From a review of Pam Belluck's Island Practice that was published in today's Boston Globe:
"Island Practice’’ weaves together tales of Dr. Tim Lepore’s almost 30 years of residence and medical practice on Nantucket Island. During this time, this maverick physician has functioned as a medical jack of all trades: delivering babies, performing surgeries, even standing in as a veterinarian when the need arose.
Over the years, Lepore, one of a handful of full-time doctors on Nantucket, has made himself an indispensible part of life on the island, which is a summer playground for the wealthy and famous and the year-round home for about 10,000. Over his career he has treated celebrities such as Jimmy Buffett and various Kennedys as well as legions of fishermen, foreign workers, and waitresses — the book begins with Lepore bushwacking his way through a forest to make a house call on a virtual hermit, “Underground Tom’’ of the subtitle.
“Hundreds of people would have died if he wasn’t there,’’ notes a mainland surgeon who sometimes covers for Lepore when he takes an infrequent trip off the island. “His is a job that very few people want to do, and nobody’s doing it like he does it,’’ says a fellow island physician.
The hours Lepore works are the stuff of legend. He counts among his many jobs: general surgeon, head of medicine at Nantucket Cottage Hospital, high-school football team doctor, tick-disease expert, and school committee member.
Lepore moved to the island after a stint as an emergency room doctor in Providence. The satisfaction he so obviously derives from the intensity of his work and the very close relationships forged with his patients is enviable (even if many of them seem unable to distinguish between his office and the middle of the street when it comes to seeking medical advice).
This lifestyle can be very emotionally and physically taxing, however, even for someone such as Lepore, 67, who is willing to sacrifice much for it. He describes his patients as being “like little piranhas. They take a little bit out of your heart.” In contrast, many younger physicians have a very different outlook on how to integrate medicine into their lives (and not vice versa). It’s not surprising that Lepore opposes the duty-hour restrictions for trainees that have put an end to 36-hour shifts. He doesn’t have any, and that seems to suit him just fine.
Belluck's writing is beautiful, and Lepore is as impressive as he is offbeat. The full review can be found here:
Dennis Rosen, M.D.
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