10 Questions -November/December 2010
...with Dr. Margot Hartmann
Dr. Margot Hartmann spent the last 11 years on Nantucket as head of the E.R. When the CEO position at Nantucket Cottage Hospital opened up this summer, Dr. Hartmann was tapped to fill the role, to the delight of the island community.
Q. How did you get to Nantucket. What is your story?
A. I first saw Nantucket Columbus Day Weekend 1993, when my friend Rita suggested a trip to the island. Frankly I had never even heard of Nantucket, but love an adventure. We stayed at the Beachside just outside of town, rented a Jeep and walked and rode all over the island. I just quietly fell in love with the place. From that time on, each time I was leaving, I'd be figuring out how and when to get back. I loved being here in the dead of winter – usually 10 days around Presidents Day in February – staying at the Whaler efficiency apartments, getting out of the cold at the Tap Room or the Brotherhood. Bundling up and walking Madaket Beach. The end of May was also a favorite time to come. I'd never known Nantucket in July and August until I took a job at the hospital in 1999, after a series of conversations with Tim Lepore.
Q. When did you know you wanted to become a doctor? Did anyone inspire you?
A. Looking back, I think I always wanted to be a doctor, but didn't realize it until my early thirties. As a child, I read all the Cherry Ames books; I was a candy-striper, then did alot of science courses in college and went into sleep research – eventually the basis of my Ph.D. But something was missing until I literally woke up one night and knew I had to be a doctor. I had no idea how I would do that in England, where I lived at the time, and it wasn't easy – but the path became very simple. I just knew that was what I was supposed to be. My grandfather, my mother's father, inspired me – although he had died long before. He was a surgeon and researcher and there was always a special awe about him for me. He gave me my first science book – I must have been 7 or so, and I still remember that moment. I had no idea where it would lead in my life, but I knew even then that something important was happening. I feel very connected to him in my work with patients … what would Gramps do?
Q. What's it like practicing medicine on Nantucket? What's different than being on the mainland?
A. First, it is a wonder to be able to do what you love in a place that you love. After that, you learn that you can make most things happen for most clinical situations, just in a different and customized way. For starters, you learn to keep a weather eye out – sort of a sixth vital sign – which influences your judgment about when and how to intervene for a patient. There is a great team pulling together that happens among all the clinicians out here from EMTs through the continuum of care – we're all out here doing wilderness medicine, pulling together to make something excellent happen at important moments in people's lives. Of course, there are the wild transport stories and you learn how important it is to make the clinical relationships off-island to get care for your patients. You have to have enough experience to be able to practice safely without a cadre of specialists available. You get very clear about what we should be doing in our little hospital, and which patients are better treated off-island, either for staffing or specialist reasons.
Q. When the job opened up, why did you decide to throw your hat in the ring for the CEO position?
A. It became increasingly clear over the past year especially that the hospital was in a precarious situation, and we physicians were in a unique and perhaps critical position to contribute to its turn-around. I increasingly felt it was vital that one of us who are practicing stakeholders in Cottage Hospital and the island community become actively involved at the administrative level.
I thought I could bring an understanding of what it takes to deliver good care out here to the tough conversations that face us.
Q. What does the Nantucket Cottage Hospital do exceptionally well?
A. I think we do an excellent job, in most cases, of coordinating local, high-quality, personalized care despite our remoteness. We bridge the island patient with tertiary care in ways most people don't even realize and often seamlessly, thanks to MedFlight and relationships established over the years with centers of excellence in Boston, including Mass General.
Q. What three pieces of advice would you give about improving one's health?
A. Give up smoking; find exercise you enjoy and work that you love; and be compassionate to yourself and others (can I have four?)
Q. How do you like to relax and unwind?
A. I love practicing yoga and meditation, walking the beach, reading and travel.
Q. What do you love most about living on Nantucket?
A. The incredibly seductive combination of sophistication and remote, wild beauty. Also there's something essential about the island that is always there underneath, whatever manmade things may (temporarily!) be added … then there's the community that shares this awareness – year-rounders and seasonal islanders alike – it connects us all somehow.