Island Practice (28 page)

But drinking was something else altogether. At one point, Stark asked Lepore for a drug called naltrexone, sometimes prescribed to help diminish cravings. Lepore gave her a prescription, but naltrexone was ineffective, and Stark continued to drink.

“For me alcohol really was a numbing thing, not wanting to deal with certain problems,” she says. “But I could feel how it was affecting my health.”

Both Browne and Stark felt Nantucket was something of an enabler. “The island, because it’s at the end of the world here, people come to Nantucket to escape,” says Browne, who arrived in 1982 after dropping out of college and reading an article about scallop fishing. “It’s not a big jump from coming here to escape to escaping in other ways, like with alcohol.”

Stark, whose family moved to the island when she was a teenager after her father left Wall Street and became an artist, finds the winters “extremely isolating. On a February night you can go to a bar or an AA meeting.”

But “we were both a little resistant to going to AA. And on Nantucket, there’s really no anonymous.”

Browne and Stark considered a thirty-day residential rehab program like Hazelden, but it was expensive, and they balked at separating themselves from Stark’s son and other aspects of their life for an entire month. Stark feared that the detoxification process “can be very dangerous, and some people die from that.” And they were afraid of failing, of finding out they wouldn’t be able to manage life without alcohol.

“I wanted to stop drinking but I knew I needed help with the physical dependence,” Browne says.

No one seemed to have the answer, “except Dr. Lepore on a Wednesday.” The Wednesday in question was December 8, 2010, when Browne and Stark walked into Lepore’s office.

“You’re going to have to do a lot of it yourself, but I can help you, and let’s do it now,” Lepore told them. He prescribed Librium, a drug that can alleviate anxiety and agitation caused by alcohol withdrawal.
“Take these whenever you feel like it—it’s hard to OD on this stuff. Come see us Friday.”

“You’re not open on Friday,” Browne pointed out.

“I’ll be open for you.”

By Friday, Browne’s cravings had quieted so much that he didn’t even take the Librium. “I felt like stopping drinking would be this great big deal. Dr. Lepore just met me where I was—and he saved my life.”

Lepore also encouraged Browne to change his medication, and treated Browne for his ADHD.

Stark had a bumpier path. After her visit to Lepore, her hopes of staying sober were stymied by the force of her habit. Five days later at about three in the morning, she drank from a case of Prosecco they had in the house, drinking one to two bottles in one sitting. A week later, she did the same thing. Around Christmas, she had a Bloody Mary (her mother’s name was Mary) at her father’s house. “It made me feel physically ill,” she recalls.

Stark returned to Lepore and confessed what had happened. He listened and urged her to keep trying. “I didn’t ever feel ashamed or embarrassed,” she says. In December 2011, both she and Browne celebrated a year of not drinking a drop. “I went and got my one year chip,” Stark says. “I brought my son. It felt really good.” They now keep their Polpis Road home stocked with a wide assortment of teas, not alcohol.

They still consult Lepore. “I even love going to his office, where there’s all these weird knick-knacks,” Stark says. “It’s more like a gun shop than a doctor’s office with all those stuffed creatures. I don’t think he dusts. You really get a good feeling in there.”

Browne says that “everyone I know who drinks way too much, which is a lot of people on Nantucket, I want to tell them to go see Dr. Lepore.”

They believe they could never have broken their addiction under other circumstances.

“There’s something really lost in modern medicine—it’s so removed and impersonal now, waiting and going back to get tested, you just feel so worked over,” Stark says. “It can be so demoralizing and exhausting. The whole medical system is a form of mafia; doctors are afraid to do anything. That’s what the beauty of Dr. Lepore is. He’s a maverick. He’s excited to figure things out. He’s not afraid to do things.”

Down a dusty lane near the village of Siasconset, universally called’Sconset, sits a tidy cottage tucked behind a wooden fence. Inside are cheerful aqua-colored curtains, seaside decorating touches, and a ceiling fan whirring amiably overhead. A visitor to this charming home is more than likely to be invited in for tea and cookies.

