every channel for a full thirty-six hours.

All stations received a record number of phone calls.

After escaping the reporters, Leslie rushed to the operating room and went directly to the nursing station. The San Francisco General Hospital operating room was an active place. Cases were done twenty-four hours a day, seven days a week.

At that moment, Mark was one of four cases.

“How is he?” Leslie asked the head nurse, Gwen. Despite the other cases, Mark was everyone’s primary concern. He was the most critical.

“So far, so good. They just started,” Gwen said. Then, looking at Leslie, Gwen reached for a long white coat that hung on a hook on the wall. “Here. I don’t know who this belongs to. It’s been hanging here for at least three weeks. Whoever it belongs to, you need it more.”

“Thanks, Gwen.”

“We cleared out one waiting room for you and his friends and family. Waiting room B.”

“Thanks,” Leslie breathed. “I guess I’d better make some phone calls.”

It was ten-fifteen. Leslie decided she would call Janet after the show. Leslie got Kathleen’s parents’ telephone number from directory assistance.

“Yes, Dr. Adams. Of course I remember you,” Virginia Jordaine said. “You took such good care of me.”

“How are you, Mrs. Jordaine?”

“Fine. Very well. No more angina even. They say I finally just clipped off the part of the narrowed artery that was causing the pain. So, I’m even better.”

“I’m glad. Uh, is Kathleen there?”

“Oh, no, dear. She lives in the city. With Mark Collinsworth. Do you need their number?”

“Yes, please.” Lives in the city with Mark. Virginia Jordaine sounded calm about it. Who wouldn’t be? Leslie didn’t know Mark’s home telephone number. The page operator would have it, but Virginia Jordaine provided the number from memory.

“Thank you,” Leslie said.

“Hi, babe,” Kathleen answered the phone on the second ring. It was the time that Mark always called if he could. Even if it was to say he couldn’t talk.

“Kathleen, it’s Leslie Adams.”

“Oh, Leslie. Mark’s not here.”

“I know, Kathleen. Mark’s had an accident.” Leslie’s voice broke. Hot tears began to track down her cheeks.

“Leslie.!”

“Mark is in surgery, Kathleen. He’s been injured.”

“Injured?”

“Shot.”

“Shot! No. No! He couldn’t be shot. How is he?
Leslie?
”

“He’s in surgery. He was shot in the chest. He was conscious before surgery. Not paralyzed,” Leslie said. She gave Kathleen all die positive information she could think of. She didn’t tell her about the blood. She didn’t tell Kathleen that if Mark lost one more drop of blood he could die. “Come to surgery, waiting room B, OK? Kathleen, take a taxi. It’s much safer.”

“Yes. I will. Leslie, are you with him? Will you be?”

“I’m here. Very near. In the OR.”

Two hours later Mark was still in surgery, still alive. Janet, Leslie and Kathleen sat in waiting room B. It had taken the press no time to find the location. They had already established interest in the blue-eyed heroine who wouldn’t speak to them. Then someone identified Janet, star of
Joanna
, San Francisco’s hottest theater production, and their interest soared. No one recognized Kathleen or even asked her name. That was very lucky.

Leslie had to pass through the reporters to get into the OR to check on Mark. Each time it was an ordeal.

They all felt trapped. They sat, silently, each on one of the three couches arranged at right angles to each other against the pale yellow walls.

Aware of Leslie’s problem with the eager reporters, Gwen began to deliver the reports so that Leslie did not have to leave the room. Still, it made Leslie restless. What if something happened and Gwen couldn’t get away? Because something had happened.

“He hasn’t bled at all,” she said. “And they’ve ligated the artery. They had to remove his right lower lobe.”

Kathleen and Janet gasped in unison.

“It’s not a big deal,” Leslie and Gwen reassured them.

“Why is he still in there?” Janet asked.

“Because there are lots of bone splinters. They are picking them out one by one. And because the wound was contaminated. They want to clean it thoroughly. They don’t want to have to go back in. They’re just being very careful. His vital signs have been rock-steady.”

