Blind Med Student’s Vision Has No Limits

He bends down, scalpel in his left hand, ready to pluck at the insides of the lifeless arm.

“Are we headfirst?” he asks, his nose nearly touching the cadaver’s limb dangling over the side of a coffin-like steel tank.

He edges closer and pulls at white and reddish-brown strands, nerves and muscles bundled like a nest of telephone wires.

“Tim, stick your hand in there,” a voice suggests.

He gingerly runs his forefinger along veins that feel like cold spaghetti, following the stringy road map until he reaches a tangled, cavernous spot. He has hit the armpit; it is called the axilla.

“Tim, have you felt this?”

He moves his fingers to a braid of nerves, thick and solid; it is called the brachial plexus.

This is Anatomy 711.

It is the first step in a long, long journey for Tim Cordes. Within seven, maybe eight, years, he will leave the University of Wisconsin with a medical degree and a Ph.D.

Within weeks, he will have to identify 19 forearm muscles, many the same size, some stacked on top of one another. He will have to put his fingers inside a head and identify eight nerves, six blood vessels and six muscles in an area no bigger than two ice cubes.

He’ll have do all this with a clock ticking.

So when the four-hour lab is over, he heads to a study session.

But first, he leans down and unfurls a leather leash coiled around a table leg. Up pops Electra, his German shepherd guide dog.

Tim knows he will have to do what some consider impossible. He will have to identify these body parts without seeing them.

Tim Cordes is blind.

*

Tim’s life has followed a predictable, if extraordinary, pattern.

He decides to do something blind people normally don’t do, and the world says:

(a) You can’t,

(b) You shouldn’t, or

(c) Young man, that’s courageous, but it’s best not to even try.

Then, just as predictably, Tim succeeds. Doubters become champions. He takes it in stride. He insists he’s no one’s profile in courage.

“When people keep telling you that you’re special, I have to keep reminding myself, I’m not,” he says, his words a staccato burst of a young man in a hurry. “When you start thinking you’re special, you have to rely on that. I can’t do that.”

What Tim does rely on is hard work, whether it’s mastering anatomy by navigating his hands, day after day, around hundreds of minuscule routes in the human body, or mastering martial arts by being hurled onto mats, hour after hour, bloodied and bruised.

His work ethic has paid off.

Consider the resume of Timothy John Cordes, born legally blind, totally sightless at 16, now 22 and studying to be a doctor--specifically, a medical researcher.

Valedictorian at Notre Dame. Black belt in jujitsu, tae kwon do. Canoeist, water skier. Music composer. Biochemistry researcher. His lowest college grade: a single A- in Spanish.

When Tim entered Notre Dame, alma mater of his father and two older sisters, he started as a biology major and encountered a familiar response: skepticism.

“They had a textbook there,” Tim recalls, “and they handed it to my father and flipped open to a picture of a kidney and said, ‘How’s he going to do this?’ ”

As always, he found ways.

There were books on tape and in Braille, raised drawings he could feel and a high-powered computer that simultaneously reads into his earpiece whatever he types.

Most of all, there was Tim’s facile mind, his ability to absorb, interpret and visualize scientific concepts.

He was also helped by the limited vision he once had; if someone said a cell was blue, he had a mental image. But now, he says, “I find myself thinking how things feel in three dimensions just as much as how they look.”

He used all those tools when he switched to biochemistry--with extraordinary success.

Brian Goess, a chemistry graduate student at Harvard who worked in a lab across the hall at Notre Dame, says he would describe the results of his spectrum --a line graph of peaks and valleys--and Tim would help interpret them.

“It almost sounds cliche, but you don’t think of Tim as having any sort of impairment,” Goess says. “It didn’t take long for most kids to realize that this kid was their competition. He was the guy to catch.”

Easier said than done.

“He was off the scale compared to everybody else,” says Paul Helquist, a Notre Dame biochemistry professor. Now in his 25th year of teaching, he calls Tim “the best student I’ve ever had.”

“He’s developed the very special skill to internalize very complicated materials--pictures, complex mathematical graphs, chemical graphs--that most of us, including myself, have to actually see to interpret what they mean.”

At times, it seemed he was a step ahead of the faculty.

Helquist remembers a chemistry test in which 1,000 students were given one impossibly difficult question for extra credit. Sure enough, no one got it. Then Tim, a freshman, approached the distinguished professor.

“I think I’m right,” he said. “I can’t find my mistake.”

A review showed his calculations were more precise than those in the answer key.

But Helquist says Tim was more than brilliant; he was poised and could lead with a lighthearted touch.

Once, filling in for the professor on a lecture about carbohydrates, Tim reworked Helquist’s notes and offered candy bars--carbohydrates, get it?--for correct answers.

Tim tutored biochemistry and was involved in student government and the American Chemical Society. His tastes were eclectic: He enjoyed Dante and the Fighting Irish football team.

