The Carlton Club

Katherine Stone

Copyright © 1988 Katherine Stone

Since its first publication in 1988,
The Carlton Club
has been published in mass market paperback, large print hardcover, and foreign language editions. Ebook and trade paperback editions published in 2011.

“THAT’S ENOUGH FOR ME”

Words and Music by Paul Williams

© 1970 IRVING MUSIC, INC. (BMI)

All Rights Reserved—International Copyright Secured.

Used by permission.

Katherine Stone is the
New York Times
bestselling author of twenty-one novels, including
Pearl
Moon, A Midnight Clear, Home at Last, Thief of Hearts,
and
Happy Endings.
Her books are sold worldwide and have been translated into twenty languages. A physician who now writes full-time, she lives with her husband, physician-novelist Jack Chase (
The Magruder Transplant, Mortality Rate, Fatal Analysis)
in the Pacific Northwest. Trade paperback and ebook editions of all her bestselling novels are now being published.

Please visit her website, KatherineStone.com, for additional information and newsletter signup.

NOVELS by Katherine Stone

ROOMMATES

THE CARLTON CLUB

BEL AIR

TWINS

LOVE SONGS

RAINBOWS

PROMISES

ILLUSIONS

HAPPY ENDINGS

PEARL MOON

IMAGINE LOVE

BED OF ROSES

THIEF OF HEARTS

HOME AT LAST

A MIDNIGHT CLEAR

ISLAND
OF DREAMS

STAR LIGHT, STAR BRIGHT

THE OTHER TWIN

ANOTHER MAN’S SON

THE CINDERELLA HOUR

CAROLINE’S JOURNAL

PART ONE

San Francisco
, California
. . . November,
1980

Dr. Leslie Adams gazed out University Hospital’s eleventh floor picture window mesmerized by the magnificence of San Francisco at daybreak. As she watched, the pearl gray sky became yellow. It was the kind of pastel autumn dawn that promised a soft muted sun. It would be a gentle sun, just warm enough to melt the thick layer of fog that covered San Francisco Bay like a plush down comforter. Leslie knew the kind of fresh, crisp, exhilarating day it would be. A warm sun. A cool, but not cold, breeze. A day for light woolen scarves and rosy red cheeks and mugs of hot chocolate. Leslie loved days like this. She had memories, lovely distant memories, of such days. A walk in a secluded pine-scented meadow. A wind-tossed ferry boat ride across white capped water.

Leslie thought about the rich taste of hot chocolate as she curled her hands around her barely warm cup of over brewed black coffee and sighed. The sigh was a little nostalgic, because of the memories, and a little wistful, because she would love to be out there today, enjoying the autumn briskness. But mostly it was, simply, a sigh of fatigue.

It had been a long, busy sleepless night; but she had made it, and her patients had made it.

Everyone had survived. Now, finally, as the night’s cold darkness yielded to the warmth of the new-day sun, the hospital was silent. At peace. Sleeping.

Mark would tell her that, even if only for an hour, she should try to sleep.

Mark. He had hoped she would have an easy night. That was what he was really telling her ten hours ago. . . .

“I have a feeling it is going to be a quiet night,” he said as he walked into the doctors’ write-up area.

“Mark! Hi,” she said looking up, a little startled, from the medical record she was reviewing. “What did you say?”

“I said I have a feeling it’s going to be a quiet night,” he repeated as he settled into a chair across from her. “Very quiet. No more admissions. No midnight fever workups or chest pain.”

“Dream on,” she said, laughing.

“This is a very strong feeling,” he countered lightly. Then he leveled his dark brown eyes at her and added seriously, “Which means that Dr. Leslie Adams, intern extraordinaire, can get some sleep.”

Leslie’s eyes met his for a brief awkward moment, then fell, unable to hold his gaze. They both knew that, even if the night was quiet, Leslie wouldn’t sleep. She wouldn’t even try. I can’t really sleep at the hospital, Leslie explained easily to anyone who questioned her habit of staying up all night when she was on call.

It was true. It was difficult to sleep at the hospital. The interruptions were frequent, and the hours when it was even possible to sleep were few. It was true, but those weren’t the real reasons. The real reason was too personal, too superstitious, too silly to tell anyone.

Leslie believed that if she stayed awake, alert, keeping vigil over the patients in her charge, nothing bad would happen to them. Somehow her wakeful presence would protect them against the unknown, unpredictable catastrophes that could and did occur.

