JOHN A. TUCKER, MD

I welcome the membership to the 119th Annual Meeting of the American Laryngological Association. Seventy-three years ago, in 1925, my father, Dr Gabriel Tucker, Sr, became a member of this Association. My brother, Gabriel Jr, was elected in 1970 and was President in 1984. I became a member in 1973.

I would like to thank the membership and the Council for the privilege and honor of being your President this past year. It has been, and will continue to be, a source of fulfillment in my professional and family life. I thank the participants and all the authors who have literally created this program. My Presidential address will reflect on the history of bronchoesophagology and laryngology and the Tucker family.

Gabriel Tucker, Sr, was a native of the hills of West Virginia of Scottish and Irish ancestry. He was born in 1880, one year after the ALA was founded. He was the son of a farmer. His preliminary education was in a Fairmont, West Virginia, normal school. He received his Doctor of Medicine from Jefferson Medical College in Philadelphia in 1905. The next 3 years were spent in surgical training at Mercy Hospital in Pittsburgh. In 1909 he married Irene Jarvis of Philadelphia. He then answered an advertisement in the Pittsburgh paper and practiced industrial medicine and surgery in Cannonsburg, Pa, for a coal mining company. In 1917 he returned to Pittsburgh to practice otolaryngology with B. M. Dickinson. He joined the US Army Medical Corps in 1918 and was assigned to Base Hospital #126.

Here, his wife, Irene, died in the influenza epidemic. In 1918 Beatrice Jarvis, Irene's younger sister, graduated from Wellesley College. Following the Armistice, in 1919, Gabriel Sr returned to Philadelphia and became associated with Dr Fielding Lewis and then Chevalier Jackson at Jefferson Medical College and Hospital. He also became affiliated with the hospital of the University of Pennsylvania and later with the University of Pennsylvania Graduate School in 1921, a relationship he would continue for the next 35 years.

In 1923, Gabriel Sr married Beatrice Jarvis, the younger sister of Irene. In 1924, Gabriel Tucker, Jr, was born. That year Gabriel Sr also published his Triological thesis on esophageal retrograde bougienage, entitled "Cicatricial Stenosis of the Esophagus with Particular Reference to the Treatment of Continuous String Retrograde Bougienage with the Author's Bougie." The clinical picture of lye ingestion was classically illustrated by a chalk talk on gastrostomy in the early 1920s from the bronchoscopic clinic of Dr ChevalierJackson: "Dr Clerf has brought in a plump happy child, aged four years. When she came to the bronchoscopic clinic three months ago, she was emaciated to a skeleton and was dying of hunger and thirst. Many times in the two years since she had swallowed lye, her esophagus had stopped up completely so that even liquids would not go down. It had, on previous occasions, always opened again, so that liquid could be swallowed. But at last there came a time when it did not open. In daily expectation of the usual reopening, surgical relief had been postponed by the parents and various physicians until she seemed to be dying. She was hurriedly brought to the Bronchoscopic clinic on a pillow looking like skin and bones; the skin was parched, dry and rough to the palpatory finger; the pulse was weak and rapid; the eyes were glazed; the only sign of consciousness was that the child cried occasionally, but no tears came. When the lips moved, my ear at her mouth caught the whispered moaning sound of 'Water, water, water.' Not many such patients have been saved. A Murphy drip and hypodermocleisis were started at once.

"A gastrostomy was done by Dr Thomas A. Shallow in 14 minutes; the child made a good recovery. To the gastrostomy she owes her life and health, not only because of the rescue in the emergency but because of the relatively rapid cure it enabled Dr Gabriel Tucker to obtain by retrograde methods."

In 1925 Dr Tucker accompanied Dr Jackson to the first international course of broncho-esophagology in Paris. Dr Jackson's associates at that time in the early 1920s were Dr Tucker, Dr Clerf, Dr Lukens, and Dr Moore. The first team of the 1920s included Dr Chevalier Lawrence Jackson (Dr Jackson's only child), Dr Tucker, and Dr Clerf. In 1926, a second son, Chevalier Jackson Tucker, was born to Gabriel and Beatrice Tucker.

In 1930, Dr Jackson retired from Jefferson and the University of Pennsylvania. Dr Lewis Clerf succeeded Dr Jackson at Jefferson, and Dr Gabriel Tucker became the chairman of bronchoesophagology and laryngeal surgery at the University of Pennsylvania and the chairman of the graduate school of the University. Dr Chevalier Jackson and Dr C. L. Jackson were now at Temple University. Dr Clerf at Jefferson and Dr Gabriel Tucker at Penn both conducted personal annual courses in broncho-esophagoscopy and laryngology and rapidly spread knowledge of perioral endoscopy, the "new specialty," throughout the world. In 1930, the third son, John, was born. In 1932 a family portrait illustrates a proud father, a mother, and 3 boys. There are 3 future presidents of the ABEA 1940, 1973, and 1983 - 3 ALA members, and 2 Presidents. In 1932, the chairman's address by Dr Gabriel Tucker at the AMA Section Council was entitled "The Infant Larynx -Direct Laryngoscopic Observations." Dr Oscar Batson of the Graduate School of Medicine and Dr Gabriel Tucker measured 30 larynges of cadavers of premature infants up to 2 years of age, establishing endolaryngeal subglottic and other pediatric laryngeal dimensions with the aid of a special calibrating forceps.

