The Carlton Club (9 page)

“Yes, of course. But mostly in the context of not making, trying not to make, the same mistakes with you. With us.”

Oh, Mark, Kathleen thought, I’ll stay.

But her decision was firm.

“Besides,” she said lightly, “you need to sow some wild oats.”

“Sow some wild oats? You make me sound like a sixteen year old—”

“Cornhusk
er
.”

“Kathleen, I’m twenty-seven, chronically tired, completely, deliriously happy to be with you.” Mark paused, then asked. “Do you really want me to sleep with other women while you’re gone?”

“Yes!” No, not really, Kathleen thought, an ache settling in the pit of her stomach. Was the risk worth it? Sleep with them, Mark, she thought, but don’t fall in love with them. Learn how special we really are.

“This is ridiculous.”

Kathleen shrugged. “When was the last time you slept with someone other than me or Janet?”

“Never.”

“Oh no. I’ll see you in a year. Or two.”

“Kathleen, you are reducing me to a nonthinking, unfeeling animal with irrepressible, insatiable urges. It’s only a little bit flattering. It’s mostly insulting.”

“Mark,” she began. I love you, she thought. I want you. Forever. This is the only way it can happen. She said, “Four months is a short time.”

“A lot can happen in four months,” Mark said grimly, recalling the last four months of his own life. He had lost the woman with whom he had planned to spend his life. And he had fallen in . . . cared deeply about another woman. That happened so quickly that he hadn’t had time to think.

Kathleen is right, he realized. Four months is a short time, but it could make a big difference. It could give him, give them, time to be certain.

Mark held out his arms to her. Kathleen fell into them gratefully.

“Where will you be?” He pressed his lips against her shiny black hair.

“Lots of places. Incommunicado.” Kathleen planned to be in Atherton between short trips like the one to Hawaii, but it was better if Mark didn’t know that.

“Ah, Communicado. Lovely spot,” he teased. Then he said seriously, “So the rules of this trial separation are that we don’t communicate? And I make love with every woman I meet?”

“Something like that.”

“When do you rematerialize?”

“After Wimbledon.”

“Wimbledon? The tennis championships? You’re going?”

“Of course,” Kathleen said lightly in her best Carlton Club voice that implied, Isn’t everyone? “I always do. My parents and I go. CEOs get wonderful center court seats.” “So you’ll be back when?” “A day or two after the finals. July eighth or ninth, I think.”

“In time to be with me on my birthday?”

“Which is when?”

“July eleventh.”

“If you want me to.”

“I want you to.”

“What if you don’t, by then?”

“Then I’ll let you know.”

Jean Watson—Mrs. Watson—was admitted to Leslie’s service at University Hospital on April fifteenth. Before Leslie saw her new patient, she learned the details of her complicated medical history from Mrs. Watson’s physician. Dr. Jack Samuels, a hematology-oncology specialist.

“She’s the nicest woman in the world, Leslie. With a lethal disease. This hospitalization will probably be her last. We diagnosed breast cancer a year ago, positive nodes, negative estrogen receptors. We gave her aggressive chemo and haven’t documented mets. Anyway, she was doing very well until a month ago when she presented with fatigue and bleeding from her gums. I did a bone marrow. She’s aplastic.”

“Not a marrow full of tumor?” Leslie asked.

“No. An aplastic marrow. Completely empty.”

“Maybe it will come back.”

“Leslie, she has no cells. Her marrow is completely wiped out. We’ve been supporting her with red cells, white cells and platelets all month.”

“How about a marrow transplant? Maybe you could kill her tumor at the same time. Cure everything.”

“I would love to transplant her, but we’re already almost unable to cross-match her for blood transfusions. She consumes platelets as quickly as we infuse them. Immunologically, she’d be a nightmare to transplant. She would never survive.”

“So she has an autoimmune process going on as well? Breast cancer, an aplastic marrow, and an autoimmune syndrome?”

“That’s right.”

“Maybe the tumor is making something, secreting some substance that is suppressing her marrow and making the autoantibodies,” Leslie mused.

Dr. Samuels looked at Leslie for a moment. He had heard about her. His colleagues raved about how bright she was. And pleasant. And compulsive. But he had never worked with her. He had noticed her, of course. It was hard not to notice the slender, drawn face framed in chestnut curls, the bright blue eyes and the trim but voluptuous figure unsuccessfully concealed by her white coat. And the smile, sometimes tired, sometimes wan, was always there. Always retrievable.

They all noticed her, the entire faculty, and they talked about her, kindly wondering, Who is she? What does she do when she leaves the hospital? Does she have anyone waiting for her? Is she happy?

They hoped so. They liked her.

Now, talking with her, mesmerized by her fresh, natural beauty and her large, attentive, concerned eyes, Jack Samuels knew, felt, what they had been talking about.

