BEVERLY HILLS, Calif. — It's late Friday afternoon and Los Angeles traffic is stacking up like the snow back east. The rest of the world sprung for the weekend, Cardinals outfielder Tommy Pham is in a chair at the Boxer Wachler Vision Institute.
Pham's eyes move up and down. They dart left and right. They are bright and full of life and, best of all, exactly where he needs them to be.
"My keratoconus hasn't changed from last year," he says, smiling wide. "That's great news."
Keratoconus. The word itself is like an eye-chart test waiting to happen.
It is a disease of the cornea in which the collagen is weak and, without treatment, causes the cornea to bulge out like a hernia.
"Imagine your car windshield bulging out and getting all those distortions," Dr. Brian Boxer Wachler says. "Keratoconus can be like being in a fun house, but it's not a lot of fun."
Two rooms over, Pham's baseball career was saved, literally. Following the 2011 season, Pham underwent what, at the time, was a radical new procedure, a non-invasive treatment incorporating ultraviolet light and a vitamin application that takes about 30 minutes, with the goal to stabilize a degenerative condition.
"Miracle, I think, is the best term to describe him," says Dr. Edward Bennett, professor and assistant dean for student services and alumni relations at the University of Missouri-St. Louis' College of Optometry and one of four men who essentially comprise Pham's team of eye specialists. "I've never known anybody else who played major league baseball with keratoconus. I don't know how he sees the spin on the curveball, or fastballs. You've got aberrated eyes, distorted corneas..."
And yet, on this Friday, as Pham, 29, is in the office, some breaking news comes across his phone: The St. Louis Cardinals have just traded a teammate, outfielder Randal Grichuk, to the Toronto Blue Jays.
Following a breakout 2017 season in which Pham hit .306/.411/.520 with 23 homers, 73 RBI and 25 steals, the Cardinals spent the winter shuffling things, centering them on their late-blooming star: They want him to become their everyday center fielder this summer, with Marcell Ozuna in left and Dexter Fowler moving to right. They've already spoken with Fowler, and now the pieces are tumbling.
"When you look at his athleticism, his speed, the ground he can cover, and when you're looking at how to deploy our resources, I think it makes our outfield one of the elite in the game," John Mozeliak, the Cardinals' president of baseball operations, tells B/R.
Pham learns more on this enlightening Friday: Contrary to what he's been told in recent years, he is not legally blind in his left eye.
Talk to him long enough and it is easy to ascertain that, well, Tommy Pham sees himself better than most people see themselves.
Quad Cities, Iowa, 2008. Pham smashes a home run one summer's night in a Class A game, and upon his return to the dugout, one of his teammates asks him what kind of pitch he hit out.
"Fastball," Pham replies confidently.
Some murmuring ensues. Every one of his teammates who saw the swing says, uh, no, Tommy, that was a slider.
"And when I saw the video, they were right, and I was wrong," says Pham, who immediately deduced there must be a direct correlation to the high strikeout rate (126 whiffs in 312 at-bats in Quad City that summer) and other frustrations that consistently interrupted his forward progress.
So he visited a LensCrafters near the River Bandits' ballpark and was fitted for glasses. By year's end, he abandoned them because he didn't think they were helping. Then-Cardinals farm director Jeff Luhnow asked about his vision.
"We'd been working with some eye doctors in various parts of the country because one of our high-profile Dominican signees had vision problems, we voided the contract, he signed with another team and he never made it out of A ball," Luhnow, now the Houston Astros general manager, says.
"Going through that process was really eye-opening for me, no pun intended. Because most major league hitters have above-average vision, 20/10, 20/12, 20/14. Often, even if you're 20/20, you're not good enough to be a big league hitter. It's depth perception and contrast sensitivity that make them able to see a ball in a way that most human beings just can't do. It became clear to me that vision was an incredibly important part of the formula, and if you had an elite athlete with poor vision, your chances of being a major league player were low."
Later that September, Pham was diagnosed with keratoconus by a St. Louis eye specialist. Or, as Pham understood it, kera…what?
"I knew nothing about it," Pham says.
He learned why glasses do not work for keratoconus patients: Even though a person is able to see better in certain cases, the doctor explained, with glasses, the prescription is right in the middle of the lenses.
In the batter's box, an effective hitter keeps his head still and follows the ball with his eyes. Do that while wearing glasses, and the hitters' eyes move out of the center of the lenses, thus losing the benefit of the prescription. It was no surprise, then, that Pham moved his head, rather than his eyes, while following the ball wearing glasses. And that led to frustration.
Problem is for the estimated one in 500 to 2,000 people with keratoconus, most contact lenses don't fit correctly because they are round, and the eye degeneration makes the cornea oval shaped.
