An Interview with Dr. Appell: Boyhood in New York City

Ken Appell discusses his early childhood in Queens, New York; this 8 1/2-minute segment was taped in August 2008. (Transcript follows; for pictures of his house and neighborhood, see the accompanying photo gallery.)

"I was born March 23rd, 1923 in New York City, Manhattan – one of the unusual [cases] when somebody was born in Manhattan, not immigrated there. We lived on 77th Street off York Avenue, and my family – including my father and my mother and my sister – subsequently moved to Queens, where my dad bought a house on 42nd Street in Long Island City, and we lived there for many years. My mother subsequently died while we lived there. I was about five years old, I guess, when she passed away. And the rest of my childhood was influenced by my grandmother, who lived next door, and I was brought up essentially under her direction.

My family was, my father was of German extraction – Bavarian – and my mother was Czechoslovak, from Bohemia. I went to grammar school P.S. 6 in Astoria, which is still there, the school is still there. And it was a school that you walked to – it was a walk of about, oh, about three city blocks. Which was fine in the spring and summer but in the wintertime it was plowing through a lot of snow (chuckles). I graduated from P.S. 6 after falling off a gate and breaking my arm, and subsequently went to Bryant High School, which at that time was located in Long Island City. And Bryant was an interesting school, in the sense that the students came from a wide area in Queens, and Brooklyn, even. The school subsequently moved to a new building in Queens. While they were building that school, some of the students from Long Island City High School were switched over to a school in Sunnyside which was sort of an annex of Bryant High School. And that was an interesting experience because walking from my house on 25th Avenue and 42nd Street in Astoria to Sunnyside was a walk of approximately, maybe, 1 1/2 to two miles. And in order to get there, I improvised a shortcut through the Long Island City freight yards. I would get to school by hopping across the tracks and getting to school that way.

My dad worked for the Railway Express Agency,* he drove an electric truck in Manhattan. He did that for years, and he drove one of the last electric trucks the Railway Express Agency had in Manhattan. So my association with my father was, ah, sort of distant. He was kind of a quiet man, he didn’t socialize too much – although he did like to have some friends in for a drink once in a while, you know, he enjoyed that.

My upbringing was essentially under the aegis of my grandmother, who did all the cooking. And we went from my apartment to her apartment, which was next door – we lived in two family houses there. I would take my meals there with my grandmother, and she was the one that made me go to church with her every Sunday (chuckles) and every holiday, and on Friday I had to eat fish. She was a devout Catholic, and an absolute world-reknowned cook! (chuckles) I can remember her manufacturing a soup for the family and starting off with an empty bottle of ketchup, which she rinsed out with water, put it in the pot, and managed to get various and sundry ingredients from the refrigerator and come up with this delicious soup that everybody enjoyed. She was a wonderful person, and I adored her. She was a woman who managed to do a lot of things with very little income.

Uh, she used to like to go to a Bohemian church over in New York City -- I think it was in the 60s between 1st and 2nd Avenue, I think it was. And I remember her taking me there on Sundays many times to listen to, uh, short plays and things that were done in Czechoslovak. And of course I didn’t understand that much Czechoslovak. The only Czech I understood was what my grandmother taught me, and she didn’t teach me enough to follow the script of a play. But I would spend a Sunday over there, and we would have dinner over there – a typical Czechoslovak meal a lot of times, with what they call knedlíky** and zeli*** and pork, you know. That was very pleasant. She also used to take me to soccer games. At that time, a trolley car ran down Steinway Avenue, which was the main drag in Astoria, and at the end of the road, at Steinway Avenue, there was a soccer field. And of course the ethnic, uh, mid-European people in the area all gathered there on a Sunday, and they would play soccer. I didn’t know what soccer was (chuckles) from anything, but I’d watch them running up and down the field kicking this ball, and that was a pleasant way of spending a Sunday afternoon, too.

As far as my high school was concerned, uh, I wasn’t particularly interested in anything except maybe biology was a little more fascinating to me than anything else. I always felt rather – I didn’t feel that I was a real “brain,” as you would call it, you know. Although I did get good marks, I got good marks because I’d spend time. I had this quality of being very – if I started to do something, I really stuck to it, and I worked at it, and so I spent a lot of effort that way. But I guess biology was one of the more interesting subjects that I had."

* An important cargo railroad (1917-1975).
** dumplings (bread or potatoe)
*** sauerkraut

The Life & Career of Kenneth Charles Appell, M.D.: A Quick Biography

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On March 23, 1923, Kenneth Appell was born in New York City on Manhattan’s Upper East Side (East 77th Street, off York Avenue); after the death of his mother, his father moved with Ken and his sister Florence into a brick two-bedroom house in Astoria, Queens (see gallery).

