Island Practice, Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor by Pam Belluck (2012)
Dr. Tim Lepore (rhymes with peppery) left his mainland emergency medicine practice in Providence, Rhode Island to raise his family and tend to the people of Nantucket, MA. When he served a shift in the cottage hospital on the island one summer, he thought that trading the mean streets and mayhem of Providence in the 1980's for the quiet beauty of an American vacation paradise would be a gamble worth taking. Thirty years later, Dr. Lepore is such a fixture on the island, so legendary, and so deeply eccentric, that New York Times reporter Pam Belluck has written a book about him, his doctoring, his relationships with his patients, his service to Nantucket, his medical triumphs and tragedies. The good doctor is made in a mold that may have existed more commonly before managed care pushed patients and doctors into a few minutes of allotted time. He is the kind of doctor baby boomers remember having when they were young or heard about and wished they had. Dr Lepore has time to pay attention to his patients; he knows about their personal lives; he listens and he isn't afraid to tell the unvarnished truth to them. Dr. Lepore is no warm and fuzzy TV doctor like Marcus Welby, MD, though. Lepore is blunt, his bedside manner is more Dr. House than Dr. Welby. His waiting room is filled with heads of game he has shot and other evidence of his strange hobbies: "skulls, arrowheads, snake skin, turtle shells, fish jaws, and antlers." (17)
Chapter 1: Dr. Lepore is crashing through the underbrush on the island trying to find the "twigaloo" of Underground Tom, a homeless man who squats wherever he can remain undetected and builds tree-houses, underground bunkers or twig houses to live in until the authorities toss him off public land. The doctor makes house calls to Tom, if he can only find the well-hidden hovel. "Lepore allowed Johnson to pay his medical "fee" by providing informal advice about fashioning arrowheads." (17)
Chapter 3: Dr. Lepore makes scalpels out of obsidian by using a flint-napping method used in the Upper Paleolithic era and he uses them to perform surgery. (47) This method is discontinued when the health department objects to the method of sterilization used on the volcanic glass scalpels.(48)
Chapter 4: Moby-Tick. Dr. Lepore is an interesting mix of politically conservative ideas (pro-hunting) and libertarian ideas - he refers patients with severe pain to an island hippie who makes marijuana cookies. In Chapter 4, Lepore's practicality goes against the beliefs of the liberal segment of the island's population. Nantucket has a very high rate of tick-borne illness: Lyme disease, babesiosis and anaplasmosis (65). Lepore has educated himself to become a leading authority on tick-borne diseases and he thinks that the most effective way to combat the disease is to kill more deer which are the hosts for the infected ticks. Naturally that opinion does not go over well in Nantucket even though almost every resident or visitor has been infected or known someone who has been. The part-time population of celebrities and others who own summer cottages don't seem to like to hunt or to let anyone else extend the hunting season on Bambi. Lepore prints out bumper stickers ironically proclaiming "Save Our Ticks!" "Honk If You Love Ticks" (68).
It's a town hall confrontation we have seen here in New Jersey often enough.
Island Practice is a fascinating portrait of an eccentric, but highly capable doctor devoted to his community and his patients.
Readers who enjoy medical memoirs, biographies and popular non-fiction might also like:
The Immortal Life of Henrietta Lacks by Rebecca Skloot
Every Patient Tells a Story by Lisa Sanders