The cookies look like Grandma’s—round, about two inches in diameter, with a little rise in the center and a tinge of golden brown on the bottom. But Henry, who lives here, makes them in his own special way. He starts with basic oatmeal, chocolate chip, or sugar cookie recipes and then adds his secret ingredient: pot.

“You ever get high, good girl?” he asks a visitor, setting out cookies on homey china plates. “With these, you’re not thinking suicidal thoughts; you’re not retaining fluid; you’re not having nose bleeds. You have to decide in your heart that you want to know what the fuck is going on. You will be rocketed into the fourth dimension.”

Some cookie. Henry—who asked that only his middle name be used because otherwise “they would put me in jail,” and “if I get popped
over this shit, a lot of people are going to suffer”—started baking his cookies at Lepore’s request and has become Lepore’s supplier. The confections are not for the doctor himself but for patients, especially cancer patients who can’t handle nausea from chemotherapy or have trouble eating enough to maintain strength.

“The hospital doesn’t know—this is just something I do,” Lepore confesses. “If I feel a patient needs it, I’ll ask, and he will make me some cookies or brownies.”

Medical marijuana is not legal in Massachusetts. The closest the state has come is a bill introduced in the legislature that would protect patients, doctors, and caregivers from getting prosecuted for using medical marijuana. Possession of more than an ounce of marijuana is a criminal offense in Massachusetts; less than an ounce is subject to civil penalties like fines. (Henry doesn’t reveal how much pot he puts in a batch.) But Lepore is not fazed that he might be going outside current law in these circumstances. If he believes it is right for a patient, he believes he should take the risk.

It isn’t the only way Lepore moves beyond what many doctors would do. Some of his methods are impish—pants stealing, for instance. If he thinks someone should stay in the hospital longer than that patient wants to, “I just take their pants away. They have no choice but to run out in a johnny.”

And part of the portfolio he assigns himself is driven by curiosity about how far he can stretch his skills. Can he treat an altogether different species? A horse with Lyme disease? A sheep with pregnancy complications?

But Lepore will also undertake practices that clash with his own political or philosophical beliefs. He’ll dole out Henry’s cookies even though he is against legalizing marijuana because “people don’t handle it right in this culture.”

And although he is not in favor of abortion, he has recently become one of a very few doctors this side of Boston (he thinks he may be the
only one) who will perform abortions. In doing so, he has had to confront not only his own moral discomfort but the resistance of members of his staff, as well as threats from anti-abortion advocates.

“It is not considered a practice builder,” Lepore admits. “I do not advertise it, but people understand what’s going on.”

Lepore met Henry nearly two decades ago, not long after Henry arrived, a complete Nantucket neophyte (“I didn’t even know Nantucket was an island ’till I got up to the boat,” he says). One day, Henry got hit in the eye, and Lepore was the doctor stitching him up.

“Can you do something about my wrinkles?” Henry asked Lepore in the hospital.

“No, but I can give you tits,” Lepore replied.

“I’ve got to know this guy,” Henry thought to himself. “I asked him one day if he went to the Joseph Mengele school of medicine.”

Lepore credits Henry with introducing him to falconry, something Henry got in trouble doing back in Florida when the authorities “got pissed at him because he was drinking,” Lepore says. “He had a real alcohol problem.” By the time Lepore met him, though, he had sobered up. “We have had long talks about substance abuse, primarily alcohol. Now he’s a staunch AA guy.” But he hasn’t tried to kick his marijuana habit or his habit of disseminating dope to others.

Talking to Henry, now white-haired and in his late sixties, can be a bemusing exercise in patience and redirection, especially if he has indulged in his own tea or cookies, as he does frequently these days. The day he spoke about Lepore, he had eaten a cookie at 8 AM and sipped tea at 9 AM (“Or a cookie at 8, tea at 10—I don’t know. I’m getting immune to it now. I can eat five cookies or ten cookies”).

