by Pam Belluck
In the hospital, Lepore worked on a deer hit by a car. The driver had put the animal, unconscious, in the back seat, but the deer revived on the way, and “raised a lot of hell,” Lepore recalls.
In his office, he sutured up an injured mutt cut on its head and back. On his zoological patient roster, “sea gulls are big items.” And he tried in vain to help a sheep that had just given birth and had a prolapsed uterus, in which the womb collapses into the vaginal canal. “I kept trying to push it back, but I couldn’t get it to stay. So I popped the sheep. There was nothing you could do.”
He had greater success with Sula, a golden shepherd with two broken bones in her leg. Her owner, Beth Peterson, a home health nurse, first took her to an island veterinarian, who “put a splint on it and said the dog would have a limp,” Peterson recalls. Then the splint came off. Peterson asked Lepore for help.
“I met him over there on a Saturday morning,” Peterson says. “He scooted the dog in the back door, did an X-ray on Sula’s leg. It was so sweet and so natural and so fine to put her there in the back room. He resplinted her leg like three or four times.”
Once, someone called Lepore’s house to say “they had an eagle who was hurt and they were bringing him by,” Cathy Lepore remembers.
“Don’t bring him by,” she told the caller. “I’ve got people here visiting. He’s not a veterinarian.” They brought him by. “Get—Get out of here,” Cathy sputtered. “The nerve!”
The island also has a large population of feral cats that, Lepore says, are a threat to songbirds, pheasants, quail, and other fowl. He thinks many of the cats should be trapped and euthanized, but knows that would not be popular. An animal rights advocate, with whom Lepore had butted heads over his conviction that more deer should be killed to reduce tick diseases, was also concerned about the cats. She wanted them spayed or neutered so they wouldn’t overpopulate the island and endanger their own survival.
Lepore offered to provide that service, figuring it would help solve the problem and earn him some goodwill from a deer hunting foe.
“I’ve read enough books about spaying and neutering,” he told Cathy. “I have an anesthesia machine around. I can do it.”
“Where would you do that?” Cathy asked, incredulous.
“In the back room.”
“I think you’ve gone too far now, Tim. What patient is going to want to be in the room after a cat’s been in there?”
“They wouldn’t know,” he assured her. So far he hasn’t catered to the feral cat trade. But if it ever becomes necessary, “I’m poised.”
The case of Grace the horse was an unfamiliar challenge. Lepore had had only minimal experience treating horses. He had treated one with Lyme disease, administering IV antibiotics, but the horse bled out and died. He had sutured up the nose of a horse that cantered into a wire.
But Grace was in distress, and it wasn’t clear exactly why. She had been “perfectly healthy” until that morning, says Duncan, a physiatrist, who bought her from Amish farmers in Ohio and would ride her downtown to pick up the mail and to the nursing home where she works weekly with elderly residents.
When Duncan came to see him about Grace, Lepore mined his brain for possibilities. Duncan said she had gone out to feed Grace and found her standing there shaking, her gums white. Then she mentioned a berry stain on her mane and said Grace might have been munching on a nearby chokecherry tree. Lepore happened to know that the seeds of chokecherry fruit can contain large amounts of hydrogen cyanide. So while Lepore was seeing patients in his office, Duncan brought over samples of the plant, and Lepore studied toxicology reports. He gave her a big batch of vitamin B12, used to treat cyanide poisoning.
It helped, but not enough. Duncan got assistance from a veterinarian and a veterinary technician, who gave the horse enemas and walked her around. But not long after Lepore drove to Duncan’s early that evening, the horse sank to the ground. Lepore went to the hospital and his office to cadge some supplies: more B12 and some Ringer’s lactate, a saline solution to restore lost fluid. Besides the vet and the vet tech, Lepore was joined by Wayne Wilbur, a nurse anesthetist from the hospital. With no large-animal veterinarian on Nantucket, they called some on Cape Cod for advice.
“It was a real in-field kind of warlike situation,” Duncan recalls. “Dr. Lepore was in his element.”