Then Leslie suggested that the tumor might be secreting a substance. That was what he thought. It would be extremely unusual. Reportable. Most interns, or even residents, would never have considered it.

“That’s what I’ve been wondering, too,” he said.

“Does that mean we will be giving her more chemotherapy?” she asked.

“Maybe. I haven’t decided. It’s awfully hard to give chemotherapy that destroys the marrow to someone whose marrow you are trying to stimulate. Not to mention the trouble with supporting her with blood products.”

“But if it is all due to tumor and we don’t treat it,” Leslie began quietly.

“I know. This is a tough one. Let’s discuss it after you see her and review her records. Let me know what you think,” he said, scarcely believing what he heard himself say. Jack Samuels had never, ever, asked for an intern’s opinion on such an important decision. Of course, as a faculty member, he went through the usual rituals of involving the interns, engaging them in Socratic dialogue. He even listened to what they said.

But he had never before solicited an opinion.

Leslie simply nodded and said, “OK.”

“I guess she’s not on the floor yet. I was going to introduce you.”

“I’ll see her as soon as she arrives. Then shall I call you?”

“Yes.”

“All right. Thank you, Dr. Samuels.”

“Call me Jack, Leslie,” he said, amazing himself again, but chuckling inwardly at how his wife, herself a physician, would diagnose what had happened. An acute, self-limited attack of middle age, she would say, laughing.

From Jack Samuels’s description, Leslie formed a clear picture of what Mrs. Watson would look like: frail, exhausted, dying.

“Mrs. Watson?” Leslie asked with surprise when she saw the woman sitting in the bed assigned to Jean Watson.

Jean Watson sat cross-legged on the hospital bed. She wore a modest, fluffy, bright yellow robe. Her hair was dark red, her face freckled, her eyes merry and twinkly and her smile broad. Her fifty-eight year old face, wrinkled and full of character, instantly sent the message that those fifty-eight years had been full, interesting, happy ones.

“Yes?” she chirped.

“Mrs. Watson, I’m Leslie Adams. I’m the intern who will be taking care of you.”

Leslie usually introduced herself as Leslie Adams, intern, rather than Dr. Adams. It caused less distance.

Sometimes Leslie had to be firm about who she was and the authority she had. Then she was Dr. Adams. The doctor. Those times usually occurred in the San Francisco General Hospital emergency room with alcoholics, drug addicts and psychotic patients who were too drugged, confused or belligerent to pay attention to anything but her size, her fragile prettiness and her sex. Leslie had to tell them, clearly, directly, that she was their doctor. And that she was in charge.

But it wasn’t necessary with Mrs. Watson.

“You’re a doctor!”

“Well, yes,” Leslie said patiently. “Interns are doctors.”

“Dear, I know that. I was reacting to your age, not your rank. You look so young! I’ve been in hospitals enough in the past year that I know the entire hierarchy. I’m even up on the name change. Aren’t you really an R-l?”

Leslie smiled. It was true. The term intern was officially being abandoned. They would all be residents: first year, R-
1
s; second year, like Mark, R-
2
s; and so on. The term intern might disappear, but the job description, the tradition of being an intern, the ordeal of the internship year, wouldn’t change.

“A rose by any other name,” Leslie said, laughing.

“Ah yes. I see.”

It surprised Leslie that Mrs. Watson thought she looked young. Before her internship Leslie had looked young, but she felt she had aged so much in the past nine months. She felt older. She noticed little lines on her face, around her eyes, that she had never seen before. She knew she looked drawn and gaunt. She felt the tugging of her skin.

Mrs. Watson was the picture of health, of robust, genetically predetermined long life. Leslie learned, as she took Mrs. Watson’s family history, that her parents had died at ages ninety-two and ninety-four.

“And never misheard a word or lost a thought in all those years,” Jean Watson said proudly.

It wasn’t until Jean Watson removed her fluffy yellow robe that the magnitude of her illness became apparent. Her body was ravaged—thin, wrinkled, missing one breast and blue-black with bruises because the low platelet count did not enable her blood to clot properly.

“I’m a mess, aren’t I?” she asked, smiling wryly.

Leslie smiled back, unable to think of anything to say. She was taken aback by the deathlike body attached to the lively, happy woman she was beginning to know.

“I think you need a central line, to minimize the needle sticks,” she said, finally.

“A Hickman? I’ve had a few. They don’t last long; they clot off in spite of my low platelets!”

Great, Leslie thought. Jack Samuels had forgotten to mention that problem.

“OK. Well, then, you’ll just have to help me find the veins,” Leslie said lightly, knowing how hard it would be, how fragile the veins must be, how overused already.

“They’re pretty bad,” Jean Watson said.

