Doctor, author, bioethics board Judy Lottmann has a storied life

Judy Lottmann recently attended her 50-year class reunion for Augustana College, which is in Sioux Falls, South Dakota. She has quite a storied background, from having been raised on a farm in Northern Minnesota, to the present, where she serves on the bioethics committee, for Rural Wisconsin Hospital Cooperative. From being a rural surgeon in Sparta, to sitting in on the first meeting in New York - in order to give structure to rural clinics and hospitals. She has been on an interesting journey.

After receiving her undergraduate degree, at Augustana College, Lottmann attended Pritzker School of Medicine, at the University of Chicago. Next, she would go on to complete her 5-year surgery residency, up at Saint Paul Ramsey Hospital. After her residency, she went go on to Devils Lake, North Dakota, where she honed her craft and gained valuable knowledge, before taking a job in Sparta, Wisconsin.

Residency

Lottmann was the very last resident of the Saint Paul Ramsey Hospital residency program, as the program was absorbed by the University of Minnesota, right after she began her residency. At that time, back in the 1970s, the residency only took three residents a year, one of which was female. “It was not uncommon for the entire surgical crew on-call, to be female,” stated Lottmann. “That was the reason I chose that program, so I would not have to fight that prejudice of being a woman surgeon, which there were not that many of, at the time.”

Lottmann explained that it was only another resident and herself in that last class, and the other dropped out, leaving her as the very last official resident through Saint Paul Ramsey. “When I became Chief Resident, all the residents under me were University of Minnesota residents,” Lottmann stated.

After finishing her residency, Doctor Lottmann took a job in Devils Lake, North Dakota. During her time there, a total of 15 months, Lottmann was the second surgeon. Most often patients were referred to the first surgeon, as he had been there a while. Lottmann said that she took up women’s health, just to keep busy. “That was an interesting job. I actually had to punch a timeclock, as it was mandatory to be in the clinic a certain number of hours,” Lottman stated.

“It turned out to be a blessing [those 15 months], as that surgeon taught me how to do a number of procedures that my residency did not cover. When I had finished my 5-year residency, I ran across an article in Better Home and Gardens that listed the top 10 most common procedures done in the United States… I could do five. He taught me how to do a lot more, even though I did not get to do a lot of the surgeries.” Lottmann learned how to do Hysterectomies, C-sections, ear tubes and a whole bunch of things that she had not learned in her residency.

As a general surgeon, Lottmann was well versed in abdominal surgeries, such as gallbladders and appendixes. But for rural surgery, she still had to learn orthopedic procedures, obstetrics and gynecology (referred to by Doctors as OB/Gyne), EMT procedures, and more. “That type of training was not included in the general surgery residency,” said Lottmann. “If you want to practice in a small community, you must have that training. There are actual rural surgery training programs now. In fact, I attended the first meeting, in Cooperstown, New York. We all got together, to break ground on establishing that program.”

Lottmann went on to explain that the rural academics is now included in the general surgery program. “Now, you just rotate through the various other specialties, during your surgical training, so that you learn a little bit of everyone of them,” explained Lottmann. “The rural programs are being incorporated in areas that will need those types of surgeons, like Wisconsin and North Dakota. For a period of their time in the program, residents will go and spend some time with a rural surgeon.” The Gunderson Surgery Training Program is set up like this.

After her 15 months in North Dakota, Lottmann wanted to go somewhere where she could perform more surgeries than she currently was. She ended up in Sparta because of an an ad in a newspaper. “I saw that ad for a surgeon needed in Sparta, Wisconsin, and that was how I ended up here,” she said. Lottmann had grown up, near Mille Lacs Lake, in Northern Minnesota, so the winters were nothing out of the ordinary for her.

Sparta

Lottmann was the only surgeon in Sparta, from 1983 through 1990. There was a surgeon in Tomah, Mauston, Viroqua and Black River Falls. “Hillsboro did not have a surgeon, so we would all take turns going there,” Lottman stated.

When the Sparta Hospital was taken over by Mayo, Dr. Lottman lost 2/3 of her caseload. “So, at that point, I had to decide what I wanted to do. I had the credentials, so I could go anywhere,” she told the Herald. “But my husband Keith and I wanted to stay in the area, so I decided to just do what I could.” Lottmann provided some surgical services in Whitehall. For a period of time, Black River Falls had no coverage, so she provided services there as well, a couple days a week.

Looking Back

Judy Lottmann has been retired from her practice for 12 years now, and laughed, as she recalled her youth. “I had a sister, who was a year ahead of me in school,” Lottman recollected. “She went to Augustana College, ahead of me. I majored in pre-med classes, not even knowing that they were pre-med. I just really liked biology, chemistry and physics. I took the exams to get into grad school, in chemistry, then I took the MCAT. Well, I did way better on the MCAT, and was advised to go into medical school, so I did.”

Lottman said that the first two years were like regular college, mostly bookwork and exams. Then students start doing rotations on the various specialties, to see what they are most interested in. “As I was going through rotations, I just kept eliminating them,” quipped Lottmann. “I think my last rotation was on surgery, and it just felt like I had come home. That was where I belonged.”

Lottmann informed the Herald that the medical team she was working with (for the general surgery rotation) were involved in doing open-heart surgery, and that two of the residents had gotten hepatitis, leaving only two of them on that rotation. “Back then, they closed the sternum with wire, and they both nicked themselves with the wire, and got hepatitis. So now, there were only two of us on the rotation. That may have played a role in me liking general surgery so much, because I was able to get so much hands-on experience during that rotation.”

Currently

Lottmann now sits on the Ethics Committee at Tomah Health, and on the Ethics Round Table, for Rural Wisconsin Hospital Cooperative. They have roundtables of various entities from around the hospitals, to include physicians, nurses, social workers, infectious diseases, and more. Lottmann attends the ethics roundtable. The person in charge of the ethics round table, is the ethicist from Gunderson Health System, Dr. Thomas D. Harter.

Members of the Rural Wisconsin Hospital Cooperative come together quarterly, to share what issues they are dealing with. Each department has their own roundtable. They discuss what they can do and possible approaches that may be used for certain scenarios.

“It was really interesting through the pandemic,” Lottman said. “Seeing how these rural hospitals were dealing with situations, like shortages of beds, meds, supplies and things like that.” The committees would meet via Zoom. “The rural hospitals do not have an unlimited number of nurses, or any personnel,” she said. “It was incredible to witness how they traversed such a difficult time.”

Lottmann also mentioned that the meetings during the pandemic provided a bit of solace for all the struggling doctors and nurses. In some way, it felt comforting to know that they were all going through the same hardships, although not physically together. They understood that they must press on.

 The Tomah Health Ethics Committee meets quarterly. It consists of physicians, nurses, social workers and community members. It does not have the authority to tell anybody what to do, but the committee looks at the clinical situation and gives suggestions as to what could be done. Anyone can ask for input from the Ethics Committee; the patient, the family, the doctor, the nurse and others. It is appropriate to ask for help from the Ethics Committee in any situation that causes moral distress or an ethical dilemma. Emergency meetings can be called if necessary.

Since she stopped practicing surgery in 2011, Dr. Lottmann has gotten her Master’s Degree in Bioethics. She also published a book, in 2014, about her experience as a Rural Surgeon, called: “On Call, A Rural Surgeon’s Story.”  These days she keeps herself busy with grandkids and great grandkids. She is also very active in her church and continues to like to learn new things.