“Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor” should be required reading for anyone considering relocation to an island. While author Pam Belluck’s primary character study is the daring, quirky, indefatigable Dr. Timothy J. Lepore, Nantucket isn’t far behind. They were made for each other.
“Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor,” by Pam Belluck. PublicAffairs, New York, 2012. 274 pages. $25.99
“Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor” should be required reading for anyone considering relocation to an island.
While author Pam Belluck’s primary character study is the daring, quirky, indefatigable Dr. Timothy J. Lepore, Nantucket isn’t far behind. They were made for each other.
New York Times staff writer Belluck saw a story that begged to be told and that most everyone on Nantucket is likely to read, probably with mixed reactions. She examines Nantucket through Lepore’s scope and finds, among other things, way too many ticks bearing three frightful diseases. And there’s much more. Depression, alcoholism, isolation, poverty, lack of resources and services, bad weather and complicated travel to get off island are some of the problems that Lepore confronts. He does so in idiosyncratic ways that make him hard to like, sometimes, and indispensable always.
It takes a book to present a rounded picture of Lepore. He is one of the island’s primary care physicians, its only surgeon and, along with his wife Cathy who is a school nurse, he works in myriad ways to stabilize a island population of 10,000 in winter to close to 60,000 in summer. He does what he thinks he has to do to help, from taking in a girl whose mother tried to poison her to desperately trying to save the life of a horse writhing in baffling agony. He does abortions despite his own feelings on the matter, he treats a man living in the woods who is always one step ahead of the police, he hunts, he runs the Boston Marathon every year without proper training and conditioning and he finds delicious ways to provide medical marijuana to patients who need it.
Island life, we learn, is not easy. Just as Galapagos incubated unique studies in evolution, inhabited islands can incubate dysfunction. Nantucket, off the coast of Cape Cod and accessed primarily by ferry, is mobbed in the summer by people requiring many specialized services. The disparity between the wealthy and the impoverished is stunning. Bad weather imprisons everyone, even those suffering an embolism or stroke. There’s no privacy or escape from scrutiny for the regular, year-round folks. And life can be downright boring. If you are in a service occupation, as Lepore is, there’s no time for watching magenta sunrises or sunbathing during the brief, beautiful season of summer. In his own words he works too much but it’s clear he loves it. His door is essentially always open. People knock 24 hours a day. He may be curt and abrupt, but he is reliably compassionate. Thus the abortion or the attempt to treat a goat with a prolapsed uterus.
Belluck doesn’t hold much back. She gets into the kinky things people do to themselves in boats and the island proper in moments of high passion that result in extreme pain and, once, death. She has fun with much in this section of the book and readers who laugh out loud on a subway while reading this chapter should be warned ahead of time that it’s hard to stop laughing.
Her revelations about the enormous danger resulting from a large deer population are sobering, however. Lyme disease is one of three that ticks pass on to humans and animals in Nantucket and these diseases are devastating. Lepore is a vocal, relentless advocate for annihilating the deer population on Nantucket. His is a controversial position in Nantucket. Given the prominence of diseases and the dire nature of their effects, even some deer lovers will wonder why. Are Nantucket residents foolhardy, inured or some form of crusty Yankee with Galapagos syndrome?
Belluck’s book is a tad clunky. She interviewed numerous people including Lepore and his family and she gathered lots of fascinating material. But “Island Practice” never gets away from feeling like a lengthy newspaper article, with all its attributions and setups of quotes and reportorial formality. And though we learn a lot about Lepore, his deepest motivations and feelings are never clear. We get a 360-degree look at the man but Belluck is not able to penetrate the circumference.
Rae Padilla Francoeur’s memoir, “Free Fall: A Late-in-Life Love Affair,” is available online or in bookstores. Write her at firstname.lastname@example.org. Or read her blog at http://www.freefallrae.blogspot.com/ or follow her @RaeAF.