They inserted an intravenous tube in the horse’s neck—not easy with a 1,400-pound, thrashing animal. The horse kept dislodging the tube, and Lepore repeatedly helped sew it back in. They arranged three sticks like a teepee to hold the IV bag in place, so gravity would help propel the fluid, and they eventually pumped in thirty-six liters. “That’s what kept her alive for so long,” Duncan says. “I have this image of Dr. Lepore squeezing the IV bags so the fluid would run faster.”
Although “we thought it was cyanide,” Duncan says, there were other possibilities. Hoping to pinpoint the diagnosis, Lepore recalls, “I even got the hospital to run some blood work for me in the middle of the night. Sometimes they can get a twist in their bowel,” or “they can get a fecal impaction.”
The team in Duncan’s field commandeered a bilge pump, using it to flush out the stomach by pumping water through a tube Lepore inserted in the horse’s nose. To clean stool out of the horse’s rectum, “one guy was going in up to his elbow without a glove,” Lepore says. “That was not me. I chew my fingernails.”
Grace kept “struggling and struggling to get up, and falling,” Duncan remembers, and as she moved, she was getting too close to fence posts in the field. Finally, Lepore and Wilbur pried the posts up so Grace wouldn’t get hurt knocking into them. They gave the horse pain medication to ease her discomfort. As the night stretched on, they worked by the beam of one of Lepore’s $200 flashlights. “It’s a pain in the ass to see the goddamn horse trying to get up,” he recalls. “It’s a bitch to have it down like that because they really don’t tolerate being down that much. It’s just so frustrating because it was a nice horse.”
At one point, Duncan got the fire department to come, and using a front loader a construction company had left nearby, firefighters tried hoisting Grace to her feet. “But there wasn’t an ounce of strength in her to stand up,” Duncan says.
Still, when Lepore left around midnight, “I thought we were going to make it,” he says. Duncan says the B12 seemed to give her more energy, and “she was doing some hopping around, so we thought she might get better.”
Lepore got home to find that “Cathy was pissed off at me” for having stayed there so long. “She’d had dinner ready. She thought I should have been home. But what are you gonna do? If somebody has a sick horse, I’m going to try and help them. Even people I don’t like I try and help. And sometimes dealing with other species is interesting—you learn things.”
Around 6 AM the next day, Lepore dropped by to check on Grace, but “the horse was down, and there was nobody there. It was just awful.”
Duncan had called a veterinarian to put Grace to sleep at 4 AM, having run out of medication for her pain and realizing that nothing could save her. Later, Duncan and Wilbur performed two autopsies, concluding that it was not poisoning but a twisted gut that blocked Grace’s abdomen, ruptured a blood vessel, and caused her to bleed out.
The case was over, but Lepore’s interest in it was not. You never know when another horse would have a kinked bowel or would eat the poisonous parts of a chokecherry tree.
“I had somebody get me all the stuff on cyanide poisoning,” he said that day. “I’ll be ready to go tomorrow.”
Henry has thought a lot about why he is involved with marijuana and offers a mélange of religious and spiritual references, some more intelligible than others.
He says, for instance, that God, in Leviticus, said “he wants you to eat from the fullness of the earth,” and that “God hid man’s divinity right inside of him, the last place you’ll ever look. Every time you have a cookie you stay in that consciousness, you learn to stay in creation, you learn
to overstand the condition of man.”
Henry also has political arguments of a sort, saying that John Hancock “and those guys all got high” and that “Mahatma Gandhi said that only an unjust man obeys an unjust law.” To Henry, of course, that law is the one making marijuana illegal, which he thinks is absurd. “The same people who want to lock you up—when their relatives get sick, they’re the ones who want the cookies from you.”
He says marijuana makes as much medical sense as taking legitimate drugs. “You watch a drug ad on TV, and they list side effects, and you’re like, holy shit—people are buying this?”
And he cites compassion. “I’m so sorry that by the time these people get the cookies most of them are on their way out.” But, “if you’re dying, sweetie, or if you’re sick or just fucked up, and you do some weed, and it makes you feel better and have consciousness, there should be no law against it. If you’re going to die, you might as well have fun.”
