Eric Appelt and his extraordinary commitment to medicine

Dr. Eric Appelt was born to be a superstar.  During his career, he has redefined what it means to be committed to medicine, and he embodies the practice of perseverance on a daily basis.  I am proud to say that he is one of my role models as I continue my medical education.

As a young man growing up in Brenham, TX, Appelt was the kind of son every parent wanted.  In very modest terms, he told me, “During high school, I lettered in football, soccer, and tennis. I tried staying well-rounded, but my classes were always my top priority.”

Appelt loved competition, and he relished the opportunity to excel.  He graduated from Brenham High School as valedictorian and decided to attend Texas A&M University, focused but still unsure of where his early successes would lead him. “I didn’t know if I wanted to go into medicine or engineering,” he said. “Those were the subjects I enjoyed the most.  But after taking one advanced math course at A&M, I said ‘Forget this!’  Where do I sign up for medical school?”

After graduating near the top of his class at Texas A&M, Appelt pursued a medical degree from the University of Texas Medical Branch at Galveston (UTMB).   To no one’s surprise, he flourished in the school’s system, propelling himself to the top of his class.  Like many medical students, he found his calling during his third year. “I fell in love with surgery,” he told me.  “The idea of immediately fixing someone in the Operating Room without a ton of medication was very appealing. I also loved seeing patients in clinic, so surgery seemed like the perfect fit.”

After graduating from UTMB as valedictorian, Appelt was accepted into a rigorous residency program in Plastic Surgery at UT Southwestern Medical Center in Dallas.  Although life quickly became stressful, Appelt was on track to fulfill both his professional and personal goals.

“We got hammered on a daily basis.  Like most residents, I was under a lot of stress and I was pretty sleep deprived.  But in the end, I loved what I was doing, and every procedure was a welcome challenge,” Appelt said.

But things would soon become much more challenging for Dr. Appelt.  In his second year of residency, he began to experience his first symptoms. “I was wearing my loops (specialized surgical glasses) during a surgery, and I noticed that the vision in my left eye was really blurry,” he recalls. “It became so bad that I felt like I wasn’t even seeing in 3-D anymore.  It was really warm in the Operating Room that day, so I just chalked it up to the heat.”  He completed the surgery without any issues and resumed his duties undeterred.

A few days later, Appelt met some friends in a local park for a softball game near his apartment.  He vividly recalled the event. “It was a pretty hot day when we played.  The pitcher threw a fast one, and I hit the ball to the fence, but I barely made it to second base.  My legs felt so wobbly and uncoordinated.  They just weren’t moving the way I wanted, and I had this weird foot drop.  Something was definitely wrong.”  While the symptoms in his legs quickly ceased, the blurry vision did not.  It seemed to unpredictably come and go, so Appelt set up an appointment with an ophthalmologist to have his eyes checked.  At that appointment, Appelt received some very jarring news.

“The ophthalmologist told me that my optic nerves looked fine,” he said. “But then he began explaining to me that the symptoms I was describing could be explained by the Uhthoff Phenomenon, which is something that is seen in people with Multiple Sclerosis (MS).  That really set off an alarm in my head.  My aunt has MS, and I thought to myself, ‘Oh my God, I’ve got it too.”

Dr. Appelt could feel his surgical career teetering at the cliff’s edge.  He was unsure of what to do next.  Should he tell his wife and family?  What about his residency program director? His fellow residents?  “I had a choice,” he explained to me. “It was probably the biggest decision of my life, but it did not take me very long.  I decided to tell only my wife and my parents.  I was going to keep this secret from everyone else, and I was going to continue residency like nothing was wrong.”

However, Appelt would require treatment to prevent progression of the disease.  He established care with a neurologist, and together, they timed his weekly Interferon therapies so that he would feel minimal effects during surgeries.  “I would get these horrible fevers about once a week because of the medicine,” he said.  “But my skills were fine in the Operating Room.  No one suspected anything.” And this was how Dr. Appelt proceeded for almost 3 ½ years.  He valiantly coped with his condition without anyone noticing, but halfway through his fifth and final year of residency, his luck appeared to run out.

He suffered a severe exacerbation of the neurodegenerative disease.  The low point of the episode was when he collapsed in a parking lot after a routine surgery and was forced to crawl to his car, using other vehicles for support.  “At that point, I was already having some problems with bladder spasticity, which became a problem when I was in the Operating Room.  I could deal with that, but the parking lot experience was the worst of it.  I never thought it would get so bad.”  Fearing that he might be forever wheelchair-bound, Appelt found himself at another crossroads.  He explained, “There was no way I could continue to operate when the next exacerbation could be right around the corner.  It was not a smart risk to take.  It wasn’t fair to me, it wasn’t fair to my wife, and it certainly wasn’t fair to my patients.  I had made it so incredibly far, but I knew the writing was on the wall.  I had no choice but to change careers.”

Appelt was forced to reckon with his debilitating diagnosis.  First, he met personally with his residency program director, a stern man who was uncharacteristically speechless during their meeting.  Next, he drafted a one-page letter describing his condition and sent it to everyone he knew, including his residency colleagues. He admitted that he had been hiding this stressful secret so that he would not be treated differently.  In this message, he expressed his desire to complete the final six months of his residency.  He followed through with that promise.  Six months later, Appelt walked proudly alongside his fellow residency classmates, donning his graduation cap and gown with the same confidence that had come to define him.  “I am not a quitter, and I will finish everything I set out to do,” he declared to me. “I had followed that philosophy my entire life, and this instance would be no different.”

Three days after graduation, Dr. Eric Appelt, a fully trained Plastic Surgeon, started a residency in Radiology at the University of Texas Health Science Center in San Antonio.   Dr. Appelt found in Radiology the ideal career for someone with his circumstances, and he is grateful that the San Antonio-based program took a chance on him. Astoundingly, his commitment to medicine never faltered before starting his new career. “It never crossed my mind for even a second to leave medicine and pursue a life in the business world,” he said.  “Medicine was my calling, and Radiology gave me yet another opportunity to pursue that calling.”

Dr. Appelt has since finished his Radiology residency, and he is currently practicing in the Bryan/College Station area.  He and his wife Connie, who stood by him throughout his ordeal, have two children named Cole and Ashlyn.  He loves his newest job, and he is so grateful that it allows him to have a great family life.  “Don’t get me wrong,” he said. “I miss so much about surgery, particularly the patient interaction.  But I had to move on.  I know there’s a chance that I may not be able to walk when I wake up tomorrow, so it’s the positive aspect that sustains me.”

He believes that his experiences with MS have profoundly changed him.  “I’m still as driven as ever, but I know how to stop and smell the roses now,” he told me. ”I appreciate the smaller things in life, because my future is so uncertain.  It’s not the path I initially chose, but I believe I found a better career ultimately.”

Dr. Eric Appelt was born to be a superstar, and he has become just that.  At 37 years old, he believes the most valuable lesson he has learned is one that his father ingrained in him as a young boy.  “Hard work is the key ingredient,” he explained to me. “You don’t always get dealt the poker royal flush, so don’t complain if you get a faulty hand.  Make the best of what you’ve been given, and take it as far as you can go.  You’ll be amazed at what you end up with.”

Sunjay Devarajan is a medical student.

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