[gui-talk] Fwd: article on blind doctor in the US.

[Steve Pattison]

 From:    "adam Morris" <lists at damorris.com>
 To:      "vip-l" <vip-l at freelists.org>


It's not uncommon for co-workers to stumble upon Tim Cordes sitting in the 
dark.
"I couldn't function in the dark, but he 'sees,'" says Dr. Nancy Barklage, 
who recalls entering a room prior to a UW Health staff meeting, turning on 
the lights and finding Cordes quietly working on his laptop while waiting 
for others to arrive. "I've experienced this a number of times now and it 
still kind of puts you into his reality."

Cordes is blind.

As an infant, he was diagnosed with Leber's disease, a rare degenerative 
condition of the retina that gradually steals one's sight. Cordes still 
remembers one of the first times he heard someone trying to explain how his 
impending blindness would affect his life. "Your son can be president of the 
United States, but he's never going to fly a plane or drive a car," an 
ophthalmologist explained to his parents when Cordes was about 7.

"And as a young boy who liked planes and cars, that was one of my first 
indications that things wouldn't necessarily go smoothly," says Cordes. 
"That made me sad."

He never did fly a plane or drive a car. In fact, when most of his friends 
in Cedar Falls, Iowa, were learning to drive, a 16-year-old Cordes got his 
first guide dog, a German shepherd named Electra.

But Cordes didn't shrink from life. He's now a 34-year-old trailblazing 
physician who is wrapping up the third year of a four-year residency program 
with UW-Madison's department of psychiatry.

"He has overcome challenges that most of us have just never been faced 
with," says Barklage, an associate professor of psychiatry who has 
supervised Cordes' work at UW Health's Psychiatric Institute and Clinic the 
past three years.

Cordes has been reticent to share his story, not wanting to become a poster 
boy for overcoming visual disabilities. But he's slowly becoming more at 
ease telling his inspirational tale. Earlier this spring, the husband and 
father of two young boys wowed 450 members of the Madison Civics Club with a 
speech at Monona Terrace titled, "How I See Possibilities." In July, he'll 
give a similar talk in Dallas at the National Federation of the Blind's 
annual convention. And he contributed a chapter for a book to be published 
later this summer by the Association of American Medical Colleges that is 
designed to guide medical schools in accommodating students with 
disabilities. Cordes' chapter deals with the use of service animals.

"Thirteen years ago, I was knocking on a lot of closed doors," Cordes says 
of his struggles to have medical schools seriously consider him as a 
candidate for admittance. "So the fact a book is coming out describing the 
issues people with disabilities face and ways to accommodate them, I think 
is tremendous progress."

Cordes was valedictorian of his class at the University of Notre Dame in 
1998, posting a 3.99 GPA while earning an undergraduate degree in 
biochemistry and conducting research on antibiotics. He then was accepted 
into the UW School of Medicine and Public Health's medical scientist 
training program, completing the notoriously challenging sequence that 
requires a student to finish both medical school and a Ph.D.-level research 
program.

Over the years, Cordes also earned black belts in jujitsu and tae kwon do, 
carried the Olympic torch during its cross-country journey to the Salt Lake 
City Games in 2002, and developed computer software that uses a number of 
musical instruments, varying tones and left-right speakers to allow those 
with vision problems to conceptualize and study protein structures.

Despite these made-for-the-big-screen qualities to his life, Cordes remains 
leery of being put on a pedestal: "I look forward to a world where people 
with disabilities do what they can and what they want, and it's not exciting 
or it's not different."

Dr. Brad Schwartz still remembers the paperwork Cordes forwarded to the UW 
Medical School when applying to the medical scientist training program.

While most attempting to head down this path are high achievers, Schwartz 
says Cordes stood out from the pack due to his Medical College Admission 
Test scores, 3.99 GPA in a demanding major and his interesting research on 
antibiotics. It was a reference letter from a Notre Dame researcher, 
however, that floored Schwartz, who was director of the program in the 
spring of 1998.

"It's just this incredible, glowing letter," says Schwartz, now the dean of 
the University of Illinois-Urbana's College of Medicine. "And then you get 
to the last line, and it says, 'This is all the more remarkable because Tim 
is blind.' We're all thinking, 'Oh my God!'"

Schwartz says his admissions review committee agreed Cordes was a 
"one-in-a-million" candidate and assumed "every program in the country would 
be fighting to get him because he was so remarkable."

But that wasn't the case. In fact, Cordes applied to eight schools, but no 
one else showed interest. During one med school exit interview, doctors and 
researchers at a rival Big Ten Conference institution made it clear to 
Cordes, who has only a limited amount of light perception, that there was no 
way a blind student could complete the school's required coursework and 
rotations to earn a medical degree.

Cordes doesn't appear bitter about these rejections, but his mother, Therese 
Cordes, acknowledges it was a difficult time for her son. "To have someone 
tell Tim he's not good enough, despite all he accomplished, was very, very 
tough on him," she says.

