Latest Reading: “Island Practice” by Pam Belluck

I just finished reading this account of Dr. Tim Lepore (pronounced peppery), a general family medical doctor on the island of Nantucket. The book is a well-written journalism piece by Belluck, a New York Times reporter. Lepore is quite a character, that puts his patience first, and at 67, a stark example how the financial structure of healthcare is changing in the USA. I am from a small town in the isolated northern part of Michigan and can relate to Nantucket, a small island 30 miles off the coast of Massachusetts. It is a small town hospital struggling to stay alive in the face of rising costs. Many hospitals are facing the same challenges.

I was particularly interested in Dr. Lepore’s research into tick-born diseases. He is an expert because Nantucket has an overpopulation of deer and hence, one of the highest rates of tick-caused diseases like Lyme Disease. I learned that the baby ticks pick up bacteria or parasites from feeding on mice. As the ticks grow, they change to deer and come in contact with humans. The deer allow the ticks to have enough sustenance to produce baby ticks. There are deer on Nantucket because in the 1920’s, a boat saw a deer swimming off the coast and they rescued the buck and set it on the island. A few years later, two does were imported from Michigan and today, there are thousands of deer on the island. Dr. Lepore found that the white-footed mouse has blood flooded with parasites and the mice had lots of deer ticks feeding on them, but no dog ticks. The major diseases are Lyme, babesiosis, and anaplasmosis. Being from Upper Michigan, I have a special interest in ticks and my wife always freaks out when she finds them on the kids. We have found quite a few on us this spring and summer in Belgrade, but the diseases associated with them are rare here and there are no deer in Belgrade. Even on Nantucket, of the 2,500 hospital visits they get a year of suspected tick cases, only about 10 percent were actually diseases. The treatment is heavy antibiotics.

Another part of the story was the living conditions on the island. Nantucket is known for tourism and extremely rich summer residents. It has an extremely high cost of living and for the permanent residents, there is much poverty due to the seasonal employment nature of the economy combined with the high cost of living and the isolation from the mainland. There is a lot of alcohol and drug abuse and depression. Some of this is also caused by the great income disparities between the locals and the tourists/summer residents. I read with interest about rash of teen suicides at Nantucket High School and the struggles with chemical dependency the counselors and teachers face with the students. The scourge of alcohol and drugs reminds me of small towns in Northern Michigan. Much potential is wasted due to excessive drinking.

Dr. Lepore is very opinionated and insightful. One of the things I am struggling with is children spending too much time watching television and playing video games. Lepore says, “I have this thing about books – you read, you can create the world.” … “In a video game it makes the world for you. You’re a watcher, not a participant. Unplugging the computer is the only way we can get her (referring to his niece) off the internet.”

The book was a fast read. There are plenty of characters on the island that come to see Dr. Lepore and it keeps it interesting. There are lots of topics covered too, like abortion, gun collecting, marriage, raising kids, immigrant stories, etc.

I have a friend from Nantucket and I will email him and see what he thinks of the book. I’ll report back on this post if there is anything relevant.



He tested the white-footed mice and found their blood flooded with parasites, and it ws