Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor

Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor

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by Pam Belluck

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With a Foreword by Nathaniel Philbrick, author of the bestseller In the Heart of the Sea

If you need an appendectomy, he can do it with a stone scalpel he carved himself. If you have a condition nobody can diagnose—“creeping eruption” perhaps—he can identify what it is, and treat it. A baby with


With a Foreword by Nathaniel Philbrick, author of the bestseller In the Heart of the Sea

If you need an appendectomy, he can do it with a stone scalpel he carved himself. If you have a condition nobody can diagnose—“creeping eruption” perhaps—he can identify what it is, and treat it. A baby with toe-tourniquet syndrome, a human leg that’s washed ashore, a horse with Lyme disease, a narcoleptic falling face-first in the street, a hermit living underground—hardly anything is off-limits for Dr. Timothy J. Lepore.

This is the spirited, true story of a colorful, contrarian doctor on the world-famous island of Nantucket. Thirty miles out to sea, in a strikingly offbeat place known for wealthy summer people but also home to independent-minded, idiosyncratic year-rounders, Lepore holds the life of the island, often quite literally, in his hands. He’s surgeon, medical examiner, football team doctor, tick expert, unofficial psychologist, accidental homicide detective, occasional veterinarian. When crisis strikes, he’s deeply involved.

He’s treated Jimmy Buffett, Chris Matthews, and various Kennedy relatives, but he makes house calls for anyone and lets people pay him nothing—or anything: oatmeal raisin cookies, a weather-beaten .44 Magnum, a picture of a Nepalese shaman.

Lepore can be controversial and contradictory, espousing conservative views while performing abortions and giving patients marijuana cookies. He has unusual hobbies: he’s a gun fanatic, roadkill collector, and concocter of pastimes like knitting dog-hair sweaters.

Ultimately, Island Practice is about a doctor utterly essential to a community at a time when medicine is increasingly money-driven and impersonal. Can he remain a maverick even as a healthcare chain subsumes his hospital? Every community has—or, some would say, needs—a Doctor Lepore, and his island’s drive to retain individuality in a cookie-cutter world is echoed across the country.

Editorial Reviews

Publishers Weekly
Belluck, a health writer for the New York Times, introduces readers to Dr. Timothy Lepore, an eccentric jack-of-all-trades practicing in Nantucket—he's a surgeon, physician, psychiatrist, and occasional veterinarian, and he's got a cache of 200 guns booby-trapped with tear gas. In page-turning prose, Belluck details some of Lepore's remarkable cases and his decidedly unique methods of diagnosing and treating patients (e.g., if a patient wants to leave the hospital before Lepore gives the go-ahead, he "just takes their pants away"). When 56-year-old Elliot Norton came in with a droopy lip and feeling generally unwell, Lepore thought "Something smell wrong," and ordered a CAT scan, revealing several potentially deadly aneurysms. He even saved the toes of a two-month-old by spotting the rare "toe-tourniquet syndrome," which is caused by hair wrapping around infants' toes and cutting off circulation. Truly dedicated to his community, Lepore allows patients to come to his home, provides treatment in trade (opting for cookies or a handgun in lieu of cash), and though he doesn't agree with legalizing marijuana ("people don't handle it right in this culture"), he'll procure weed brownies for cancer patients. Inspiring and entertaining, Lepore's story and his beloved island come to life in Belluck's hands. (May)
From the Publisher

“If you were as entranced as I was with John Berendt’s Midnight in the Garden of Good and Evil and Susan Orlean’s The Orchid Thief, you’ll find similar pleasures in Island Practice.”—Huntington News

“Much in this book by Pam Belluck comes as a revelation. Some of it is fascinating; some of it is hilarious; and some of it is sad and very troubling. In Island Practice, Belluck has created a remarkable portrait of a physician and the island community to which he remains steadfastly devoted.”—from the Foreword by Nathaniel Philbrick, author of In the Heart of the Sea and The Last Stand