In 2010, Henry felt sick and visited Lepore, who discovered that he had anemia and suspected he might have cancer. It turned out that Henry had multiple myeloma, cancer of white blood cells in the bone marrow. Lepore arranged for him to see a specialist in Boston, and he began receiving weekly blood transfusions. Henry was also prescribed steroids, which he continues to take, but the side effects have been unpleasant.
“These steroids turn me into a total asshole,” Henry claims. “I told a nurse to get a job at a gas station so she won’t be around sick people.” He has to take the steroids, sometimes ten a day, in a regimen of three weeks on, one week off.
So Henry turned to his own remedies to offset the steroids’ impact. He couldn’t smoke a joint or use a bong because his immune system is compromised, and “if I smoked, it could fuck up my blood and my system. That’s when I thought of cookies. There’s no downside or side effects that make you want to go to the bell tower with a gun or start a war. The cookies take away the hostility and aggression.”
Henry’s condition has been touch and go. About six months after getting diagnosed, he was so short of breath that “I couldn’t walk from this chair to the couch, and I would get up to go pee and have to brace myself on the window because I couldn’t just stand there unsupported.”
But then, perched before tea and cookies at his sun-dabbled kitchen table, Henry brightens. “I truly believe,” he murmurs, “I’ll beat this thing.”
CHAPTER 12
THE LOST
One winter night in 2007, Tim and Cathy Lepore drove to a house on Cow Pond Lane. It belonged to a family Lepore had treated for years, and he and Cathy, a counselor at the high school who was widely trusted by students, were concerned about one member in particular: Vaughn, fifteen, a freshman. Cathy knew that an older girl had recently broken up with him and that some of his friends were worried about how he might react.
“I figured the best way to do it is to go over there, just to check on him,” recalls Cathy, who chatted with Vaughn for a while that night. “He didn’t say he was depressed. He said, ‘I’m fine—don’t worry. I’m not going to do anything.’”
Cathy was somewhat reassured, but she advised his mother, Linda, to keep an eye on him. Linda had been trying to do just that.
Linda, a down-to-earth woman who wears her hair in a single long gray braid, grew up on Nantucket, left when she was twenty, and returned in 1990. She raised three daughters and Vaughn, the youngest, who never knew his father, a different man from the father of his sisters. When Vaughn was young, Linda married a man on Nantucket, a coworker in the high school’s food service program, but they went through a bitter divorce in 2005.
Vaughn, whose blond hair almost touched his shoulders, was popular and athletic. He played football, golfed, surfed, and snowboarded. But by the age of fourteen, he was smoking cigarettes, using marijuana and alcohol. Linda struggled with how to handle it.
“I never yelled at him, never swore at him, never raised my hand,” she says. “I just talked to him calmly. Vaughn would smoke and drink and misbehave, and as a mom I would take care of the situation, get him to bed, and if he was too heavy on the floor, I’d leave him there and talk about it in the morning.” The biggest punishment she levied was taking his cell phone away when he was drunk.
Vaughn was getting counseling on-island, but things did not improve, and in the fall of 2005 Linda told the counselor, “I need help. What are my options? What can I do?” The counselor recommended sending Vaughn to a therapeutic school in Utah. So Linda arranged it, without telling Vaughn, who found out when he was picked up one morning by a service that escorted him on the plane to Utah. “I thought if he stayed here, he would get arrested and have a rap sheet,” his mother worried.
In phone calls and letters home, Vaughn would say “how sorry he was,” urging his mother to “come pick me up.” Linda told him he wasn’t ready and kept him there nine months, until she ran out of money to pay for the program.
In July 2006, Vaughn returned to Nantucket and seemed okay for a while, getting slightly better grades than before and staying out of the hair of a school official he had tangled with. Although his previous counselor was unavailable, Linda found him other counselors. But eventually he drifted back toward a group of kids who were doing drugs, stealing cars, and breaking into houses, recalls Steve Tornovish, a police detective.
