2014 Issues   /   January 2014

Blind Psychiatrist at Madison VA ‘Sees’ Patients’ Needs Clearly

USM By U.S. Medicine
January 7, 2014

By Steve Lewis

MADISON, WI — Tim Cordes, MD, a psychiatrist at the William S. Middleton VA Hospital in Madison, WI, may be legally blind, but his insight into his patients’ needs is considered extraordinary.

“He’s very calm,” said Dean Krahn, MD, chief of psychiatry at the Madison VA. “Given that he can’t see, I think that he’s more attentive to everything you say. He picks up on a lot; he listens closely for the sound of your breathing, the tone of your voice. … He senses a lot about the patient and has a unique way of picking up on things other doctors might miss.”

Being legally blind would seem to present unique challenges for a medical student, but Cordes told U.S. Medicine that he found ways to overcome them.

Tim Cordes, MD, sitting with a patient

Tim Cordes, MD, sitting with a patient

“There were actually two kinds of challenges, real and technical — like how to work in a visual environment,” he recalls. “I used technology whenever I could — for example, an Opticon device which converts a postage-stamp-sized field of view of an image to vibrating pins I can feel. I could use that to look at EKGs, and X-rays to some degree. I used computers whenever I could and EMR (electronic medical records) when they came online.” Cordes notes that he had been using keyboards since he was 8 years old.

When it came to physical exams, he explains, a sighted physician watches people move their arms and legs, “So I place my hands on their arms and legs” to obtain the same types of information. The key to his success, he declares, has been to “just be consistent and work hard and do my best.”

Drawn to VA

Cordes says he developed an interest in science long before he determined that he wanted to be a physician. “Then I realized I wanted to do something more personal or human, and medicine seemed like the place to do that,” he recounts.

His clerkship experience in medical school at a VA facility “got me to thinking about” working at such a facility. “I worked with some really neat patients in an inpatient rotation; I saw them come to the hospital, get better and leave — so it was a great experience,” he says. “Ironically, one of those patients I saw as a medical student in 2003 I am now caring for as his primary psychiatrist.”

In addition, Cordes says, “I really like my co-workers and the patient population. And the EMR is really accessible with the speech software I use.”

How does he respond to observations that he brings something unique to his patient care?

“I think I’m just differently tuned — I’m not sure if I’m more tuned,” Cordes insists. “I pick up on different cues patients are sending and put their story together in different way. I can listen to their gait — how they walk down the hall — clues on what they wear or where they gaze from the sounds they make. In other words, I get a lot of what other people consider ‘visual’ information through other channels. Breathing absolutely provides clues on emotions, and hands — whether they are steady or playing with papers, for example — also provide clues.”

Asked what he finds most rewarding about the practice of psychiatry, Cordes responds, Working with people and with their individual stories. After a while, with whatever you do in most areas of medicine, things become the same. But in psychiatry there is always a unique story, a specific set of circumstances they work through, and that’s what I like about it.”

In addition to his love of psychiatry, Cordes says he draws special satisfaction from working with veterans. “I like working with this patient population,” he notes. “It’s hard to describe; we lump them together and we call them ‘vets,’ but I see guys from the age of 80 down to 20, with all different kinds of life experiences.”

Although his patients have one thing in common — their military service — each individual is unique and totally distinguished from the general population, Cordes maintains.

“They have had to work, function and perform at levels a lot of people in the general population never had to,” he explains. “Sometimes you can draw from that when you work with them; both you and they know they can be capable of doing more than think they are.”

As for the future, Cordes suggests, his main goal is “To be the best clinician I can be.” He also wants to pass on what he knows to the residents he teaches.

Cordes says he has put his resume on the White House’s job site “to see if there are other ways I can be serving, but I definitely like what I’m doing right now.”

Related Articles

Celebrating U.S. Medicine’s 50th Anniversary

Tell us what you think are the most important advances in federal medicine over the last five decades.  Please don’t forget to identify yourself by degree, specialty and practice location. We will choose some of the... View Article

Military Nurse-Researcher Learned New Field to Help PTSD Patients

By Steve Lewis Spending much of her career as an oncology nurse, Stacey Young-McCaughan, RN, PhD, a retired Army colonel and professor at the University of Texas Health Science Center at San Antonio School of... View Article

U.S. Medicine Recommends

More From 2014 issues

2014 Issues

VA Slammed for Slow Action Against Officials Behind Wait-Time Scandal

Legislators: Only Four Senior Executives Removed by Mid-November

2014 Issues

VA Launches Largest Overhaul Ever as McDonald Pushes Reforms

WASHINGTON - New VA Secretary Robert McDonald continues to methodically tackle the issues that have caused a breakdown in efficient veteran care over the last few years, now pushing the agency to undertake the largest reorganization since its founding.

2014 Issues

VA’s IT Security Controls Cited for 15th Year in a Row

Controversial Scheduling System Will Be Replaced in 2015

2014 Issues

Study Offers New Statistics on How Many OEF/OIF Veterans Have PTSD

VA’s Consolidated Mail Outpatient Pharmacy (CMOP) in Charleston, SC. New legislation is seeking to increase clinician input into formulary decisionmaking. WASHINGTON — Legislation to prevent VA from outsourcing creation of its drug formulary and to... View Article

2014 Issues

Danger of Pneumonia Increases with Veterans’ Worsened Health Status

VA’s Consolidated Mail Outpatient Pharmacy (CMOP) in Charleston, SC. New legislation is seeking to increase clinician input into formulary decisionmaking. WASHINGTON — Legislation to prevent VA from outsourcing creation of its drug formulary and to... View Article

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up