“Pam Belluck has dissected the antics and heroism of a Nantucket doctor who doubles as the resident wizard. This physician not only makes house calls (even to tree-houses), but also invites patients to drop in at his house for treatment. If you suffer from Nantucket Fever—or any other ill while on that island—Dr. Tim Lepore is your man.”—Dava Sobel, author of Longitude and Galileo’s Daughter

“Through the improbable story of an eccentric and intensely creative Nantucket doctor—the man has operated with flints!—Pam Belluck has crafted an elegant and wildly entertaining depiction of the struggle to maintain humanity and empathy in the face of health care ’s ongoing industrialization. A natural storyteller with a reporter’s eye for detail and a stand-up comic’s dry wit, Belluck leaves the reader with an urge to feign illness just to have an excuse to visit her subject. A truly wonderful read.”—Warren St. John, author of Rammer Jammer Yellow Hammer and Outcasts United

“If you want to understand the ‘real’ Nantucket, you must read Island Practice. Dr. Tim Lepore personifies the island’s fierce, quirky, and independent spirit. This is a book about an extraordinary man—a doctor, yes, but also a community hero. His story is as engrossing as the best fiction . . . but it’s all true.”—Elin Hilderbrand, author of Silver Girl and other novels

“[An] absorbing debut. . . . An intriguing biography of a unique—and on Nantucket, irreplaceable—doctor.”—Kirkus

“Page-turning prose. . . . Inspiring and entertaining, Lepore ’s story and his beloved island come to life in Belluck’s hands.”—Publisher’s Weekly

“A vibrant, throbbing, and sometimes painful book about life on an island and all the messiness that goes along with helping people through hard times if you’re the local doctor. . . . Island Practice is chock full of colorful anecdotes of island life, humor, empathy, color ful and sometimes X-rated medical emergencies, and the mundane that make up the life of a country, or island, doctor.”—Nantucket Inquirer and Mirror

“Funny, startling, and sobering by turns.”—Columbus Dispatch

“This is a riveting portrait of a dynamic, headstrong physician. Medical nonfiction fans will find much to enjoy. Lepore may remind readers of Dr. Paul Farmer from Tracy Kidder’s Mountains Beyond Mountains.”—Library Journal

“Thank goodness for writers like Pam Belluck who, in Island Practice, presents Dr. Tim Lepore, a cross between Marcus Welby and Hawkeye Pierce of M*A*S*H fame. . . . Island Practice is a work of evocative imagery and human description. It is readable, captivating, and almost cautionary in its description of what we have lost in today’s world of medicine. Author Pam Belluck has integrated medical, personal, and family issues into a fascinating portrait of a remarkable man.”—New York Journal of Books

“[Belluck is] an energetic reporter who found in Lepore an irresistible subject.”—New York Times Book Review

“A fun profile of Nantucket’s gun-toting, marijuana-prescribing, house-call-making local doc.”—People magazine

“Throughout, Belluck’s prose is beautiful and lyrical . . . the Lepore she gives us is a fascinating character.”—Boston Globe

Island Practice is a thorough dissection of a man doing his best to stand up to impersonal twenty-first-century medical practices. . . . What’s more, the book sketches a complex portrait of Nantucket itself—the stuff you won’t see in Frommer’s—that makes you glad that at least one guy is ready for anything.”—Minneapolis Star Tribune

“[I]ntriguing cases handled by Lepore are described in the new book Island Practice, written by Pam Belluck, a New York Times health writer.”—

New York Times writer Pam Belluck . . . clearly knew great material when she found it.”—Nantucket Chronicle

Island Practice gives readers an inside look at the peculiar challenges of health care on the island while reflecting on those that all communities face.”—Boston Globe’s “White Coat Notes”

New York Times staff writer Belluck saw a story that begged to be told . . . readers who laugh out loud on a subway . . . should be warned ahead of time that it’s hard to stop laughing.”—GateHouse News Service