“Well, I’m pretty good at starting lines in tricky, delicate veins,” Leslie said cheerfully. She knew it would be tough for Mrs. Watson because it hurt to have needle sticks over and over, and because it was frustrating. It was a reminder of the body’s betrayal. The body had betrayed the mind and the spirit. The body had gotten sick, weak. The body was going to die.

As Leslie watched Jean Watson’s body die over the next few weeks, despite chemotherapy and plasmapheresis and white cell, red cell and platelet transfusions, Leslie learned about the quick, lively, loving mind that did not want to die. Not yet. Not ever.

Leslie spent many hours with Jean, caring for her, talking to her. Each day she patiently and as gently as possible searched for veins. She started intravenous lines for the necessary transfusions and medications, and she withdrew blood to check the blood counts. Leslie watched the first few moments of each transfusion. Jean’s immunologically primed body might have a serious allergic reaction to the blood products.

They talked. Occasionally about a possible vein to try, rarely about Jean’s medical condition and mostly about their lives.

“Next time. Next life, I am going to have a daughter,” Jean said one day.

“You have pretty wonderful sons,” Leslie said, gently tapping a potential vein, trying to make it stand up.

“I do. I know. But five boys and no girls!” she laughed.

Leslie had met all five sons, all redheaded and freckle-faced, like their mother. All with merry eyes and smiles, like hers. After seeing the sons and their mother, Leslie expected that Mr. Watson would be redheaded, too.

But he wasn’t. He had a full head of dark curly hair and dark eyes that had managed to skip his children’s generation. Perhaps his redheaded sons would have curly blackhaired girls. Grandchildren, maybe granddaughters, that Jean Watson would never see.

Carl Watson was a kind, loving man. He and the “boys,” as the Watsons fondly referred to their sons, visited Jean daily. The boys ranged in age from sixteen to thirty. During their visits, Leslie always heard laughter coming from Jean’s room, light feminine laughs surrounded by a chorus of deep masculine ones.

Seeing the Watsons together, laughing, talking, loving, made Leslie think about her own parents. The weekly calls to her parents in Seattle began to last a little longer. Sometimes she called them twice a week. It was so comforting to talk to them, to hear their voices, to have her mother quiz her about her weight and her health and men.

The Watsons were so like Leslie’s family. Close and loving. Except our family is lucky. At least we have been lucky so far, Leslie thought, wondering superstitiously how to insure the luck forever. The Watsons had done nothing wrong. Jean’s illness was simply a tragedy. Senseless. Painful. Nobody’s fault. No way to prevent it.

Luck. Fate. Divine will.

Mark looked at the envelope for a moment. His name and address were handwritten, but the return address was engraved in dark blue script. Union Square Theater. On Geary. The handwriting looked like Kathleen’s.

Mark opened the envelope quickly. Kathleen had been gone for six weeks. It seemed much longer.

It was Kathleen’s handwriting. The envelope contained a note dated February twenty-seventh, the day before she left for Hawaii, two theater tickets and an engraved invitation. Mark read the note first.

Hi! This note is to be attached to two excellent opening night tickets to
Joanna
—yet to be printed—and an invitation to the dress rehearsal party—yet to be engraved—and sent to you in time for both events. Assuming all has gone as planned, do with them as you will.

I am looking forward to your birthday.

Aloha,

Kathleen

Mark smiled as he read her note. It was a gentle reminder of her energy and her humor. Not that he needed to be reminded. He thought about her constantly. Missed her. Wanted her.

But he knew that she was right about this time apart.

He did need the time and the privacy. He had to try to solve the issues, the ones he could solve, like his real feelings about losing Janet. Sadness. Regret. But no urge to try again, to try to go back. There was no place to go. The place in time where the love of Janet and Mark had flourished existed only in their minds, because they could remember, and in their hearts, aching hearts, that had lost the feeling.

Mark and Janet were over. Mark had to salvage the lessons and move on. He had to try not to make the same mistakes. Already with Kathleen he had repeated a mistake, but Kathleen had told him. In time.

Mark needed this time alone to think of the other mistakes he had made, could make again, could avoid. But what about the mistakes he didn’t recognize? What if Kathleen didn’t recognize them either, until, as with Janet, it was too late?

Mark knew there would always be the risk of mistakes, of alienating someone he loved, because of his moods and because of the other problem. The big, unresolved problem. The problem that Janet had recognized and he had denied, vehemently, angrily.

Only now, as he spent his nights alone and forced himself to think, did he realize that Janet had been right. Mark didn’t like being a doctor. It was so simple and so complicated. It was what he had been destined to be. By his father. By his own inner drive. Something about being the best.

But Mark didn’t like it. More than that, Janet was right, he hated it.

What was he going to do about it?