One January night, one of Vaughn’s sisters, who was working undercover for the Nantucket police, busted some drug dealers. Vaughn had nothing to do with the arrests, but Linda says he was taunted about it at school: “Oh, your sister’s a snitch.”
Then, soon after the Lepores’ visit, Vaughn took his mother’s car in the middle of the night and was pulled over by a trooper. At the police station, an officer told Vaughn he would now be denied a driver’s license until he turned eighteen.
“Why are you so rebellious?” Linda asked Vaughn at the police station. “Who has a hold on you more than me? Do you realize what you have done? It will be put in the paper. You will be back on probation. And my insurance just doubled moneywise because you took the car for a spin. Am I right, Mr. Officer?”
“Mom, I’m sorry,” Vaughn said.
Vaughn missed school for several days after that, but by Saturday, February 3, Linda thought he was improving. He was up early and ate breakfast with her. He asked her for a printer and some paper, discussed cleaning his room, and inquired about her plans for the day.
“I have to go into school to call parents,” replied Linda, whose job included balancing accounts and making sure parents paid for school lunches. “Why don’t we go out to lunch today, that place where you like the steak sandwich, and I’ll have a hamburger? You call me, or I’ll call you. When you’re hungry, call me.”
Linda was so busy at work that by the time she caught her breath it was 2 PM. She called home, and when Vaughn didn’t answer, she left a message: “I guess our lunch turned into dinner.”
Not long afterward, she arrived home, called out to Vaughn, and began walking upstairs toward his room. Hearing his cell phone ring on the main floor, she paused. No one answered it.
“Why would his phone be on the kitchen level?” she wondered, and headed back downstairs. She saw the phone. And then she saw the note. She began to cry.
“I went to his room, couldn’t find him. I went all around the house, couldn’t find him.” She finally tried the basement: “I found him there.”
Linda opened her mouth to scream, but nothing came out. Her fifteen-year-old son had stood on a chair and hanged himself with his own belt. She bolted upstairs, grabbed a knife, and cut him down. But it was too late.
She called 911, she called one of her daughters, and she called the Lepores, who raced over. Vaughn was still in the basement. Lepore had to pronounce him dead.
Linda never showed anyone the note Vaughn wrote, not even the police. It mentioned two other teenagers, and “I don’t believe in an eye for an eye,” she says. “I’m not one to accuse someone that what their child did was wrong. I called the t
wo mothers, and I told them I have to talk to you. Your child was mentioned, and that’s all I’m going to tell you. If your child says, ‘Oh, did he write about me?’ say, ‘Yeah, he’ll miss you.’”
The note did say that Vaughn was “really sorry for all the pain he caused me and he loved me very much, and his sisters too,” Linda says. “He was so depressed; he was so sad. They talk about the dark hole. They don’t see light at the end of the rainbow.”
What Vaughn’s mother couldn’t know, what the island didn’t know, was that Vaughn would not be the only one to look at a rainbow and see darkness. In the months that followed, several other young people on Nantucket, most of them teenagers, would die. Others would attempt suicide or talk about wanting to. “At one time we had about six kids in a week with suicidal ideation,” recalls Peter MacKay, the social services manager for the hospital.
Even the day after Vaughn’s death, a boy who knew Vaughn tried to kill himself. “I put a message out to the kids: bring that kid to me,” Linda says. “I took him to my bedroom. I said, ‘I know you miss him, but you can’t do this.’ He was so sad and so upset that he lost a very good friend, and he wanted to go see him right away. But I said, ‘I can’t worry about you and Vaughn.’”
Linda realized then that she could not hibernate in grief over her son’s death. It would have broken her, for one thing. And she felt a responsibility to try to keep others from following Vaughn’s path. She couldn’t sleep. The day after he took his life, a Sunday, she was up at 3 AM, writing a message for Vaughn’s friends and classmates. She called a friend and asked her to make sure it was read at a school assembly the next day. The gist was, “If you’re depressed or angry, you should talk to somebody, go to counseling. If you don’t like that counselor, find another one. This is not a movie that you can flick off.”