Who knew what a weird world Nantucket could be?

In her new non-fiction book, "Island Practice," New York Times writer and Weston resident Pam Belluck traces the life of one of the island's most eccentric characters, Dr. Tim Lepore, Nantucket's only surgeon.

Lepore is a true "character," to employ the phrase Sen. John Kerry, a one-time patient, uses in the book, running from his home to the hospital to perform surgeries at all hours of the night, waging an anti-tick campaign on the island and carving his own obsidian scalpels by prehistoric methods, which he thinks are better than modern metal ones.

Belluck will discuss the book and read from it at the New Canaan Library on Sunday, Oct. 21, at 4 p.m. in the Lamb Room.

The book contains story after colorful story of the life and practice of Lepore, and is in development as a television show for CBS.

One of those stories is at the beginning of the chapter "Cut, Sew, and Tie," in which the reader learns Lepore's nonchalant description of how to perform surgery: A man comes to the hospital having been stabbed in the chest by his wife with a butcher's knife. Blood was filling up the man's left ventricle. Lepore had only seconds to decide what the course of action should be, cutting into the man's chest and spreading his ribs.

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"He found the hole in the ventricle and controlled the bleeding by sticking his finger in it," Belluck wrote. "He asked nurses for special sutures for stitching up blood vessels, but the hospital had none. `Give me some black silk,' he demanded instead, his knowledge of obscure medical facts kicking in. He knew that in the 1890s, black silk thread was used to fix a stab wound to the heart."

Though given only a 1 percent chance of survival, the man survived, even going on in his life to run marathons.

If the story demonstrates Lepore's cunning, its setup shows Belluck's mastery. The chapter begins: "Maybe it happened because Doug Kenward came home late and forgot the potatoes. Maybe it had more to do with how much his wife had to drink. Whatever the reason, the result on that Sunday afternoon was bloody. Kenward's wife stabbed him in the heart with a butcher knife -- in front of their 16-year-old son."

How does Belluck know that it was a Sunday afternoon? How does she know that Kenward had forgotten potatoes? Presumably, because she asked. And she probably didn't ask only one person. Such attention to detail belies her successful career as a journalist with The New York Times as a regional bureau chief, and now as a science writer.

Belluck said the idea for the book came from a profile assignment she was asked to do for the Times.

"I was the Times' New England Bureau chief, and all the chiefs were asked to find somebody in the region that wasn't famous but was doing something interesting. I'd heard about a guy who was running a nude bowling league in Maine. One guy was running a campaign to have Vermont secede and form a new country. ... I'd saved this Tufts alumni newsletter, I can't tell you why. There was one line: `Dr. Lepore is the only surgeon on the island of Nantucket,' (which was interesting to me). He was engaging over the phone. We did a profile, and immediately we got calls from book companies," Belluck said.

Lepore comes off in some respects as a hero to the island's year-round population, but also as something of an iconoclast: Holding deeply conservative political ideals on a liberal island; supporting a campaign to kill the island's deer in order to reduce the tick population, which he believes is a health hazard; and on and on. Belluck said that even though he can be particular, he was a great subject to work with because of how hands off he was. She noted that he is not the kind of person to let publicity bother him.

"He's dealt with it really well," she said. "He's getting a kick out of the whole thing. But he's not letting it go to his head. He's going to continue to be as dedicated as possible to his patients. I'll call him up and he'll immediately start telling me about patients he's had. He came to the book opening in Boston. He had a good time, but ended up missing a stabbing that night, and that was the thing he cared the most about."

For her part, Belluck feels good about the project's success.

"It's very, very rewarding," she said in an interview. "I had no idea that any of that would happen, but I do have to say that in working on it, there were things that struck me at times as things that felt cinematic, or too interesting, they felt like `Northern Exposure,' or `House,' in a way."

It is altogether improbable that anyone could fit the whole of any community's culture, any society's health care policy dilemma, or of any man's individual life into a 264-page book. But that doesn't mean that it's not worth it to take some time, open up a book, and appreciate the small beauty of an accomplished doctor who attempts to knit sweaters out of the hair the family dogs have shed.

twoods@bcnnew.com; 203-972-4413; @Woods_NCNews