Island Practice (23 page)

T.J. now exhibits only “a small amount of motor dysfunction,” is “very right handed,” and has “a little bit of atrophy on his left leg,” Lepore says. “If he gets tired, he sort of contorts his left hand.” When T.J.
wanted to be a doctor, some medical schools were concerned. “People wanted to know whether or not he was going to have a repeat of it.”

But he has become an obstetrician-gynecologist in Springfield, Massachusetts, able to perform surgery, even though “I hold my forceps a little funny” and “my grip for my left hand is just a little bit impaired.” He sees these simply as “areas where I’m a little weak and I have to compensate.”

Lepore tried to model the need to compensate for deficiencies and take initiative to fix problems. No one else would do it for you—or should—was his belief.

When T.J. struck Nick with a hockey stick above his eyelid, causing a deep gash, it was Lepore who stitched his face. Doctors are generally advised against treating family members, but Lepore never considered asking anyone else. “That’s easy, of course,” he says. “No surgeon thinks he is second best.”

Sometimes, though, his pragmatism verged on boot-camp toughness.

One late fall day when Cathy was off-island shopping, her friend Pam Michelsen got a call from Meredith, who was about nine. “Her daddy had locked them out of the house because he was reading, and they were fighting. He was mad at them, and he just threw them out. And it was bitter, bitter cold.”

Michelsen called Lepore. “Tim, you can’t lock the kids out of the house. It’s freezing.”

Lepore, from an upstairs window, tossed coats outside. Soon Meredith called again. “We’re still freezing to death!” Michelsen jumped in her car. It took a while to reach the Lepores’ because she lived far north-west of downtown, “which is the other side of the world because, you know, ten feet is ten miles” on Nantucket. She grabbed the children, who were huddled on the porch, and took them until Cathy got home.

It wasn’t the first Lepore lockout. When the children argued, he’d send them outside, then race downstairs to lock the bulkhead from the inside and block other means of reentry. “I don’t think any other parents
have been locking their kids out,” he acknowledges, and “I don’t think Cathy endorsed it. But I’m trying to keep things comfortable, and the kids are fighting and raising hell.”

It wasn’t just self-interest, he asserts. “It was a way to catch their attention. They stopped fighting, and they had to work together. It united them against a common enemy: me.” Besides, contends Lepore, it was more humane than a spanking. “No blood, no foul.”

It worked, at least temporarily. “They were a good deal more contrite. You just keep them a little bit uneasy, and they have to deal with an irrational parent.” They never knew what to expect. Once, after he had locked them out, “I caught Meredith sneaking in the house. I had fallen asleep on the couch downstairs, and she came in through the window. She wasn’t quite prepared to see dear old Dad sitting there.”

The Ajax episode demonstrated another side of dear old Dad. Nick was about twelve, and Lepore took him hunting for rabbits for Ajax, his red-tailed hawk. As Lepore recalls, “Nick wasn’t working particularly hard. He was lollygagging instead of beating the brush trying to get rabbits moving.”

Suddenly, Nick recalls, he heard a “Whoof!” and whipped around. “There was Ajax, with its wings fully spread out and its talons and feet pointed. I ducked as quickly as I could, and it went whap on the top of my head.” Grappling for a secure hold, the bird “started refooting and plucking out tufts of hair.”

“The bird is on my head!” Nick screamed, immobilized with terror. “My dad said, ‘I’ll be right there.’ So nonchalant.” A friend of Lepore’s displayed more urgency, “charging through the brush” and ordering Nick not to move. “He reached down, gets the bird off my head. It felt like a half hour, but I’m sure it was about five seconds.”

The hawk punctured holes in Nick’s scalp. Blood cascaded down. But Lepore did not react the way Nick expected. “Nick, go sit in the car—there’s about twenty minutes of light left,” he said. “I just want to hunt a little bit longer.”

Nick gaped at his father, thinking, “Are you serious? I have blood streaming down my head!” Hiking through the brush to the road, he approached the only house. An old couple answered. “My dad’s bird attacked me,” Nick panted. They were patients of Lepore’s, naturally. They brought Nick inside, where he got cleaned up and drank orange juice. As Nick left the house, his father, having finished hunting, approached, notably unruffled.