So, Leslie didn’t sleep. She simply patrolled. A quiet, serious sentry. A highly trained shepherd. Unobtrusive, but ever-present. It was illogical. Silly. But it was working. It felt right.

Doing what felt right was what Leslie had always done. At Roosevelt High School in Seattle, doing what felt right won her recognition as Most Inspirational and Most Likely To Succeed. Doing what felt right drew good-natured teasing from her friends about being too good, too perfect: predictable, reliable Leslie. They teased her at Radcliffe, too, when she chose biology over a Saturday night mixer or an organic chemistry experiment over the Harvard-Yale crew race.

The teasing was always gentle. They were her friends, after all. And no one begrudged Leslie her rules. She didn’t try to impose them on anyone else, and she didn’t expect anyone else to follow them. Her friends knew that Leslie’s rules were just for Leslie, just the way Leslie had to do things.

Now, as an intern, she had to stay up all night, awake, alert, vigilant. It was the only way that felt right. It didn’t make sense, she knew that, but it felt right.

Except when Mark teased her. Then she felt foolish. What if Mark guessed the real reason, her silly superstition? Mark was so rational, so logical. He would think it ridiculous. He would think her ridiculous. Mark, of all people.

“No plans to sleep?” Mark asked finally, interrupting the silence, sorry that he made her uncomfortable.

Leslie tossed the chestnut curls that fell into her sapphire blue eyes and smiled bravely. “No plans to sleep. I have a feeling it’s going to be busy.”

Mark smiled. She could be so sensitive. And so proud.

“Any problems with your patients?” he asked.

“No. The patient I just admitted with acute asthma is already clearing. I’m just reviewing his old chart. Then I’ll be all caught up,” Leslie said, ready for the busy night to begin or for a long quiet night of patrolling.

“I think I’ll go home, then,” Mark said, standing up suddenly.

Go home. Mark’s words caught Leslie by surprise. It was only seven. For the past month, because he no longer had a reason to leave—because he no longer had a home—Mark frequently spent extra hours at the hospital. Even when he could leave, when other residents were in charge, he often stayed to help Leslie with her patients or to review charts or to read journals.

It must be better than being alone, Leslie decided as she watched the new pattern emerge. It must be better for Mark to be here than to be alone with all the unanswerable questions that must be tormenting him. Not that the hospital really provided escape. Leslie saw the pain and sadness in his dark eyes, even though he tried to hide it. Even though he told no one, not even her.

She knew of course, because Janet was her friend. She and Janet talked about it all the time.

But Mark and Leslie never talked about it.

“Home,” she echoed softly.

“If you don’t need anything.”

“No,” Leslie said quickly. “Everything’s under control.”

She sensed his restlessness as he leaned against the doorjamb waiting for her to say goodnight. Restless, eager, full of anticipation, there was a glimmer of hope in the dark eyes where, recently, there had been none. Was Mark rushing off to see Janet?

No. Leslie would have known that.

Mark was leaving, eager, full of hope, to be with someone else, and just the thought of whomever she was made his eyes sparkle with life and happiness.

“Have a nice evening,” Leslie said gaily, smiling above the ache that consumed her.

“You too.” Mark smiled back. “Try to get some sleep.”

He would have told her to try to sleep now, ten hours later, if even for an hour.

Had he slept, Leslie wondered as she took a swallow of lukewarm, bitter coffee. Where had he slept? And with whom.

Stop thinking about him, she told herself sternly, forcing her thoughts away from Mark and back to the glorious day that was unfolding before her. This time as she gazed out the window she focused on the thick layer of fog that lay beneath the pale yellow glow of the autumn dawn.

Fog. It wasn’t supposed to be there. It was November. This kind of fog—thick, opaque, smothering—was a summer phenomenon. Leslie had learned about the notorious San Francisco summer fog, four months before, the day her internship began. Four months. It seemed so long ago.

The department chairman had told them, the internship class of
1980-81
, how delighted he was to have them in his internal medicine program. He was delighted. He looked at the bright, healthy, eager young doctors assembled before him. He knew they were among the nation’s best. The internship class that listened intently to the words of their department chairman that day in June was a select group. And carefully selected at that.

They had all graduated at the top of their medical school classes. They had all been elected to Alpha Omega Alpha, the medical school equivalent of Phi Beta Kappa. The only question, a question the most competitive among them might ask a colleague, was, When were you elected to AOA? Junior year? Autumn of senior year? Or, perish the thought, spring of senior year?