Even at UW-Madison, those close to the situation say some top medical school 
administrators were adamantly opposed to admitting Cordes. Concerns centered 
on two factors: the cost to make all the necessary accommodations for a 
blind student; and the fear that the Association of American Medical 
Colleges might frown on a school admitting a student who couldn't see.

In the end, Schwartz stood his ground against the naysayers and Cordes was 
ultimately one of 143 students earning a slot in med school out of 2,300 who 
applied. Although no official records are kept and there are various scales 
to measure the extent of vision loss, published reports in 1998 indicated 
Cordes was only the second blind person ever admitted to a U.S. medical 
school. The first was David Hartman, a 1976 Temple grad and psychiatrist in 
Virginia whom Cordes considers a role model.

Some members of the Medical School were guarded about Cordes' chances of 
success at first, says Schwartz. "But I can tell you, each year that he went 
along he won over more and more people," he says. In the years to come, 
Cordes would learn the lessons and complete the tasks asked of every other 
doctor-in-training.

In the classroom, he used books on tape and in Braille to learn the 
fundamentals. He also relied heavily on a computer that could read 
downloaded texts and e-mails at a blistering 500 words per minute - 
something Cordes can easily understand but would sound like gibberish to 
someone accustomed to normal-paced speech. The university also provided him 
with a machine - "It looks a little like an Easy-Bake oven," says Cordes - 
that makes raised-line drawings so he could interpret images using his sense 
of touch.

In the lab, he helped dissect a human cadaver and used his fingers to 
identify the various nerves, muscles and organs. "I was the guy who reached 
into the chest and pulled out the lungs," says Cordes. When it came to 
hospital rotations, he helped deliver babies (earning Student of the Year 
honors in the obstetrics and gynecology rotation), observed surgery - "I 
felt blood flowing through an aorta" - and intubated patients during an 
anesthesiology rotation.

The school also hired "visual describers" to tag along with Cordes and his 
seeing-eye dog to help Cordes read paper charts or act as his eyes during a 
physical exam. In 2004, he earned the title of medical doctor.

His Ph.D. work centered on biomolecular chemistry and the makeup of 
proteins, a field that relies heavily on colorful, computer-generated models 
of complex molecular structures. Out of necessity, Cordes wrote a computer 
program that replicates the 3-D images using a range of audio tones and 
surround-sound speakers, allowing him to "visualize" the proteins in his 
head. In 2007 he earned his Ph.D.

Although Cordes isn't one to puff out his chest and say "I told you so," he 
is proud of the fact he never allowed others to squash his dreams. "Choosing 
to ignore what other people say, when they say it can't be done, is a 
powerful tool," says Cordes.

When Cordes started his medical school journey more than a decade ago, he 
had no desire to work directly with patients. Research was his passion, and 
the medical scientist training program is designed to develop people who can 
bridge the gap between basic research and clinical work.

"I think it was just intellectual curiosity," Cordes said of the 
research-first focus.

But while working his way through the various rotations during his third 
year of medical school, Cordes started to zero in on a specialty and 
re-think his career options. He knew he couldn't be a radiologist but 
thought any other area was up for grabs. A four-week psychiatry rotation at 
the William S. Middleton Memorial Veterans Hospital stood out.

"I was lucky and had a really great psychiatrist running the ward I was on," 
Cordes says of Dr. Tony Braus. "Some of the patients we saw there really got 
better in a relatively short time, and we could see some improvements in 
people."

While he enjoyed interacting with the patients, Cordes also saw the 
potential to conduct groundbreaking research in the study and treatment of 
mental disorders. "There is just a lot we don't know," he says. "In other 
places of medicine, some of the more fundamental questions have been asked 
and answered, but in psychiatry we are just starting to ask them."

So after earning his M.D. and Ph.D., Cordes in 2007 entered a four-year, 
psychiatry research track residency program, which allows him to spend time 
working with patients and conducting research. Although he notes there has 
been no single "ah-ha" moment, Cordes says it's becoming clear his desire to 
work as a clinician and teacher of future doctors is stronger than his drive 
to focus solely on research.

Cordes' typical week currently consists of two-and-a-half days at the 
Veterans Hospital, where he helps supervise the medical interns in an 
inpatient psychiatry unit, and one full day of outpatient care at a UW 
Health clinic in University Research Park, where he oversees more than 100 
patients. He also spends a half-day attending lectures and gets one full day 
for research. His research mainly consists of mining data and searching for 
interesting patterns using the Midlife Development in the United States 
survey, which examines the lives of people ages 30 to 70 in such areas as 
physical health, psychological well-being and factors that might lead to 
mental illness.

At the Veterans Hospital, he also worked on a clinical trial systematically 
rating symptoms in patients with post-traumatic stress disorder.

While he has a proven track record as a researcher, Cordes is also earning 
kudos as a clinician.

"In psychiatry, part of what we do is getting to know patients, establishing 
a rapport and trying to understand what's going on with them so we can help 
them out," says Art Walaszek, the residency training director for UW-Madison's 
department of psychiatry. "And Tim just has an incredible, natural ability 
to put people at ease and communicate and listen to them. I don't know 
exactly how he does it, but he just has this awareness of what's going on 
with the patient."

