Island Practice (19 page)

Lepore isn’t reckless with guns, despite all his bluster. Occasionally, though, he has what might be described as a vigilante moment. One night, next door at Chris Fraker’s, Fraker’s daughter Jen came home with a date to find a man sitting on the kitchen floor. He was eating yogurt and seemed confused and on edge. Fraker was in the shower, and his daughter called out, “Dad, is this someone you know?” Fraker came out in a towel and yelled to his wife, “Debbie, call Tim Lepore and the police, in that order.”

Lepore grabbed a gun, one of his Colt 1903s, and shoved it in his pocket, then headed to the Fraker house. He did not brandish the weapon, not wanting to provoke an already delicate situation, and once there he realized the man was drunk and nonthreatening. The police took him away. “It turned out to be a drug addict so high he didn’t know where he was—he thought he was in a different house,” Lepore recalls. But he was glad he brought the gun. “I didn’t know what I was getting into.”

Lepore also makes his own ammunition—out of fascination and because “I’m cheap as hell.” At first, he just reloaded shotgun shells, picking them up from the ground and packing them with powder at home. He experimented with different techniques, switching from a “hot load,” in which a large amount of powder creates pressure that spits bullets out faster, and instead putting “less powder in or a different powder so it doesn’t kick as much.”

He tried stuffing other types of bullet casings, collecting obscure calibers, which he stores in a rack of tiny plastic bins, the kind that might be expected to hold nails and screws. He has casings for 9 millimeters, .38 specials, .223s, .44 and .357 Magnums, the 7.65 Argentine, even the .303 Savage, a gun, he notes, that they stopped making seventy-five years ago.

When he needed a new challenge, he decided to make the bullets too. He’d send his sons, T.J. and Nick, to scavenge lead from the shooting range. He discovered that pure lead itself is too soft; it’s better to have lead mixed with tin and antimony. So he sought out unusual sources: lead ingots people make fishing lures out of, linotype used in newspaper printing, and old wheel weights he’d ask for at gas stations. “I melt them all down, cast them into ingots, then melt them down again,” pouring the liquefied lead into molds.

Lepore used to make bullets in his cellar, but the awful smell of the boiling pot of lead annoyed Cathy. He moved to the garage and then discovered a workshop next to the hospital’s emergency room that was used by the maintenance crew. He carted in an electric pot, lead, and molds. As nurses did triage and swabbed wounds in the ER, Lepore played with molten metal to feed his guns. “I would go in there and cast bullets all day, waiting for patients.” When the ER got reconfigured, though, Lepore’s ammo lab was sacrificed, ostensibly for reasons of space, although, he admits “there’s probably some health and safety concerns as well.”

Lepore’s ammunition work surprises even members of the gun crowd on the island, like Bruce Watts, the former fire chief Lepore teargassed.
Although Watts is an avid hunter, he concedes, “I don’t even load my own shells. I go to the store and buy them.”

Meanwhile, Lepore sends his son Nick, a lawyer in Atlanta, “random text messages, asking me to get some reloading supplies for him,” Nick says. “He wants some 1943 Japanese brass part of a bullet. I tell him, ‘I can’t buy these things and send them to you because that would violate federal law.’”

One Saturday, Lepore pulls on a hunter’s orange vest and an orange wool cap and collects his Browning shotgun—square-back, auto five, twelve-gauge, circa 1935. “It’s semiautomatic and goes bang five times for you,” he says reverentially. He looks through his array of whistles that generate deer calls—Doe Bleat, Buck Grunt and Snort, Bleat-in-Heat—but opts not to take one with him. He only has a little time to hunt this afternoon.

Lepore drives to the moors, a stretch of heather, cranberry bogs, bayberry, huckleberry, and scrub oak. It is 35 degrees, but the island’s ferocious winter wind makes it feel much colder.

Lepore couldn’t care less. His boots crunching on frozen stalks and dried grasses, he points out branches where bucks have scraped their antlers. He spots a deer blind someone built, a ladder leaning up into a tree. He scans the brush for deer for an hour or so, but if any are around, they are waiting him out. Maybe they know they can. Lepore has no time to play the patient hunter, squatting silently until his quarry appears.

He can never be like his friend Ronnie Conway, an electrical lineman for National Grid, who hunts with a regular posse of buddies and has a living room festooned with the mounted heads of deer he has shot. Still at the taxidermists the day of Lepore’s brief if-you-can-call-it-that hunt is a buck so impressive its antlers have twelve points, an animal Conway nabbed only after pursuing him for more than a year.

It’s hard for Lepore to find time to hunt with Conway and his group, although “I like to get him out as much as possible,” Conway says. During one such trip, Conway, in a deer stand, thought he heard a phone ring. “No, he can’t have his cell phone out here,” Conway thought. “But when I came out of my stand, he was gone. It turned out some guy had a heart attack.”

Perhaps because of interruptions like that, Lepore says he has probably killed only eight deer over the decades, and none worthy of displaying. “I don’t have any great racks—you can say it, I’m not ashamed. I’ve only shot does and a couple of small bucks. If I mounted any of them, it would be like stuffing a dog.”

The antlers hanging in his office are “sheds” that he found on the ground after deer sloughed them off. Sometimes when Lepore is out in the moors looking for antlers, he wanders completely off the deer trails into thick, nearly impenetrable brush. As darkness falls, Lepore calls Cathy: “I’m lost—come find me. Go someplace high, and turn on the lights and honk the horn.” Before her friend Pam Michelsen moved off-island, she and Cathy developed a system: Drive out to the middle of the moors and climb up Altar Rock, the island’s second-highest point at all of 108 feet above sea level. Then blow a whistle. Keep on blowing until the doctor finds his way out of the woods.