They had all spent the month between medical school graduation and the beginning of their internship preparing for the year that lay ahead. Some simply rested, knowing but not really believing the rumors of the exhaustion that would beset them. Not
them
. Some traveled. Some got married. Some read,
re
read, textbooks of medicine. Some studied the how-to manuals for interns.

All framed their recently earned Doctor of Medicine diplomas. None spent any time dreading the year to come. The University of California at San Francisco was the internship they wanted. It was the ultimate trophy, the reward for their hard work. It was the best.

They were the best.

That June day, the day the internship started, they were eager. Ready. The department chairman looked at them thoughtfully. He knew from years of experience that, as prepared as they were, as smart as they were, as eager and as confident as they were, they were not ready. They could not be adequately prepared for the year—the ordeal—that lay ahead.

He tried to tell them. He knew that they would hear his words, but they wouldn’t understand. In a month he could repeat the speech, and they would look at him with their dark-circled eyes and gaunt faces and nod wisely. In a month they would understand. He wondered if any of them would remember that he had told them.

“Your internship is like our weather here in San Francisco,” he said earnestly.

They listened, politely, smiling. He was such a distinguished physician. They were so glad to be here.

“In the summer months we have fog. Oh, there are brief glimpses of sun and clarity, but mostly, it is foggy and gray and dismal at a time—summer—when it should be just the opposite. That’s what these summer months of your internship will be like. They will be foggy, confusing and grim.”

The eager faces looked puzzled. Was he being funny?

“There will be questions you can’t answer,” he explained. “Problems you don’t know how to handle. Patients you can’t save. It is very different from, for example, National Boards. On National Boards there are clear questions with correct answers, and I know from your applications how well you all did on your Boards.”

A titter of relief. Good, he knows how good we are. But what is he talking about?

“But doctors,” he continued, “take care of real patients and lots of foggy questions without clear answers. There will be days when the shades of gray, like the fog, seem relentless. It’s difficult because it is so different from what you expect. In summer you expect sun not fog. When you start your internship, having graduated top in your class, you expect to continue to have all the right answers.”

He looked at them, knowing what they were thinking: I do have the right answers. I will have. I always have had.

“But,” he said pleasantly, “the fog of your internship will lift as predictably as the San Francisco summer fog vanishes. By mid September the breezes will be fresh and cool, and the skies will be clear and blue. Your spirits will lift. Your confidence will be restored. You’ll understand that shades of gray are part of medicine. Come September it will be smooth sailing.”

It had been exactly as he predicted: a difficult, confusing, disillusioning adjustment. But it had also been just as he promised. By September, when the sun came out, the fog vanished and the skies were blue, they were adjusted. They knew they could and would make it. The exhaustion, the pressure, the energy required did not change.

But the fog had lifted.

Now, almost two months later, the fog had returned.

How would the department chairman explain it? A fog relapse. What could it mean? The interns have gotten too confident, too sure. Let the fog return! A reminder.

As Leslie toyed with the meaning, the symbolism, of the fog, she thought lovingly about her parents in Seattle. Her mother, a journalist, and her father, a professor of English at the University of Washington, could spend endless hours happily analyzing the symbols and metaphors and hidden meanings in their favorite books and poems. Leslie was their only child, the precious daughter who, despite the genes that should have made her a writer or a poet, was a scientist. Susan and Matthew Adams watched her grow up with proud loving amazement. How could their daughter prefer Galileo to Faulkner, volunteer work at the hospital to the Repertory’s production of
Man and Superman
science projects to novels and physics to poetry?

This November fog, Leslie decided finally, feeling truly the daughter of her literary parents, was not a professional fog. It was not a soupy signal that the lessons of shades of gray and uncertainty had been inadequately learned and needed remedial work. If it was a symbol at all, Leslie concluded, it was a symbol of personal fog.

In the distance Leslie heard the comforting sounds of the hospital waking up, preparing for the new day. The elevators, silent and immobile all night, now moved constantly as they shuttled the rested day shift to its wards and retrieved the tired night shift. Leslie heard the rattle of breakfast carts being wheeled from room to room, the clank of the bedside scales, the quiet chatter of nurses’ reports and the almost soundless footfalls of the morning blood-draw team in their rubber-soled shoes.