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Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor Hardcover – June 5, 2012

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Product Details

  • Hardcover: 288 pages
  • Publisher: PublicAffairs; 1 edition (June 5, 2012)
  • Language: English
  • ISBN-10: 1586487515
  • ISBN-13: 978-1586487515
  • Product Dimensions: 9.8 x 6.6 x 1.1 inches
  • Shipping Weight: 1.1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (44 customer reviews)
  • Amazon Best Sellers Rank: #1,019,381 in Books (See Top 100 in Books)

Editorial Reviews


“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

About 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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Customer Reviews

I felt like I knew Tim and his family.
Kathy summers
Island Practice is the mesmerizing story of Dr. Tim Lepore, the only surgeon on Nantucket Island.
Julie L Flygare
This book captures him to a t, he is a real life person committed to his patients.
Peter W. Brown

Most Helpful Customer Reviews

17 of 17 people found the following review helpful By Westport Reader on May 28, 2012
Format: Hardcover Verified Purchase
Island Practice is tale of quirkiness and peculiarities as well as nuanced reporting on moral and political issues like abortion, substance abuse, suicide and, especially, medical care as it has been practiced, but perhaps, may not be in the future. Belluck's description of the Nantucket's only surgeon's behavior gives insights about his pragmatic dealings with real people in tough situations as well a showing this unique doctor plying his trade while holding onto his values and persona. The lesson is that medicine is a micro and macro issue and where you sit defines what you see. Dr. Lepore and his special patients need a kind of care that is uniquely available because of his personality and the unusual characteristics of Nantucket. Anyone who is a patient wants a doctor to go above and beyond the crazy quilt of the insurance and hospital and malpractice "rules" to get us the care we need. Island Practice entertains with stories yet leaves you wondering how will that care be provided in the future, not just on Nantucket, but especially in an isolated situation. Loved all the characters - and they couldn't have been more unusual if this was a work of fiction - so kudos to Belluck for finding them, introducing us to them and getting them to share their unusual tales.
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10 of 10 people found the following review helpful By curiositykeeper on June 2, 2012
Format: Hardcover
I couldn't put this book down. Granted, I'm a Nantucketer, so it was especially riveting to read about people I know or might know in the future, and to find out more about Dr. Lepore. But even with that added interest, this was a truly interesting and well written book. It never seemed to bog down in too much detail, or be too sketchy. It very accurately captures the atmosphere of Nantucket, positive and negative. I could see this book as the basis for a television series, a cross between House, Northern Exposure, and Doc Martin. We are a small community with plenty of characters, both beholding to and resenting the extremely wealthy who surround us. One thing I like about the book is that it focuses on the lives of the year-round, working class people rather than the rich people. Too often anything about Nantucket seems to think it disappears when the tourists aren't here, a perspective as immature as a child surprised to see a teacher at the grocery store. I especially liked the discussion about the hospital being bought by the mega-corporation... it's a crucial issue in a small town in a world that's getting smaller and more regulated all the time.
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7 of 7 people found the following review helpful By Deborah Scroggins on June 19, 2012
Format: Hardcover
In the skilled hands of New York Times writer Pam Belluck, this tale of a quirky doctor and the unique island to which he ministers becomes a rollicking good read. Dr. Tim Lepore is a character right out of the Enlightenment with his insatiable curiousity and adventuresome willingness to experiment. But Belluck shows that he cares deeply for his patients and indeed for all the living creatures on Nantucket - ticks aside, that is. The book reveals a Nantucket that may surprise even frequent visitors. In Belluck's telling, the world of the island's permanent residents is more like "Northern Exposure" than Norman Rockwell. But "Island Practice" has a more serious message, too. The independent practitioners of the world are under threat from massive corporations and insurance companies. Yet without Dr. Lepore, Nantucketers would find huge gaps in their medical care. Congratulations to Belluck on bringing him and his world to a wider audience.
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6 of 6 people found the following review helpful By J. on June 7, 2012
Format: Hardcover Verified Purchase
Having been a summer resident on Nantucket and also having spent a full (very long) year on island, I could not put this book down.

Pam Belluck captures the idiosyncrasies and quirkiness of Dr. Lepore while highlighting his brilliance, devotion to his craft (all of them) and most especially gives the reader ringside seats into the many life saving decisions he faces on a daily basis.

Dr. Lepore is a man like no other. He turns away no one, is willing to save a horse in the middle of the night, delivers babies, performs surgery, treats addicts and advocates for his patients that is unheard of in today's medical practices. I know this not only from reading the book, but also because he was my physician during my time on Nantucket.

I always knew him to be a fantastic physician but also a unique and quirky character. Now I know he has endless wells of compassion and will always fight for what is right for his patient.

He is second to no one and Nantucket is so very fortunate to call him their own.

I highly recommend Island Practice, as it captures island life very vividly while drawing the reader in to both the private and professional life of Dr. Lepore.

"You can't polish a meatball"...but you can enjoy it just the same. ;)
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6 of 6 people found the following review helpful By David Kinchen on June 6, 2012
Format: Hardcover
Dr. Timothy J. Lepore (pronounced to rhyme with peppery) has earned a reputation as an idiosyncratic, contrarian family practice physician in his decades on Nantucket Island, but, as Pam Belluck shows in her very readable book "Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor" that he's really a survivor from a not-too-distant past when family doctors were not as money-driven and impersonal as they've been forced to become in today's medical-industrial complex.

Since moving to Nantucket in 1983 with his understanding beyond belief wife Cathy, Lepore has 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 revolver, a picture of a Nepalese shaman.

"Cobblestone rash"? Belluck says it's an equal opportunity malady resulting from slipping or falling -- or stumbling drunk -- on Nantucket's picturesquely uneven streets. Related to this are moped accidents. Dr. Tim to the author: "I've told people if they want the moped experience they could just let me hit them with a bat and then go over them with a sander."

If you need an appendectomy, Lepore 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 the 67-year-old physician who has a stuffed armadillo on display in his office.
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