Once, with forty-five minutes to spare before the wedding of one of his longtime nurses, Lepore decided to scout out a new hunting spot. He drove to Hidden Forest, bumping along dirt roads until the dirt became mud and the car got stuck. He called Cathy, who was livid and sent Chris Fraker to the rescue. But the car was so mired they had to wait for a professional tow. Lepore missed the wedding.

“Hunting—this is the best way I can put it—it’s very different from going for a walk in the woods,” Lepore muses. “You’re more alive to everything around you, to the wind, to sounds, to looking to see things.”

Besides, whatever gets injured on a hunt, it’s a game animal, not a patient. “I haven’t tried to fix anything I’ve shot,” Lepore says, and maybe that’s part of it. In hunting, it’s okay to let things die.

Alexandra McLaughlin could see them and hear them: people buzzing around her, anxiously wondering what to do. She had just gone out for a walk with her dog. But suddenly she was sprawled on the ground, face down.

Passersby seeing her in the dirt panicked and called 911. Someone, perhaps thinking she was having a seizure and might bite her tongue, said, “Let’s shove a wallet in her mouth.” But McLaughlin wasn’t having a seizure or a heart attack or a fainting spell. She wished she could explain what was going on, but, although fully conscious, she couldn’t move or utter a sound. She could only lie there, humiliated.

“My face,” she recalls, “was right next to a dog turd.”

McLaughlin was the ultimate medical enigma. For more than two decades, since she was about ten, no one could determine what was wrong with her. Many doctors had tried. They suggested thyroid problems, renal problems, Lyme disease. One doctor proposed postural orthostatic tachycardia syndrome, POTS, in which the heart rate revs
when people stand up. Brain cancer was tossed around. Depression? Bipolar?

“I kept getting misdiagnosed.” And she kept getting worse. Falling down had been a rare symptom for most of her life, but since moving to Nantucket in 2009, she was collapsing constantly—face down on the street, on the beach, in stores. “People find me on the ground all the time. It looks like I’m dead.” She’s had surgery on her knee, wrist, ankle, and fingers, and “I had to give up horseback riding, which I love, because I would fall off.”

McLaughlin’s symptoms can be triggered when she’s startled, even “when people honk to say hello to me” on the street. And “whenever I have a strong emotion, I can’t move my arms,” or her knees buckle, and she turns to Jell-O.

“When I’m really, really happy, I know it’s going to happen. So I start thinking of something awful: dead puppies in a washing machine or something. When I get really angry, I can’t move my head, and my jaw goes slack. I have to think of the funniest YouTube videos I’ve ever seen.”

Once on the beach, McLaughlin saw a mother playfully chasing after her daughter with sunscreen, the girl squealing: “I’m a princess, and princesses don’t get burned.” It was so “funny and delightful” that “I was doomed,” McLaughlin says. “I fell right down.”

Glancing at photographs of close family or friends can make her “high five the table with my face” without warning. And watch out “if I’m talking to somebody I’m madly in love with. I don’t look him in the eye.”

McLaughlin’s condition could cause her to hallucinate, seeing spiders where there were none, for instance. She was also experiencing sudden onsets of fatigue and “could nod off to sleep and not realize that I’ve slept. I was unable to get out of bed, unable to drive my car, can’t work, can’t do anything.”

McLaughlin moved to Nantucket when she was thirty-one because the island, where her family had summered, seemed a good place to reboot
after her marriage broke up. (She asked to be identified by her birth surname instead of her married surname.) Soon after arriving on-island, she began landing in the emergency room. She inquired about primary care physicians. “Dr. Lepore may be the only doctor taking new patients,” she was told. “He doesn’t turn anybody away.” Lepore was not only available. He was fascinated.

“With him I could be more honest about what would happen to me. I had this huge history of symptoms that just never made sense. I couldn’t tell that to anybody because it sounds crazy. He said, ‘Oh that sounds really interesting.’”

McLaughlin, it turned out, had stumbled on a medical marriage made, if not in heaven, then on Nantucket. Lepore loves odd or inscrutable cases, and Nantucket has provided him with more than his share.

In the summer of 2006, Rob McMullen actually crawled into Lepore’s office. It was an extraordinary predicament for McMullen, a ship’s captain who has plied Nantucket’s waters for almost two decades. He lives alone on his sailboat,
The Snowy Egret
, drives a small cruise boat taking tourists from town to an upscale inn on the island’s northeast point, and was used to shrugging off ailments without any medical help.

But McMullen, then forty-four, was having strange symptoms. He got hot flashes and then chills so extreme that he was piling on sweaters and blankets in July. His legs began crumbling beneath him. “I really couldn’t walk.”

To get to his job, “I would crawl to the edge of the sailboat, pull myself up on the deck, pour myself into my dinghy, and then row it over to my work boat,” the
Wauwinet Lady
. There McMullen would “kind of prop myself up” while steering and making safety announcements. When he got to the inn, The Wauwinet, where he usually ate meals, “I couldn’t walk up to the hotel, so I would convince someone to buy me a turkey sandwich, and I would live on that for a few days. I was too
proud, and I didn’t want to stay in bed or go to the hospital. I think it was kind of messing with my head.”

Finally, McMullen contacted Lepore, who zeroed in on what McMullen called “twin puncture wounds on my neck that looked like I’d been bitten by a vampire.” Near the wounds was a raised lymph node that resembled skin cancer, but there was something atypical about it. “He wouldn’t give up,” McMullen recalls. “He wanted to figure out what it was.”