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In response to a unique societal need, a dedicated tonsil hospital was established in New York City in 1921. Its contributions were both medical and moral. The hospital's director, Robert Fowler, impressed by the variability of available surgical techniques, undertook a quest for the "better tonsil operation." His findings, published in an exhaustive text, highlighted several obscure anatomic relationships. Emphasis was on the primacy of anatomic mastery over the allure of new technology, with attention to the path leading from better surgery to better outcomes. Fowler's advocacy of both technical excellence and specialized patient care prefigured similar concerns held by otolaryngologists today., (2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.)