“What’s his crit, Gwen?” Leslie asked finally, reluctantly.

“Eleven.”

Oh no, Leslie thought.

“What does that mean?” Kathleen asked, sensing Leslie’s concern despite her effort to appear calm.

“It’s low,” Leslie admitted. She didn’t add that it meant he couldn’t afford to bleed. Not even a little. If only I had gotten to the artery sooner, she thought, tormented, aching.
If only
.

“The press is a nuisance, eh? They’re even quizzing me since they can’t get at you,” Gwen said on her third visit to waiting room B. “I’ve tried to get them to leave, but they sense my lack of authority. And, I think we may be coming face to face with a little chauvinism, ladies.”

“I’m afraid so,” Leslie said. “What we need is a chief of medicine.” Or someone who thinks he is, Leslie thought. “Gwen, I can’t dial out on this phone, can I?”

“No.”

“Can it ring in?”

“The operator can connect to it.”

“Would you page Dr. Hal Perry? Then have him connected through to this extension?”

“Sure. Shall I page him stat?”

“No. Hal’s pretty good answering his pages right away. It’s one of his strong points.”

While Leslie waited she remembered Hal’s expression when she emerged from the trauma room. What was it? Certainly nothing she had seen before.

The telephone in the waiting room rang in three minutes.

“Hi boss,” Hal said.

“How are things going, Hal?”

“Fine.
Nothing
is happening. It’s like everyone, the whole world, is worried about Mark. It’s weird. Tomblike.”

Tomblike. A nice happy medical term meaning quiet.

But not a good term to use tonight.

“I mean quiet,” Hal said quickly. “I heard that Mark’s crit is eleven and they can’t transfuse him?”

“That’s right. Hal? I need a favor.”

“Shoo—” he began then caught himself. He had actually started to say “Shoot boss” like he always did, but he stopped himself, a little horrified. When he spoke it was in a voice that Leslie had never heard before, a voice to match the expression she had seen earlier.

“Anything, Leslie,” Hal said seriously. Then, before Leslie spoke, he added what had been on his mind. “You were really amazing. You really saved his life. You knew exactly what to do and you did it.”

Leslie swallowed hard. Hal was complimenting her. He admired her. It had been admiration in his eyes. Leslie smiled slightly.

“Thanks, Hal. Now here’s what I need. I want you to come down to waiting room B. Identify yourself to the press as someone with authority. I don’t even care if you lie to them. Just convince them to leave this area. Not the hospital, just this area. I don’t want you to infringe on their First Amendment rights. Just get them away. OK?”

“Sure. No problem.”

Leslie stood near the door, listening to Hal’s speech, marveling at his confidence.

“Ladies and Gentlemen of the press. I am Dr. Hal Perry. I represent the Department of Medicine. I am afraid we have a hospital policy about these waiting rooms, about who can be in this area. It’s a conflict, First Amendment rights versus patient confidentiality, but I’m sure you’ll understand that we have to protect our patients’ rights. I assure you I will be the first to hear of any changes in Dr. Collinsworth’s condition and will notify you immediately. We have arranged for you to wait in the cafeteria. It’s closed to the public at this hour, but the Department of Medicine has provided special passes for all of you. So if you will please follow Dr. Rhodes.”

Miraculously, they did follow Dr. Rhodes, the third year medical student who was carrying a fistful of yellow passes. Meal tickets. Probably Hal’s entire supply for the month.

I misjudged him, Leslie thought.

Hal lingered outside the door until the press was out of sight, then he entered waiting room B.

“How’d I do, boss?” he asked, his voice a little less confident than usual, wanting Leslie’s approval as he never had before.

“Fabulous, Hal. Truly. I’ll see that you get all those meal tickets back. That was very generous.”

“No problemo. I can get more. I have an in with the Department of Medicine secretary.” The department secretary was the keeper, a notoriously stingy keeper, of the meal tickets.