Cobblestone rash befalls those who slam drunk onto Nantucket's quaint streets. Underground Tom is a local who likes to dig himself into the earth to live, moving from one cavity to the next as authorities shoo him. And the Nantucket doctor is 67-year-old Tim Lepore, who treats the drunks, the weirdos, the rich and powerful, the just getting by, the suicidal and anyone else who needs him.

Lepore (rhymes with "peppery") is the fabled Massachusetts island's only surgeon. As medical examiner, too, he meets all its dead. He directs care at its 19-bed hospital. He's the doc for the school and football team, and has been known to sneak hurting animals into the hospital's ER. Because of Nantucket's battle with deer ticks, he is among the nation's experts on the nasty diseases they cause.

Folks in need think nothing of dropping by his home, which is "a hundred-yard dash from the hospital." He is a gun aficionado (and hunter) whose examining rooms are called Colt, Winchester, Smith and Wesson. He picks up roadkill to feed his pet hawk. He is a man of deep convictions and free opinions.

And he is, according to this tribute, beloved. He is described as "the backbone of the island," "the master of the universe" and the savior, over three decades, of "hundreds if not thousands" of lives.

Pam Belluck writes: "Against the background of a changing, churning American medical landscape, a physician like Lepore has become an outlier and a maverick, even as he represents a version of basic patient-centered health care that experts say is critical and that patients clearly crave."

I call this book a tribute, not a biography, because it glows with admiration. Belluck, a New York Times writer, seems to have spoken to everyone Lepore has ever treated, and traipsed around the island with him, too.

It reads like an extended magazine profile, layered with anecdotes (typically told with quotes from those involved) but sometimes interrupted with what we in journalism deride as "talking-head quotes" -- comments from people who are introduced by name and title and never appear again. Its dramas are brief, stacked one atop the next. No narrative tension winds through the book to keep you going.

All that said, "Island Practice" is a thorough dissection of a man doing his best to stand up to impersonal 21st-century medical practices. He knows what he loves, and loves what he does, and has committed his life to 38 square miles of this planet.

What's more, the book sketches a complex portrait of Nantucket itself -- the stuff you won't see in Frommer's -- that makes you glad that at least one guy is ready for anything.

Susan Ager is a former columnist at the Detroit Free Press. She is at