Every few minutes, he drifted to his experience in Jamaica, where he got involved with marijuana about a dozen years ago: “In Jamaica
they told me the weed cakes put men in the nut house—I had to try it. What I saw in Jamaica is what you’ll see on your deathbed. You’ll see life itself. Infinite oneness.”

Henry is given to coining new elisions of words that he unspools with great profundity. “Mystic words,” he calls them. Instead of heaven, he talks of “heav-in.” He says “people look up to the sky for heaven,” but “heav-in” signifies something like a soul. If you’ve got a problem, “in order to get it out, you gotta go to heav-in.”

There is “overstanding,” kind of a “whoa dude” version of understanding: “When I eat the cookies or drink from the chalice, every time I go to a place of overstanding knowledge. I don’t know where I’m going to go, I don’t know if it’s going to be fun, I don’t know if I’m going to have the shit scared out of me, but I go there anyway.”

And when his thoughts turn political, he might use a word like “civili-nation.” Where does he come up with these? “In that place far, far away.”

Asked what kind of marijuana he uses, he is vague: “It doesn’t have a name because it doesn’t have that kind of consciousness.” But he says it is “bubble hash, a real pure form of hash.”

Henry’s bubble-hash bakery is a relatively new innovation, begun in 2010, when Lepore, aware that Henry was making tea, asked if he could make marijuana desserts too. “Sometimes it’s better to have nice brownies or cookies or muffins,” Lepore reasons.

As a special treat, Henry even infuses Jell-O Pudding Pops with pot; he particularly likes working with pistachio flavor because the marijuana makes it “kind of chunky.” The cookies are made with “hand-chopped weed,” and although their high lasts ten to twelve hours, “they aren’t that strong,” Henry claims. He recommends refrigerating them (“if they get too hard, you warm them up in the nuke”). They can also be frozen “if you put ’em in a Tupperware so they don’t get freezer burn. They’ll last forever, man.”

Henry has also devised a coffee drink Starbucks probably doesn’t offer. Take some pot and “boil it on the stove for a long time, then add
half and half. The half and half will absorb the cannaboids, pull stuff out of the weed, and it sticks to the cream molecules. You strain it, and you can add chocolate milk to it.” Henry stores his cream concoction in what was once a bottle of Ocean Spray blueberry juice. “If you put that in your coffee at 8 AM, you’ll be stoned until noon,” he confirms with gentle satisfaction. Order it half-caff, no-foam macchiato, if you like.

But for the full-throttle experience, go for the tea. “You ever smoke a joint and get high and smoke another, and you don’t get any higher, and smoke another, and you don’t get any higher?” he asks. “The tea doesn’t do that. Oh Jesus, yes man, I drank it three times, and I kept getting put in a higher plane. I have to escape to a different level, and you can’t follow me there because if you do, I’ll escape to another level.”

Caution, though. When Henry’s sister drank the tea, he had to “put her in a tub of ice water because she was burning up in her mind. She thought she was having a heart attack, or about a hundred of them. She wouldn’t speak to me for a year.” This tea would give Earl Grey an embolism.

“I had to tone it down because people were losing their fucking minds. Some people that drink it, you never see them again, and some people that drink it, they know a little more than they did before. You drink the tea, and what you have in that near-death experience is a judgment of your life, a trillion seconds, 31,000 years. And there’s not even half that many stars in the Milky Way.”

Through trial and terror, Henry has learned to titrate his tea so it meets medicinal specifications of a sort. In one case, “a friend of mine turned me on to a dude” who was bedridden at home, so sick he needed both a heart and a liver transplant. Henry whipped up tea mixed with vanilla-flavored Odwalla protein drink. “I kept him in tea, strong-ass tea, and ran it through the feeding tube.”