Questão 34

In her new book, “Island Practice”, the New York Times reporter Pam Belluck tells the story of Dr. Timothy Lepore, a quirky 67-year-old physician who for the past 30 years has been the only surgeon working on the island of Nantucket. But Dr. Lepore is no ordinary surgeon. Life on an island, even one that has become a summer playground to the rich and famous, requires a certain amount of resourcefulness and flexibility. Over the years Dr. Lepore has taken it upon himself to deliver whatever type of medical care his island inhabitants need, often challenging conventional notions of medicine and redefining what it means to be a healer. While his surgical skills have been used for minor repairs and lifesaving procedures, he often works as a general practitioner, treating everyday ailments. Distraught island residents also call on him for counseling and comfort, and he even steps into the role of veterinarian when needed. I recently spoke with Ms. Belluck about the time she spent with Dr. Lepore. Here’s part of our conversation. 

I thought of it as this rich summer haven, but there is this whole year-round population that is really interesting and diverse and has to scrabble for a living. Even the hardship was surprising. You think any place is accessible, but there  are a lot of times where you cannot get on or off the island, and you can’t get what you need. Even though they have fast ferries and airplanes now, you’re still at the mercy of the elements, and that creates a lot of drama. 

Part of it is the fact that as the only surgeon, you kind of need to do everything, and you may not know how to do something. There was a guy who came home and had forgotten to pick up potatoes, and his wife stabbed him in the heart. It’s the kind of stab wound that only 10 percent of patients make it to the hospital alive, and 1 percent will survive. Dr. Lepore had never seen anything like this before, but there was no time to get the guy off the island. So he had to reach in and get the heart started. There wasn’t the right equipment to sew him up, and they had only six units of blood, which is not that much. But he’s an encyclopedia of arcane facts, and he remembered that in the 1800s they used black silk thread for this kind of injury. They found some black silk thread, and he managed to close this guy’s heart and get it beating again. The guy survived and became a marathon runner. There is a field hospital-type feeling to it. You’re not under fire, but there is making do with what you have and flying by the seat of your pants. Often the weather is bad, and he has never done it before, but he just has to do it. 

He takes insurance, but he also takes people who can’t pay at all. He will even allow people to pay him in kind. One of the undercurrents of the book is that his hospital on Nantucket is now run by Partners Health Care, the big health care corporation that runs Massachusetts General and Brigham and Women’s Hospital. They have instituted some new systems, but he flouts many of them. He says, “Nobody is going to manage my time. Nobody is going to tell me what to do.” They can’t really complain because they need him. 

(www.nytimes.com. Adaptado.)

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