Body language and expressions often convey information to therapists, but 
Cordes is able to pick up on these cues despite his sight limitations. He 
says he's "gotten good at listening to people - not just what they're saying 
but hearing how their body moves or what direction they're talking in."

Colleagues say they can't recall an instance in which a patient did not want 
to be seen by Cordes because he is blind. In fact, says Braus, Cordes' 
disability seemingly allows him to more easily connect with patients.

"It's almost like Tim has more credibility with some patients," says Braus, 
who today works at the VA's outpatient clinic. "Tim knows what it means to 
recover from something or to be able to compensate or overcome a problem. 
People at some level seem to relate to that."

It's not easy keeping pace with Cordes - even if you can see.

With sprinkles just starting to fall one dreary spring morning, Cordes and 
Vance - his loyal guide dog for the past nine years - walk briskly from the 
bus stop to his office.

The ride from near his home on Madison's East Side to UW Health's 
Psychiatric Institute and Clinic, which is across town in University 
Research Park, takes about 40 minutes - not bad considering Cordes has to 
transfer buses on the UW-Madison campus. The jaunt from the final stop to 
the clinic takes about five minutes at a quick pace. Somehow, Cordes 
narrowly misses several potholes on the driveway leading to his office. 
Those who have watched Cordes for years insist he has some sort of internal 
radar.

"He has this like, Zen, where he can walk through the living room and not 
step on all my son's trains," says his wife, Blue-leaf, a native of India 
and a 1994 Madison East grad who met Cordes while interviewing for the 
M.D.-Ph.D. program, which she also completed. "I don't know how he does it 
without falling and hurting himself."

Before long, Cordes is heading up a set of stairs leading to a back entrance 
of the clinic. He scans his security badge to gain entry to the facility; it's 
just past 7 a.m.

Using his sharp memory and displaying complete trust in Vance, Cordes 
quickly moves down a hall to his office, drops off his jacket and backpack, 
and heads back down a hallway to separate locked rooms that house medical 
records and the mail. He intuitively slides his hand over the keypad 
security system, and quickly taps out the code. Inside, Braille labels allow 
him to promptly grab the correct patient records and mail.

Back in his office, he sets the papers neatly on his desk before flipping 
open his laptop and scanning through e-mails using screen-reading software 
that ticks off the messages in quick order. Like clockwork, Jeanne Harris, 
one of Cordes' visual describers, arrives in the office at 7:10 a.m. to read 
over any faxed-in requests for prescription refills or hand-written notes, 
charts or surveys Cordes can't read himself. (For many printed materials, he 
can take a picture of a document with his smart phone, and a program will 
read it to him.)

Ten minutes later, the paperwork is cleared, Vance is resting on the floor 
in the office, and Cordes is preparing for a day of numbers-crunching 
research on his computer.

It's easy to be impressed by how efficiently Cordes operates, but he wishes 
others would view it as ordinary. "Just like you, I have a job to do and I 
figured out how to do it," he explains. "To me, it's gratifying how 
profoundly routine this all seems at times."

Even those closest to Cordes - the ones who have never doubted his 
potential - confess it's difficult to view this all as merely routine.

Therese Cordes still has vivid memories from three decades ago when she put 
a 2-year-old Tim in the car and drove him to meet with the University of 
Iowa's highly regarded pediatric ophthalmologists. The experts there gave 
her little hope, rattling off a list of things her only son would never be 
able to do.

"I cried all the way home," says Therese, "and then decided to forget 
everything they told me."

Tim Cordes credits his mother for being a rock of emotional support over the 
years, while his father, an engineer, was pragmatically supportive - the 
problem-solver and the one who helped Tim get up to speed with many of the 
technological gizmos he relies on.

It also didn't hurt that Cordes was being pushed by two older, successful 
sisters, both of whom were valedictorians of their high school class (Tim 
finished as runner-up during his senior year) before also moving on to Notre 
Dame.

Earlier this spring, Therese Cordes was in tears again after her son got a 
standing ovation following his riveting speech to the Madison Civics Club. 
"He's inspirational," said the proud mother.

What, exactly, the future holds for Cordes isn't clear. After he completes 
the four-year residency program in July of 2011, he's considering additional 
training so he can help people with drug addiction problems. Another option 
is to land a position working with military veterans suffering from 
post-traumatic stress disorder and severe brain injuries, work Cordes enjoys 
and finds rewarding.

No matter what direction Cordes ultimately decides to push his career, he 
has no intention of becoming part of what he calls "today's risk-averse 
society."

"I went to a playground with my son and I found out what passes for a 
teeter-totter these days," he explained during his civics club speech. "It's 
a U-shaped, spring-loaded contraption that assures nobody gets too high off 
the ground or nobody comes down too hard."

Cordes adds proudly: "I learned to swing on monkey bars - which I could not 
see well - over asphalt. I learned that if you fall it hurts, so you try not 
to fall. But it's still worth swinging."


Adam Morris

Mobile: 0414 431105

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