Quoting legendary college basketball coach John Wooden and expressing pride at his own accomplishments, Kevin Burchill, the embattled chief executive officer at the Martha's Vineyard Hospital, announced last weekend that he will resign.

"This will offer the hospital the best possible options to move forward - for everyone," Mr. Burchill said in a prepared statement read at the outset of a community forum on hospital affairs.

Mr. Burchill said he will leave when his contract runs out in October. His clash with Dr. Richard Koehler, a leading surgeon at the hospital, has been at the center of an uproar in the Vineyard community in recent weeks. Mr. Burchill has been CEO at the hospital since 1999.

Dr. Koehler and his wife, Dr. Kathleen Koehler, will also leave the Vineyard in July to practice medicine in Vermont. A star laparoscopic surgeon who came to the Vineyard seven years ago, Dr. Koehler announced his resignation two months ago, citing irreconcilable differences with Mr. Burchill. Kathleen Koehler is a gastroenteroligist with a private practice on the Island.

Held in the Tisbury School gym last Saturday and sponsored by hospital trustees, the forum drew a crowd of about 150 people. But a planned agenda for the forum - an update on hospital affairs and a question and answer session with the public - was colored by Mr. Burchill's announcement. Mr. Burchill read his statement at the outset of the session, his voice cracking with tears at the end as he thanked his wife and children for their support.

"My style was something that folks seem to want to focus on, but the substance of what I came here to do, and did, cannot be questioned," he said.

After reading his statement, Mr. Burchill left his seat alongside hospital trustees on the school stage, went down the steps and sat in the back of the gym for the remainder of the meeting.

Outgoing board chairman Fred B. Morgan Jr. tried to mask the awkward moment. "This is a sad day for the Martha's Vineyard Hospital. Kevin has done more for this hospital than any other CEO has ever accomplished," he said.

Mr. Morgan also stepped down as chairman of the board last week, formally handing the gavel to John Ferguson, a seasonal resident of the Vineyard who is the CEO of a medical center in Hackensack, N.J. Mr. Ferguson joined the board of trustees last year.

"Kevin is an absolute professional, and he will have a wonderful career ahead of him," Mr. Ferguson said.

The difficult announcement from Mr. Burchill was followed by an equally difficult report from a health care consultant about the Vineyard hospital.

Tim Prince, formerly a consultant at Stroudwater Inc. who is now employed at Mercy Hospital in Portland, Me., outlined a troubling picture of mistrust and poor relationships, both inside and outside the hospital. Mr. Prince had begun to work with the hospital on its strategic plan last year, but he said he had to stop.

"We identified the primary issue," he said. "It's relationships - between the medical staff and the hospital and between the hospital and the community."

Mr. Prince said a key problem is the fragmentation of the Island medical community. "The doctors themselves need to figure out how to work together. We refer to a medical staff, but they are not a single cohesive unit at this point. They can be - and they should be - but they are not right now," he said.

Mr. Prince wrote a report for the hospital last year, but trustees did not release the report to the public until last week. Among other things, the report recommends that the hospital focus on retaining more patient market share, especially in the area of surgery. The report recommends that the hospital develop a comprehensive women's and family health service, and that the hospital collaborate more with other health care groups on the Island.

Hospital trustees said they had begun to take steps to address some of the relationship problems; among other things they reported that trustees had held a meeting for a frank exchange with members of the medical staff one night earlier.

The meeting was described by both sides as difficult.

Tim Sweet, vice chairman of the board, read a written statement that was a formal response to some 15 questions posed to the board at a recent public forum held after Dr. Koehler announced his resignation.

"The board expresses its sincere appreciation to the Koehlers, and we're a better place for having them all these years," Mr. Sweet said.

Later in the meeting, Mr. Morgan was not quite as charitable. "When you have a person who is very unhappy with everything that goes on at the hospital - nothing is right - it is very difficult to work with this," he said.

Dr. Kathleen Koehler, who is a member of the board, responded.

To say that Richard thinks that nothing is right at the hospital - that is absolutely untrue," she said. "Both of us feel the hospital is an absolutely terrific place. We have quite an array of medical specialties, and that's unusual for a community hospital. We also have a wonderful patient base - you guys are the best, and we find so many things right with this hospital," she added.

Public comment zeroed in on some of the problems. Jerry Brighton, a West Tisbury resident who is a leadership specialist, said he had offered his services to the hospital some time ago but had received no response. Nevertheless, Mr. Brighton had some advice. "About 85 per cent of what leaders do can be defined as task or relationship. You had a guy who did a great part on the task part, but the relationship part flunked. I recommend that you find a balance in your next CEO," he said.

"Kevin was the right person at the right time for this hospital," Mr. Ferguson replied.

"What is the compelling vision of the hospital for the future? I don't know that I have heard it," Mr. Brighton said.

Dr. Greg Culley, a hospital trustee who has led the strategic planning committee, pointed to the hospital's mission statement.

Mr. Sweet reiterated his own goal for the hospital. "I want to be the best that any rural hospital can be. I want to be the envy of every other rural hospital in the country," he said.

But Mr. Sweet also acknowledged the reality. "I want so much to change the way we do business with each other, both inside and outside this institution," he said.

There was plenty of criticism for the press.

"Bad news sells papers," declared board member Charles Harff. He continued: "This board has been accused of ducking all the questions, but in my view the community does not need to know everything. . . . You should not air all the issues in public."

The remark stirred an angry response from Penn Kimball, a Vineyard Haven resident who attended the forum.

What kind of issue should the public not be informed about? Your point is that the public can't be trusted with certain information about the hospital," he said.

Dr. Culley launched into a long explanation about patient confidentiality, but Mr. Kimball said it was off the point.

"I take exception to the statement that there are laws that require you not to tell the public what the hell the board is doing," he said.

Christopher Smith, a West Tisbury resident who is a corporate turnaround specialist, questioned the relationship between the board and its own CEO."I'll tell you what the vibes I am getting are - I'm getting a we-they. The CEO is not even on the board. . . . One of the things the CEO needs to be able to do is to use his board. I don't hear that. I do not hear ‘We,'" Mr. Smith said.

Trustees countered that Mr. Burchill is, in fact, a member of the board, but there was no explanation for Mr. Burchill's seat in the back of the room.

Geraldyn DeBettencourt, an Oak Bluffs resident and former selectman, had her own blunt observation about the makeup of the board of trustees. Out of 14 board members, only two are women.

"What I see wrong with this board right now is you don't have enough women on it. Women are more effective on these boards because they don't have the ego," she said.

In the end, trustees said they will continue to hold monthly forums in an attempt to communicate more directly with the public about hospital affairs.

Concluded Mr. Morgan: "The hospital is not broken."