Gabriel Tucker, Sr, was a dynamic individual and a tireless teacher, clinical investigator, and photographer. He was a telephone addict with terrible, impulsive handwriting. The office was always glad when he called, because they could not read his writing. He pioneered the development of many new instruments for foreign body removal and for examination and treatment of the larynx, lung, and esophagus. His reputation was national and international.

In 1936, he showed the first color motion pictures of the larynx at the British Medical Association Section of Laryngology at Oxford.

In 1949, an anonymous donor established a Gabriel Tucker Chair and Department of Broncho-esophagology and Laryngeal Surgery at the Graduate School of Medicine of the University of Pennsylvania. The Chair is now held by Dr Randall Weber, Chairman of Head and Neck Surgery at the University of Pennsylvania. Dr Tucker practiced until the age of 75. He died at the age of 78, in 1958. My mother, Beatrice Jarvis, died at the age of 87, in 1982. Chevalier Jackson Tucker avoided the medical calling. He was a commercial artist by profession, and by far was the most talented artistically and musically.

Gabriel Jr and I were 6 years apart. We both went to the same grade school, Sisters of Mercy, Waldron Academy, in Philadelphia, and graduated from the Haverford School. The 6 years' difference in 1945 put Gabriel as a line officer in the Navy on a PT boat in the South Pacific. This was where, I am sure, he got the sun exposure that gave him the melanoma on his back from which he died.

After the Navy, Gabriel finished college at Princeton. He met Mary O'Brien on a Princeton weekend; they were married in 1947 and went to Johns Hopkins together. He was in the class of 1951. They had I girl and 5 boys, in that order. He then returned to Philadelphia and spent a year at the Graduate Hospital of the University of Pennsylvania with our father and eventually returned to Hopkins with Dr John Bordley. There, with the assistance of Drs Edwin Broyles and Stacy Guild, he developed the whole organ section technique to study laryngeal cancer. His earliest publication was in 1961, "A Histologic Method for the Study of Spread of Cancer of the Larynx," and in 1962, he published "Whole Organ Section, a Histologic Demonstration of Laryngeal Connective Tissue Compartments." In 1972, he returned to Philadelphia to work with Dr Charles Norris at the Jackson Clinic, to complete the circle. During this period at Temple, he produced The Whole-Organ Section Atlas of the Normal Larynx with Dr Vincent Hyams of the Armed Forces Institute of Pathology. Gabriel eventually succeeded Dr Paul Holinger at Chicago Memorial Children's Hospital, where he worked until his untimely death in 1986 at the age of 62. Gabriel, of course, has been succeeded by Dr Lauren Holinger, our President-Elect.

In 1952,1 graduated from the undergraduate school of the University of Pennsylvania. I also attended Johns Hopkins School of Medicine, class of 1957. I was a first-year medical student with Dr Paul Ward at that time and, alphabetically, we shared the same anatomy cadaver. During that time, Gabriel was a house officer with Dr Bordley. For my residency, I returned to Philadelphia, to the University of Pennsylvania, to work with Dr Joseph P. Atkins, who was formerly my father's associate and successor at Penn. Dr Atkins was truly my mentor in broncho-esophagology. In 1968, while a young attending at Penn, I saw a patient with a bifid epiglottis and wondered why. I was referred to the Carnegie Institute of Washington, Department of Embryology, on the Hopkins campus in Baltimore. There Imet Dr Ronan O'Rahilly. A 30-year relationship began with our studying the development of the normal larynx in staged human embryos, a project of laryngeal ontogeny.

Gabriel Jr started with the adult larynx, and I with the embryo. We came together with the fetus and the infant larynx, which study is still ongoing. In 19841 was president of the American Broncho-Esophagological Association at the Breakers, and 5 of our 6 children attended. Today, back at the Breakers as President of the ALA, I have my eldest child and daughter, Laurie, with us. My wife, Mary Jane, and 5 of our 6 children attended this meeting. To my wife, Mary Jane, I am indebted for her love, support, and commitment to me and our children.

The Gabriel Tucker Medal of the ALA stands as a tribute and a tradition within the ALA. It is an acknowledgment of contributions made in the past and a challenge for future pediatric otolaryngologists. Again, I thank the Association for the great honor of being President, and for listening to the family story.

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