Tribute to a long time McKenzie collaborator and supporter - Charles Aprill, MD - 20/5/2021
Charles Aprill, MD (30 Sept 1931 - 27 April 2021)
We were so sorry to have learned that the world-renowned radiologist, Dr. Charles Aprill, died on 27 April of this year. Many of you will only recognize his name from seeing it on the numerous high quality published studies in which he participated. Starting nearly 30 years ago, Dr. Aprill began to have an important impact on The McKenzie Institute.
Charlie, as he was known to his friends, first met Robin McKenzie at an international spine conference in the early 1990’s. Robin had a poster presentation on MDT and Charlie stopped by to examine it. He soon started asking detailed questions about MDT and remarked that we in MII appeared to be reaching the same sort of conclusions that he was in his radiology practice, though through purely clinical methods. It was not long before Charlie and The McKenzie Institute began formal collaboration the result of which was published in the journal Spine in 1997. In this study, McKenzie faculty were asked to identify lumbar patients’ pain generator and predict the presence of disc pathology as compared to Dr. Aprill’s discographic findings. The level of agreement was surprisingly high.
In addition to his research, Dr. Aprill’s greatest contribution to the McKenzie Institute was his public endorsement and validation of the McKenzie assessment; together with the welcome and positive exposure he gave the Institute in the larger spinal community. It cannot be overstated how important it was to have someone of Dr. Aprill’s stature speaking positively about MDT at numerous conferences. Many in this audience might not otherwise had been exposed to the MDT concepts and principles. Further, he attended many MDT courses and incorporated the MDT assessment into his clinical radiology practice. In this setting he reported finding many patients who displayed directional preference despite these patients having been referred to him for pre-surgical screening.
On behalf of all of us with The McKenzie Institute, we extend our deepest sympathy to the family of Charles Aprill and wish to share these memories five current Institute faculty worked with Dr. Aprill at his radiology clinic in New Orleans. We share their thoughts on what that experience was like and how it affected them as a collective tribute.
He was a larger-than-life figure, with deep curiosity about the nature of spinal pain. He reminded me of Robin McKenzie in this regard. The thing I will remember most about Dr. Aprill was his entertaining and frequently humorous presentations. With his wit and an always present smile, he had the ability to engage an audience and keep their attention during his very detailed presentations.
I first met Dr. Aprill in 1994 when I went to New Orleans to take part in the Donelson, Medcalf study. The cabbie I hired to take me to the clinic informed me that 18 inches of rain had fallen overnight and much of the city was flooded. It was so bad that I had to wade the last few blocks through filthy water. On entering the office, I saw x-ray, CT and MRI films floating in 12 inches of water.
When I met Dr. Aprill he said, “I don’t think we’ll be seeing any patients today, but I could use your help bailing”.
With my shoes and socks off and my pants rolled up to my knees I spent the next 7 hours bailing, mopping, and vacuuming. When I remarked about the damage to the office, Dr. Aprill seemed unconcerned. “That’s what insurance is for” he said.
For the next few years, each time I encountered Charlie, he greeted me warmly and liked to tell whoever was around, how I helped bail him out. He told the story with a real warmth and gratitude that I always appreciated.
I had many other memorable encounters with Charlie but that first was one to remember.
I remember clearly my first day with Dr. Aprill; I was very nervous. Robert had already seen 40 patients and had done a great job of predicting the findings of the discogram and I didn’t want to be the guy who screwed it all up! Then before the first patient came in, Dr. Aprill started telling me about this “stabbing pain” that he was having in his upper back and would I look at it. The last thing I wanted to do was examine his neck/back. After some coaxing, I gave in and asked him to show me where it hurt. When he turned around, he had a knife stuck underneath his armpit. He was pretty pleased with himself. He could tell I was nervous and he was either having fun with me or trying to loosen me up.
What struck me most about Dr. Aprill is how this giant in the field of back pain was really interested in what we were doing in MDT. Thank you Charlie for treating me so well and for what you did for MDT.
I have good reasons to be grateful to Dr. Aprill. While I was working at his clinic, his assistant, Bruce, eyed my shaven skull with a hungry look; “Hey we could inject an irritant into Colin’s atlanto-occipital joint and see if we can give him a headache”. Fear is an inadequate word to describe how I felt, but fortunately Charlie came to my rescue. “Do you have false teeth” he asked? On hearing that I did not, he said, “Won’t work, too difficult to get in there”.
The two days I spent with Dr. Aprill changed my life. Previously I was entirely focused on trying to get my patients better. Working with Dr. Aprill soon convinced me to put all my efforts into the assessment, because by doing a good assessment the clinical management becomes much clearer. I can never thank him enough.
I was fortunate enough to have the opportunity to work with and learn from Dr. Aprill in his clinic in New Orleans. Charlie was generous to a fault. Generous with his knowledge, generous with his time and generous with his excitement and enthusiasm around his discoveries.
It amazed me when one of the great pioneers in Interventional Pain Analysis actually invited us to spend time in his clinic; of course, it amazed me more when he would yell from the other room - "Mark, get in here, wait 'til you see this" - his excitement to share the discoveries as if it was his first time says it all to me.
Thank you, Charlie.