Library Journal
Belluck's (health & science reporter, New York Times) account of Tim Lepore—the only full-time surgeon in Nantucket, MA, who also plays many other roles—begins by describing boatloads of local characters. Though this device feels a bit disorienting, it mirrors Lepore's highly unpredictable life. Grim descriptions of serious medical trauma follow, but Belluck renders Lepore's humour, compassion, and pragmatism in such a way that infuses the narrative with balance and humanity. For readers who have never been to Nantucket, Belluck's writing may dissuade them from making the trip, what with the tick diseases and sporting injuries—fish-hook through the eyeball, anyone? On the other hand, her descriptions of life in the close-knit community will make readers feel as if they've summered on Nantucket for years, all under the watchful medical eye of Lepore. VERDICT This is a riveting portrait of a dynamic, headstrong physician. Medical nonfiction fans will find much to enjoy. Lepore may remind readers of Dr. Paul Farmer from Tracy Kidder's Mountains Beyond Mountains.—Rachael Dreyer, American Heritage Ctr., Laramie, WY
Kirkus Reviews
In this absorbing debut, award-winning New York Times staff writer Belluck chronicles the daily life of a maverick physician and the Nantucket community he serves. In addition to his job as head of medicine at Nantucket Cottage Hospital, Dr. Timothy Lepore, a general surgeon, also runs a family practice and serves as the physician for the high-school football team--those are only his official jobs. Not only is his role "central to the health and life of a community in ways that rarely occur these days," writes the author, but it is also exemplary of the art of healing. "His unconventional story shows…that what really matters is the time, effort, conviction, and care that a doctor provides." Lepore is a larger-than-life figure on Nantucket, and his quirks are the stuff of legend--e.g., he carves scalpels from obsidian using stone-age techniques, and he hunts with a pet hawk. Also legendary are his diagnostic skills and dedication to his patients. Over the 30 years that he has practiced medicine on the island, Lepore has dealt with medical emergencies at times when weather conditions prevented the transfer of a patient to a specialist on the mainland. He has treated celebrities on summer vacation, including members of the Kennedy family, but the year-rounders, many of whom work in low-wage jobs in the tourist industry, form the core of his practice. Widely traveled summer tourists may suffer exotic diseases that challenge his expertise, but depression, alcohol abuse and teen suicide are endemic on the island. Under Lepore's leadership, Nantucket's hospital has played a crucial role in maintaining the community's health, but it is becoming less sustainable. "The cost of providing free care to poor and uninsured patients ha[s] grown by 60 percent," writes Belluck. Notes the hospital's CEO, "We kept up with the medical care, but not with the business of medical care." An intriguing biography of a unique--and on Nantucket, irreplaceable--doctor.

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Meet the Author

Pam Belluck has been a staff writer for the New York Times for more than fifteen years, during which she has written about everything from cattle rustling to embryo adoption, reported from places as diverse as Medellin, Colombia, and Seongham, South Korea. She served for more than a decade as national bureau chief, covering some of the biggest stories for the paper. She is currently a health and medical writer for the Times. She has won several awards, a Knight Fellowship, and a Fulbright Scholarship.

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Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor 3.7 out of 5 based on 0 ratings. 6 reviews.
ScratchJG More than 1 year ago
WOW, what an eye opener. I loved the story this book told. The most important part "to me" was the matter of how the health organizations are working to consolidate every hospital, doctor, nurse under one umbrella to which will be not a "hospital" but an financial organization that works only to control cost and peoples lives to perform like a online factory machine called the "United Health organization of the Country. This to me is no only not in my best interest or the patient and is scary! Other wise a read and enjoyable read. Pam get me another great book to read. Thank you. John d Augusta, Maine
shecab More than 1 year ago
I lived on Nantucket for twenty-three years and was a patient of Dr.Lepore. I felt that the book was very even-handled in describing the many facets of Dr. Lepore. I always felt that his heart was in the right place.
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