When graduation time arrived, Tim applied to be valedictorian.

Collin Meissner, the assistant provost, recalls his tryout speech before a university committee: “There was an absolute sureness about him. He knew exactly who he was. There was a real grace and humility about him.”

On commencement day, Tim, with his dog Electra at his side, was the last of 2,000 students to march into the auditorium.

Walking to the podium, Tim, with his sandy hair and farm kid’s fresh-scrubbed face, smiled shyly as the graduates and 10,000 guests rose. The hall echoed with cheers, whoops and chants of his name.

Tim fought off a wave of stage fright as he talked of God, of service, of the campus’ golden dome--a sight he has never seen--and of doing your best.

As his family watched, his mother, Therese, blinked back tears.

“He has constantly amazed me,” she says. “It was just another amazing thing for him.”

Eye Disease Diagnosed Early

The diagnosis came early for Tim.

A pediatrician had noticed his eyes were in constant motion. At 5 months, Tim was diagnosed with Leber’s disease, a condition that can lead to blindness, usually around puberty.

By age 2, Tim wore glasses--his mother still has the little pair--and a pediatric ophthalmologist gave Therese Cordes the bleak news:

“He said he would not be this, he would not be that,” she recalls from the family home in Eldridge, Iowa. “Don’t expect anything-- that’s the way I read it. . . . I did a lot of crying on the way home.”

Then she ignored the advice. Tim bicycled, skateboarded and drew pictures. He collected toy cars and could identify every model. And he played as hard as any kid.

On one family vacation in northern Michigan, Tom Cordes remembers his son, then 4 or 5 with diminished sight, tumbling down an embankment while chasing his sisters in the woods, following their squeals.

When he immediately picked himself up and continued the chase, his grandfather said: “He’s going to be all right.”

Tom Cordes remembers a sadder, but pivotal, moment.

He had taken Tim, still young enough to hold his hand, to an eye doctor, who sat down with father and son and said: “Recognize that Tim can be anything he wants to be. But he’ll never drive a car and he’ll never fly an airplane.”

“It was just devastating,” Cordes remembers, because his son was fascinated by two things--cars and planes. “Tim’s face about went white.”

As they left, Tim asked his dad if that was true.

“Heck, Tim, you can drive right now!” he reassured him.

Off they went to an empty parking lot. Sitting in his dad’s lap, Tim steered the orange Mustang with the black racing stripe around and around as his father kept his foot on the gas.

“Ever since that doctor said that,” Cordes recalls, “I made up my mind to never, ever say, ‘Tim, you can’t do that.’ ”

So Tim joined the Boy Scouts. He learned to swim. He camped and canoed in Minnesota’s Boundary Waters.

Still, a little boy reading Braille in fifth grade couldn’t help but feel isolated during lunch hour, when others played football and baseball. But Tim made the best of that, too, practicing on the monkey bars and building himself into a prize-winning wrestler.

His fascination with science also grew. When his parents or sisters read to him, they had to provide detailed descriptions of illustrations and prepare for an interrogation. “You could never answer enough questions,” his father recalls.

Tim began reading Popular Mechanics and Science News in Braille as his vision faded.

“It was so slow,” Tim says of losing his sight. “It wasn’t just like I woke up one day and it was gone. I had plenty of time to get used to it.”

So did his family. “You adjust and you grieve,” his mother says.

At age 16, he got Electra, his guide dog. They were matched by their quick gaits.

“While all my peers were getting their car keys, I got a harness and a dog,” he says. “It was kind of liberating in a way.”

Therese Cordes talked with her son about that widening gulf between Tim and his classmates. “You can give platitudes,” she says, “but if you’ve never really been there, what can you tell him?”

But Tim and Electra formed a fast friendship. “She has a lot of heart,” he says, affectionately rubbing the dog’s face. And she is attuned to his every move.

Today, Tim goes to movies and concerts. He can discuss the latest George Clooney film, the music of Metallica and Alice in Chains and every episode of two science fiction favorites: “Star Trek” and “Babylon 5.”

Tom Cordes remembers a survey his son answered as a teen that asked him to rate the impact of his blindness. He chose the category: “Minor inconvenience.”

So when Tim announced he wanted to be a doctor, no one was surprised.

“I thought it sounded just like him,” says his sister, Becky, a pre-veterinary student at Iowa State University. “He would always pick the toughest thing he could be and do it.”

A Stack of Rejections

This time, it seemed Tim might not convert the doubters.

Armed with a 3.99 average, sterling recommendations and two years of research experience on antibiotics, he applied to eight medical schools. By spring, he had a stack of rejections.

He knew this path had been traveled before, having read the autobiography of David Hartman, a blind graduate of Temple University Medical School in 1976, now a psychiatrist in Virginia.