“He looked like a waif in this bloody T-shirt, like something out of a horror movie,” Lepore recalls. “They were just little puncture wounds, but on the scalp they really bleed.”

Nick realized later that his father “knew it was nothing serious. He just didn’t take into account how I didn’t know that. I was never angry at him about it, to be honest. I was fine, and he was right. He has made a lot of sacrifices as far as his time, and this day was his chance to do something fun. I should have blamed him somewhat, but I just blamed the bird. I told him to never let me watch that bird if he’s out of town because when he comes back, it’s going to be stuffed.”

The incident “made its way around the island pretty quick,” Nick recalls. After all, “I had a tuft of hair missing.” He’d expected people would be shocked. But Nantucketers knew their doctor. “Of course,” people said. “Of course, he told him to just go wait in the car.”

Lepore’s children were immersed in the medical ins and outs of a small, self-contained community, not only because of his job, but because Cathy was a school nurse before becoming a school counselor.

“In a lot of ways I grew up at the hospital,” notes T.J., who, with his siblings, would hang out at the nurse’s station while Lepore did rounds. Once, Lepore dissected a heart in Meredith’s third-grade class. She recalls that “about three-quarters of my class left the room and wanted to throw up.”

At home, “the phone rang a thousand times a day,” T.J. remembers, and patients constantly dropped by. One Sunday morning, T.J. opened the door to see Steve Tornovish, then an acquaintance of Lepore’s (later, he would marry Cathy’s sister Beth). Blood covered Tornovish’s face; he was injured playing flag football. “Dad, it’s for you,” T.J. called. Tornovish never considered going to the hospital. “That kind of shit happens at the Lepores all the time.”

Many people assumed the children knew their personal business, making it a mixed blessing to be Dr. Lepore’s kids. “It seemed like you always had to be very careful what you did in public,” Nick remembers. Other times, “people would just come up and say, ‘Oh, I want to thank your dad for so and so,’ and I had no idea who they were.”

Still, Lepore “always tried to shield us” from the pressures he felt, T.J. recalls. “Things were playing on his mind, but he lacks a certain ability to share, which is normal in his age group. He also bottles a lot up. I can remember as a kid he would get grumpy with us. That’s usually a good sign that something bad was going down or something that he hadn’t expected.”

By all accounts, Cathy is a vital stabilizer. “The woman’s a saint,” is the way Rhoda Weinman, Tim Lepore’s close friend, describes it. “She is right to heaven, I keep telling her. Just his craziness alone. She’s very, very kind; she’s very sensitive; she’s very intuitive. She, of course, absolutely adores him. And you could tell from the things he said that he adores her.”

To Michelsen, Cathy “is the glue that keeps him together. He would be that crazy person who goes out in the moors and never returns if it weren’t for her.”

Michelsen says, “if there’s a problem in the office, Tim won’t deal with it—he hates confrontation, so Cathy has to go in and break up the fights and the issues that arise.” Cathy tolerates not only Lepore’s clutter, impulsiveness, and unpredictability but also the most frustrating thing for her, having to “play the role of the Tim wife,” when people,
usually summer visitors, don’t recognize Cathy’s own importance to the island.

“She really does love him—God knows why. She told me everything he does and talks about is just so interesting. I don’t know anybody else who would be that patient.”

There is more than enough to be patient with.

Sometimes Lepore seems to blow off steam with macabre practical jokes. When Meredith’s best friend called one day, she hung up in tears because Lepore told her Meredith had been in “a horrible accident—she’s dead.”

When a girl Nick had begun dating in sixth grade phoned, Lepore said, “No, I’m sorry, he’s not available. He’s upstairs growing a penis.” The girl dumped Nick at a school dance soon after.

