The island of Nantucket’s only general surgeon, Tom Lepore, is a man of many hats. Sometime trauma surgeon, sometime psychiatrist, sometime foster parent for the island’s strays, Dr. Lepore is a polarizing character who does it all. This autobiography/expose of Nantucket’s larger-than-life doctor shows off his wackniess, his antithetical political beliefs, his surgical skill and ultimately his compassion for all of his eccentric patients. For example, patient Underground Tom, a rogue and renegade who builds elaborate underground houses on Nantucket’s private lands, so secreted away that he remains undiscovered by the authorities. Dr. Lepore, of course, makes “house calls” to the underground fortresses that Underground Tom builds, to treat all sorts of every day ailments. There are also the wayward teenagers who thrive in the Lepore house, under the manic discipline of Dr. Lepore and the quiet compassion of his wife Cathy, who appears to put up with a lot. Like Dr. Tom’s extensive gun collection. And his habit of getting lost while hunting, requiring cell-phone triangulation and rescue by his ever-patient wife. And then there is her composure with his occasional marathon habit which requires focal knee injections and generalized compunction to get through the races. Most importantly, Cathy provides a grounding counterpoint to Dr. Lepore’s erstwhile whims and provides quiet guidance to their children, who include a doctor and a nurse, as well as several stray kids who have thrived under the family’s unusual breed of success. Island Practice is a great book that illustrates that the brand of medicine thought lost into the rosy past, the dedicated doc who does it all, is still alive and well off-the-beaten-track in America.