But the doors hadn’t opened much since. Some schools bluntly said Tim couldn’t meet their standards because he was blind. Others were more subtle.

Then came the University of Wisconsin’s letter: Acceptance!

He would be one of 143 students among 2,299 applicants.

In explaining the decision to admit Tim, Dr. Philip Farrell, dean of the medical school, says some preconceived notions about doctors simply aren’t true.

“The general feeling out there is vision is necessary to practice medicine,” he says. “I don’t think that’s correct. Medicine is really cognitive. There’s more thinking than seeing.”

Still, Tim’s case was so unusual that, in the spring, Mikel Snow, associate dean for students, sent an e-mail notifying students of his admission. Some, he said, thought it terrific; others said it didn’t make sense. How could he handle it?

Snow knows there are more critics.

“I’d be extremely naive to think the 1,000 faculty in the medical center are 100% behind this,” he says. “I’m sure there are a lot of skeptics. But the people who don’t like it don’t call.”

Tim says he has encountered just one negative comment, from a second-year student who asked him on his first day, “Why are you here? Why don’t you do something else?”

But once again, Tim Cordes is making believers of those he meets.

“He doesn’t see with his eyes, but he sees as good as we do. He uses his hands, and he uses his brain to visualize,” says Dan Knoch, a classmate and good friend who notes that Tim helps others prepare for tests.

Karen Krabbenhoft, an anatomy lecturer, was impressed when Tim participated in dissecting the cadaver.

“I think it would be easy for someone [blind] to say, ‘I can’t do this’ and tend to pull back. He really pushes his abilities and maximizes his abilities.”

But how, day to day, does a blind student explore the inner workings of the body?

There’s his computer, which reads texts to him at 500 words a minute--a rat-a-tat of hiccuping sounds--and a kit that allows him to feel drawings with raised lines. And the school has hired “visual describers,” who act as narrators.

Megan Neuman, a second-year medical student, was at Tim’s side in anatomy, sometimes guiding his hands, telling him what he was feeling.

“It was much easier than I thought,” she says, noting anatomy is tactile as well as visual. “He’s very accustomed to learning like everyone else. I was surprised at how quickly he picked up on things.”

There were limitations, though; for example, body cavities so small that others could see them, but Tim couldn’t reach them.

For his practical exam, Megan guided Tim to where tiny flags marked the nerves, muscles, arteries or veins that he had to identify. He had two minutes for each part--twice as long as other students.

For another part of the test--identifying CAT scans normally on X-ray film--Krabbenhoft made raised impressions on a clear sheet, then held Tim’s hand, taking his index finger and tracing an organ or a blood vessel. Sometimes, to orient himself, he would ask to “see” other sheets in the sequence.

Snow, who also taught anatomy, discovered what others already know: Tim has an uncanny ability to visualize.

During a lecture he gave on the eye and its muscles, he used a 10-inch Styrofoam model, then posed questions. After each, there was silence. Then a correct answer. From Tim.

“I had 15 students see this model who couldn’t get it--but he did,” Snow says with wonder in his voice.

At summer’s end, Tim got his first grade in medical school: an A.

But many obstacles remain. In this fall’s histology course, the study of tissues depends largely on microscopic images, slides and diagrams.

In the lab, as other students examine slides with a five-headed microscope, a visual describer helps Tim, almost like a game of scientific charades.

“Now the spinal cord looks like a butterfly,” she says. “Then there are these purple specks.”

“So are the deep purple the nerves themselves?” he asks as an enlarged slide glows on a wall behind him. “Can you say where the astrocytes are?”

Testing is like another game: 20 Questions. Tim moves his finger over a raised drawing and asks the levels of color, shading and other details.

“Could this area be purple?” he asks. “Is it green? Does the background look glassy?” Tim says he usually has the answer in about 15 minutes.

“It’s tricky,” he says, “but we’ve got a system, and I think it works for learning.”

After two years, Tim will switch to his Ph.D. program--he wants to work on the three-dimensional structure of molecules--then, after three or four years, he’ll finish his medical degree.

“I figure I’ve got a steady job for eight years,” he says with a grin.

Although Tim plans to do research rather than practice medicine, his training will include several clinical rotations, including surgery, neurology and obstetrics-gynecology. He’s also expected to learn to do a physical--with an assistant--and scrub for and observe a surgical operation.

“We have definitely not planned how that’s going to work,” Snow says. “Somebody’s going to have to sit down with the experts to see what can and cannot be done.”

However it’s accomplished, Farrell, the dean, says Tim’s contribution to medicine is being made even now.

“We’re already learning how Tim studies and how he applies himself,” he says. “I believe we’re going to learn as much from Tim as he learns from us.”

As always, Tim is confident.

“They stuck their neck out and I’m going to do my best by them,” he says. “But I’m going to do my best--no matter what.”