Paul Johnson, a friend, compares it to the antics of Hawkeye Pierce and the other army doctors on the TV show
M*A*S*H
. “I think some of these little eccentric things are there for that reason—you throw in a little bit of insanity to get some relief because there’s a huge amount of stress.” In Lepore’s job, “you’re it, and if you can’t fix it, that person dies or gets maimed for life.”

Lepore’s hobbies are his principal outlet. Some are short-lived flashes of passion, like when he suddenly decided “he wanted the entire family to just eat polenta,” Nick recalls. “He said eventually we’ll start growing our own corn. We would go buy the corn meal, and every meal was polenta. He had cookbooks, everything you could imagine—until my mother said, ‘Okay, that’s it.’”

He asked his office manager to order flax, planning to make linen. And he scooped clay from spots on the island, scheming to make pottery the way Indians did. Buckets of clay filled his car, which on a normal day is often littered with animal bones, old socks, and other detritus.

Once, says Martina Richards, a former nurse, Lepore “got all excited about something called
Back Tuva Future
,” a CD blending Nashville
country music with the throat singing of the Tuvan people of Siberia. “He’d come into the office and try to do the Tuvan throat sound.”

And Nick, when he grew up and moved off-island, “got a random phone call telling me he needs a couple of pounds of acorn flour. It’s some kind of Korean flour; its main virtue is that it fills you up quickly. He wanted me to get it for him, but I know where it’s going. I’m not going to subject my mother to weeks of eating acorn flour.”

After all, Lepore had already subjected Cathy to his stone circle fetish. When he glimpsed a boulder he liked while running somewhere on the island, he would return to the spot with one of his lovingly-rehabilitated vehicles—military Land Rovers like the 1967
Chocolate Thunder
or the 1973
Runaway American Dream
. He hauled the stones home and arranged them in a circle on the lawn. “In the event that we lose calendars, these stones mark the winter and summer solstice,” he explains.

And what could be better to keep all those oversized rocks company? A Neolithic above-ground tomb called a dolmen. You build one of those and “you’re prepared,” says Lepore, who decided to improvise a version of these ancient structures using huge curb stones he scavenged from construction sites. He hasn’t quite collected enough of them yet. “Need a legion of serfs, perhaps.”

His plan to knit dog hair sweaters lasted for years. Lepore began saving shed fur from the family’s dogs—they’ve had up to five at once, three Nova Scotia duck-tolling retrievers, a Jack Russell, and a “Mississippi mutt,” one of the puppies regularly sent to Nantucket from an overflowing animal shelter in Mississippi. Lepore stashed the fur in plastic bags tucked in corners around the house.

It was a new one for their house cleaner, Mariellen Scannell, who thought she had “seen everything from A to Z.” Encountering a bag of hair, “I was like, ‘What the hell is this?’” Of course, “there’s a lot of stuff throughout the house that I ask myself that question: What the hell is this?”

Cathy began trashing the bags of fur, but Lepore never quite abandoned the notion. “He had a bag of dog hair that he kept in the car for the better part of five years ’cause he knew my mother would throw it away if it was in the house,” T.J. recalls.

Once something becomes a Lepore collectible, it’s almost impossible to discard. Cleaning is not his top priority. “Cathy has to do it all, including flush the toilet,” says Michelsen. “One night the furnace blew, and there’s water flooding the basement. Tim says, ‘I’m reading my book.’ Cathy and I are down there with mops and everything. We’re in the furnace room with all these boxes. I picked one off the floor, and the bottom falls out, and a real human skull and a bunch of bones roll out. I said, ‘Oh my God, Cathy. Who is this?’ She said, ‘Who knows?’”

Once Michelsen asked Lepore, “What’s the grossest thing you’ve ever seen?” thinking “it would be a one-sentence reply.”

“Hold on a minute,” Lepore answered, his eyes dancing. He dashed from the kitchen, returning with slides he had taken of horrific trauma cases he had treated years earlier in Rhode Island. He had Michelsen hold them up to the lamp light, one by one. “Here’s a guy who got shot, and his guts are lying over here. That’s his kidney. This one came in one night with no clothes on, and look what I found. Look at these things I pulled out of this guy.”