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In 1940-42, he attended Manhattan College in the Bronx, New York City, but his undergrad career was interrupted in 1942-46 by service in the U.S. Navy. He trained and was stationed at J.V. Newland Field at Baylor University in Waco, Texas; Lambert Field in St. Louis, Missouri; and air bases in Jacksonville and Pensacola, Florida. He subsequently flew missions in the Pacific theater of World War II.

The war over, in 1946-47 Ken Appell completed studies and graduated (second in his class) from Manhattan College. In 1947 he continued on to Georgetown University School of Medicine in Washington, DC, graduating in 1951 with that year’s Gold Medal in Pathology. During medical school, he returned to Astoria to marry fiancée Marcella Varmuza, who then moved to DC with him.

Right out of medical school, the newly minted physician did a 1951-52 rotating internship, at St. Vincent’s Hospital in New York City. That was followed in 1951-56 by a general surgery residence, then a year as research associate, at Brooklyn VA Hospital in Bay Ridge.

After being certified in 1958 as a diplomate of the ABS (American Board of Surgery), the following year Dr. Appell served as surgical coordinator at Grasslands Hospital in the Westchester County (New York) town of Valhalla. A year after that, he and his wife moved to Westchester, to the city of Port Chester.

Following two years as attending surgeon at the Bronx VA Medical Center, in 1961-62, through 1965 he became general surgery section chief and research associate at this same hospital. It was here, in 1963, that Kenneth Appell made medical history with his invention of the AV fistula (aka the radiocephalic fistula). During this period he also taught as a clinical instructor at Albert Einstein College of Medicine.

The Sixties were a busy decade indeed for this distinguished surgeon. Overlapping with his tenure at the Bronx V.A., in 1962-69 he was also visiting surgeon at Harlem Hospital in upper Manhattan, and in 1963-69 served as Chief of Surgery at Calvary Hospital in the Bronx. This non-profit insitutition affiliated with the Roman Catholic Archdiocese of New York is the United States’ only fully accredited specialty hospital providing acute and palliative care exclusively for advanced cancer patients. On top of all the above, during his last year Dr. Appell was also president of Calvary's board of directors. It was also during this period, in 1968, that he received a Veterans’ Administration commendation for advances in the field of hemodialysis -- primarily for his creation of the AV fistula.

In 1969, Dr. Appell's life changed significantly once again. He spent part of that year as a consultant in vascular sugery at the Holy Name Hospital in Teaneck, New Jersey and consultant in surgery at St. Joseph’s Hospital in the Westchester city of Yonkers. But that same year, he moved with his family (wife Marcy, son David, daughter Ann) to the part-rural/part-suburban town of Red Hook, 100 miles north of New York City in the Hudson Valley’s Dutchess County, and started practicing medicine at Northern Dutchess Hospital in nearby Rhinebeck. His first partner in practice was Dr. Bill Jameison, followed as of 1980 by Dr. Jim Wing.

Since 1969, Kenneth Appell has been an attending surgeon at Northern Dutchess, as well as Chief of Surgery for much of that time; in 1973 also became an attending surgeon at Rhinebeck’s Ferncliff Nursing Home. He continues at both institutions to this day, even in semi-retirement.

In more recent years, Kenneth Appell's invention of the AV fistula has finally begun to be somewhat better appreciated after years of unfair attribution to colleagues in the Bronx V.A.'s nephrology unit (it has sometimes, for example, been referred to as the Brescia-Cimino shunt). Landmarks in this process included a well received paper on the subject Dr. Appell delivered in 1988 at the Symposium on Vascular Access for Hemodialysis, held in Phoenix, Arizona. The pace has picked up a bit in the past three years, most notably in 2006 when José Ramón Polo, a distinguished surgeon based at Gregorio Marañón Hospital in Madrid, Spain, published a "historical vignette" article. "Kenneth Charles Appell, M.D.: The Surgeon Who Performed the First Radiocephalic Fistulas for Hemodialysis" appeared in the February issue of The American Surgeon (Vol. 72, No. 2). In November of last year, Dr. Appell presented keynote address at the tenth annual Veith Symposium on Vascular Access in New York City, and was awarded honory membership in the Vascular Access Society of the Americas.

For additional specifics on and images of Kenneth Charles Appell's life and career, please see the accompanying photo gallery.