It was an honor and a privilege to be President of the American Laryngological Association (ALA) in 1989, so I have a clear understanding of how much my good friend and colleague, H. Bryan Neel III, our current President, has enjoyed his presidential year.

Bryan succeeded me as Secretary of the ALA and did an outstanding job in that role. It was great fun to work with him during my years as President-Elect and President while he was Secretary. Bryan and Ingrid and Barbara and I have been good friends for many years, and so this is a particular pleasure for us to be together again and for me to be Bryan's Guest of Honor.

Although I enjoyed being President of the ALA, I just loved being Secretary. The Secretary is the stability factor for the ALA, because the President changes every year. I had been a member of the ALA for only 2 years when I was asked by Dr WilIiam Trible, the Secretary at that time, if I would be willing to succeed him in this position. Why Bill Trible selected me, I don't know exactly, because Bill was a very private person. The areas that we had most of our discussions about concerned wine and food, not laryngology, and maybe that was why Bill selected me.

When I became Secretary in 1982, I knew very few of the Fellows in the ALA. The major reason for that was that most of them were much older than I. As a matter of fact, when I came to my first Council meeting, Gabriel Tucker welcomed me to the "old boy's club." When Bill Trible invited me to be Secretary, I was already busy with my daytime job as Chairman of the Department of Otolaryngology at the University of Pittsburgh and was not really looking for lots of extra work. Bill assured me, however, that the organization was not very active and that there was very little work for the Secretary of the ALA except at the time of the Annual Meeting. Bill Trible had somewhat underestimated that, and the first several years were a lot of add-on work.

The ALA as I found it, with its rich tradition of 103 years, was remarkable indeed, but it seemed to me that there were a lot of cobwebs around and that the annual Scientific Programs were not particularly interesting or exciting.

I felt that something should be done about that and thereupon convinced Stuart Strong, who was the first President that I had the pleasure of working with, that we had to make a few changes in the demographics of the organization. Stuart had never been on the Council and had no more idea how the Council or the organization was run than I did. We managed to muddle our way through the year and had a very good time.

One of the first things I did was to make a chart of the ages of all of the "active members" of the ALA at that time, which really did look like the "old boy's club." As I examined the bylaws of the ALA, I found that there was a category called Emeritus member. A member could apply for Emeritus status at the age of 60, regardless of duration of fellowship. What I began to do then was to phone the members who were "eligible" to be Emeritus and encouraged them to take Emeritus status since the only thing that the Emeritus members couldn't do was pay dues. This was very appealing to most of the members, and we quickly developed a rather large cadre of Emeritus members. Since we had a limit of 100 active members, this achieved our goals of opening up room for younger members. We began then to shift the age histogram to the left, which went a long way towards helping to revitalize the ALA.

As Secretary, I served a succession of outstanding Presidents: Stuart Strong, John S. Lewis, Gabriel F. Tucker, Jr, Douglas P. Bryce, Loring W. Pratt, and Blair Fearon. These were all wonderful people to work with, and their wives graced the social events in very high style.

The work of an ad hoc committee chaired by Dr Loring Pratt added many new aspects to the ALA and helped immeasurably in making the organization feel good about itself. The committee consisted of Drs Pratt, Lewis, Bryce, Miller, and Myers. The following recommendations were enacted.

• Participation of foreign speakers at the Annual Meeting was encouraged.
• Persons outside of otolaryngology or even medicine were encouraged to participate in the annual program.
• An American Laryngological Association Award for outstanding achievement was instituted. Recipients of the ALA Award have included Frank H. Netter, Shigeto Ikeda, Hans L. Littmann, Arnold Aronson, Michael Ter-Pogossian, C. Everett Koop, and John C. Polanyi.
• A strong suggestion was made to new members to present papers at the Annual Meeting.
• We increased the Honorary members category to 20.
• The Laryngeal Research Award, to be given to the best research paper submitted by a resident, was created.
• More emphasis was given to the Casselberry Award so that more people would become interested in competing for it.
• I designed the green and white ties and boutonnieres that were so well accepted by our members.

One of the changes in the ALA of which I am most proud is that during my Presidency, our Council studied the issue of whether we should expand our membership. For many years, the membership had remained at 100 Active Members, and I felt that this number was too small to accommodate potential new members active in laryngology. I felt that it was important to expand the membership slightly for the following reasons.

Until the 1960s, many of the active members of the ALA were disciples of Jackson and did practice laryngology. During the decades of the 1960s, 1970s, and 1980s, many of those elected to the ALA were head and neck surgeons. With the rebirth of interest in cancer of the larynx due to the teachings by such outstanding members of our association as Drs Joseph Ogura, Max Som, and John Kirchner, there was great interest in cancer of the larynx. These individuals, myself included, are generally thought of, however, as head and neck surgeons, not laryngologists.

We witnessed the rebirth of laryngology in this last decade. Technology had finally caught up with our field, and the introduction of videostroboscopy, thyroplasty (introduced by Professor Isshiki of Japan), Dr Herbert Dedo's pioneering study of the treatment of spasmodic dysphonia (and the eventual introduction of botulinum toxin injections for this condition), and laser surgery, as well as the study of the mechanics of the human voice, have drawn new bright young people into the field. Individuals such as Bob Ossoff, Steve Schaefer, Jamie Koufman, Gerry Berke, Gayle Woodson, and now this year, Steve Zeitels and Bob Sataloff have become Fellows. I felt strongly that there had to be room to accommodate these individuals and others so that we could continuously revitalize our Association.

Over the years, the important discoveries in laryngology were always presented at the ALA Annual Meeting. When someone had something important to say about the larynx, they wanted to say it at the ALA. It seemed to me that unless the ALA expanded somewhat in order to embrace the bright, young new wave of laryngologists, these individuals would go off separately and form their own specialty society, much like what happened to the American Otological Society and the American Neurotology Society. The membership limit has been expanded to include 125 members, thereby offering an opportunity for bright new members while remaining small enough to maintain our elite status.

I feel very proud to have been involved in the inception of some of these exciting changes in the ALA. I am pleased to say that all of the members of our Association seem to have a great deal of pride and enthusiasm for the Association and are proud to be members. At most of the meetings in this country or abroad that I attend, I find our members there wearing their ties and boutonnieres with great pride, which I think symbolizes the wonderful feelings we have towards the ALA.

Mr President, I can hardly describe the pleasure that being your Guest of Honor has given me, and I would certainly have to say that being Secretary of the ALA was one of the most memorable periods of my life and certainly one of the highlights of my professional career, and that having an opportunity to express these observations and emotions in public for the first time has been a very special event.