President's message.

As I prepare to pass the torch of leader-ship to Charles Schulman, who will become AMAA president after our 2004 Sports Medicine Symposium this April, I look back on my years as a member, and then as president of AMAA with fond memories.

At the first AMAA Boston meeting I attended in 1975, I did not run; I did not even know the distance of a marathon. Founder Ronald Lawrence had invited me to talk to the group about a pioneering program in cardiac rehabilitation that I was working on in Chicago. Minutes into my talk I was asked to stop because special guest, Sir Roger Bannister, had arrived; I never completed my lecture because we were so intent on listening to Sir Roger. In addition to meeting a legend at my first AMAA event, I met two new friends--Jack Scaff (Honolulu) and Terry Kavanagh (Toronto)--who inspired me to run a marathon. They told me I had the build of a runner and had the chance to break the record at either end of the Honolulu Marathon--the fastest or, perhaps, slowest finisher.

I took up the challenge and went to Honolulu in December 1975. At the AMAA pre-race cocktail party, I was overwhelmed by runners sitting next to me who described their training schedules consisting of 40 to 60 miles a week. I wanted to hide under the table as I was admittedly undertrained, having run only 25 miles each week. It was also overwhelming to share the room with such notables as Ernst Jokl, Terry Kavanagh, Tom Bassler, Jack Scaff, Otto Appenzeller, veteran marathoner Dr. Joan Ullyot and blind runner Harry Cordellos.

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It was hot and humid in Honolulu, even with a 5:30 a.m. start, but by running and walking, I completed my first marathon with a time of 4:10:33. When I returned to Chicago, my cardiac rehab patients welcomed me like a hero and I quickly discovered that I had become a positive role model for them. I no longer was the inactive doctor who prescribed exercise for my patients, I now participated myself.

Over the next 25 years, I completed 22 marathons (including nine Boston Marathons), 12 50-milers, two finishes (out of five starts) at the Western States 100-Mile Endurance Run and one 24-hour run. Several years ago, decidedly older, I declared myself a transformed "fitness jogger" and more recently, "fitness walker."

After my first 50-miler (Michigan) in 1978, I contacted Ronald Lawrence for support in organizing an ultra-marathon in Chicago. In 1979, the inaugural American Medical Joggers Association (AMJA)--later named the American Medical Athletic Association--50-mile run was held along Chicago's beautiful lakefront. The next year, at the AMJA prerace medical meeting, a first-time marathoner announced that he was going to set a world record in the 50-mile race--and he did just that! Barney Klecker, 29, from Minnesota, completed the certified course of 50 miles in just 4:51:25. This still stands as an American record. In 1984, at another AMJA ultra-marathon, Bruce Fordyce, 28, from South Africa reset the world record with a time of 4:50:50. During its 10-year existence, the world-class AMJA Ultra-Marathons (50-mile and 100K) saw numerous historic performances. Marcy Schwam, 29, was the first woman to finish 50 miles under 6 hours (5:59:26). Bernd Heinrich, a zoology professor at the University of Vermont and master runner, completed 50 miles in 5:10:12 and the 100K in 6:38:20. Heinrich's finishes both still stand as masters world records.

As I look back at my years with AMAA, I am amazed at how many lasting friendships I have made with extraordinary individuals. Among these include Ron Lawrence, whose passion for running and vision for the health of our patients sparked the formation of AMJA/AMAA; Tom Bassler, the first editor of the AMJA Newsletter who proposed the "Bassler Hypothesis"; cardiac rehab pioneers Jack Scaff (also founder of the Honolulu Marathon) and Terry Kavanagh, who showed that cardiac patients can safely run marathons; eminent epidemiologist Ralph Paffenbarger; sports medicine pioneer Ernst Jokl and his son, Peter; Otto Appenzeller, who conducted numerous studies on the neurologic effects of distance running; Sam Paris, who has run over 30 consecutive Boston Marathons to date; cardiologist John Cantwell, who served as medical director of the 1996 Summer Olympic Games in Atlanta; Dr. Ken Cooper, who presented to AMAA members at the 100th Boston Marathon; and Walter Bortz, who believes that we can live to be 100, with a good quality of life.

Our members have also been active in research studies. In the 1970s and early 1980s, Dr. William Castelli and his group collected data on volunteers for his cardiovascular health study. He reported that marathoners had HDL levels high enough to be protective from heart disease. Dr. Art Siegel, now researching the causes and prevention of hyponatremia, has been tracking cardiac markers of injury over many years. His findings have been published in numerous journals, including the American Journal of Cardiology.

We've also had some really fun times, especially at our Saturday night dinners held during the Boston Marathon weekend. Not only did we get the chance to "let our hair down," we were often joined by honored guests such as George Sheehan, Jim Fixx, Hal Higdon, Bill Rodgers, Joan Benoit Samuelson and many others.

The past is great history, but the future is the major challenge. We need new members and active Board members with innovative ideas, as well as new programs, to keep us alive as an organization. The American Medical Athletic Association is a treasure--tell your colleagues about it and help us grow our membership and collective voice. In our nation's fight against obesity, physical inactivity, diabetes, hypertension, smoking and hyperlipidemia, we can make a difference by helping our patients follow a lifestyle that leads to good health, active living and a long life.

As I bow out of this presidency, I would like to thank the current and past AMAA staff, especially Judi Babb, Susan Kalish, Barbara Baldwin and Dave Watt, and the members of the Board of Directors for their help and support in keeping the organization active, alive and running.

As for me, to paraphrase General Douglas MacArthur, "Old runners never die, they just walk away."

Noel D. Nequin, M.D.

Fellow, American College of Sports Medicine and Founding Fellow, American Association of Cardiovascular and Pulmonary Rehabilitation