IT IS difficult for me to express, and for you to appreciate, exactly how I feel as I address you this evening. I am honored to have been chosen to deliver this William Allen Pusey Memorial Lecture before this distinguished group of dermatologists. And, I am elated to have this opportunity. Yet, all of this is tinged with a sense of humility. In 1940, this society conducted a clinical session as a feature of the annual meeting of the American Academy of Dermatology. I sat in the back of the room, awestruck as the immortals of Midwestern Dermatology—Ormsby, O'Leary, Nomland, Mitchell, Caro, and others—ascended to the podium and confidently presented their clinical brilliance couched in beautiful erudite prose. As I watched, I could not help wondering if I would ever have enough knowledge to address this society, and if I did, would I have the temerity to rise and