Following another disappointing season for Pham in 2009 at Class A West Palm Beach, Boxer Wachler, who had read about Pham's case, reached out to the Cardinals. Pham gravitated his way for two reasons: One, the doctor was located close to Pham's Las Vegas home, and two, Boxer Wachler offered to do the procedure for free.
"I was paying out of pocket, and this stuff isn't cheap," Pham says. "[Keratoconus] wasn't covered until late last year, when the season was about to end."
The procedure, called the Holcomb C3-R, was not approved by the U.S. Food and Drug Administration. But Boxer Wachler had performed it many times by then, with a success rate, he says, of 99.3 percent. And as for the other 0.7 percent, Boxer Wachler says, a second operation generally works for them.
Before, the best option for those with keratoconus was a corneal transplant.
The small, black leather bag travels with him everywhere he goes, from the Cardinals' bench to road hotels to this Beverly Hills restaurant where we've occupied a booth for the last two hours.
He watches this kit the way armed guards protect a Brink's truck, because inside are the tools essential to keeping Pham seeing the world in HD: Extra contact lenses. Solution. Hand sanitizer.
He also carries a small makeup mirror in his back pocket, including that of his uniform pants during games, in case something goes awry with a lens in the middle of an inning.
To reach this point, Pham threaded his way through 809 minor league games over 12 seasons (it took 2,338 minor league at-bats before he even got his first taste of the majors in 2014). He passed several crossroads that threatened the end of his career, from eyesight issues to assorted injuries to a sometimes bumpy minor league apprenticeship. Along the way, he acquired more knowledge than he ever knew existed about the wonders of the human eye.
He wishes he would have played winter ball following the 2008 season because he had no idea how difficult it would be to go from wearing no lenses straight to gas permeable, hard lenses. There were times when he wondered if his uncomfortable eyes would ever lose their redness.
"Now, I'm used to them," he says. "Then, whew!"
The production of each pair of his contact lens requires a corneal topography machine, which makes a map of his eyes, tracing the surface of the cornea to get the most snug fit.
Sometimes, the slightest of tweaks throw him off. Someone recommended a new soft lens in 2016, just as he had his best chance with the Cardinals: For the first time in his career, he broke camp on the Opening Day roster. He had eye molds taken for the perfect fit.
While Pham saw better than ever, a thin film of fluid was required between his eyes and lenses, and when he ran, it would cause the lenses to jiggle in his eyes and blur his vision. Pham stuck with them longer than he should have, thinking maybe it would simply take an extra couple of weeks to get accustomed to them. Over 78 games with the Cardinals in '16, he hit .226 with nine homers and 17 RBI.
During that year's All-Star break, Pham returned to Iowa, this time riding shotgun. At the wheel of the car was Bennett, and their destination was the University of Iowa for a consultation with the inventor of that particular soft lens—one that, ultimately, didn't end up working for him.
"During the trip, we talked books—all he reads is self-improvement books—and I said I do this StrengthsQuest exercise with my students," Bennett says of the online drill designed to help students discover and help develop their natural talents. "I'm not even done telling him that, and he pulls his StrengthsQuest results out of his backpack.
"I'm thinking, man, if that doesn't totally define Tommy Pham. He has a very bright, tremendous mental approach to the game. He is very intelligent. I don't know if he has a Ph.D. in life, but he's had to overcome so many challenges. He's always thinking."
Pham's biological father is in prison in Maryland, having been incarcerated for most of his life because of drugs and violence. He's close with his mother, stepfather and two sisters, but the last time he visited his father in prison was a decade ago, when he was 18 or 19.
"I'm grown now," Pham told his father. "You were never there. This relationship is over. Don't call me."
"I haven't talked to him in 10, 11 years," Pham says. "He's called, and I decline all calls. He's just another person.
"It happens to a lot of people. I'm not the only one. I'm good now. I can't complain."
He is here in Los Angeles on this January weekend for a few days to sharpen his hitting with Robert Van Scoyoc and Craig Wallenbrock, a couple of local hitting gurus who have worked with J.D. Martinez, Yoenis Cespedes and Paul Goldschmidt. What he learned is that his back—right—elbow must lead his hands on a path to the ball. His elbow must come through first and his hands second.
In a few days, he will fly to Ocala, Florida, to work on his speed at the Innovative Athletic Performance Institute.
"I really want to be the best me," he says simply.
All of it, though, revolves around his eyes. Annually, he visits Boxer Wachler in Los Angeles to ensure all is good. He's an ambassador for the National Keratoconus Foundation and likely will speak to a group in late July in Chicago when the Cardinals play the Cubs.
"I think the word 'perseverance' is sometimes overused in sport, but in this particular case it fits him perfectly," Mozeliak says. "Here's a young man that literally so many times was counted out."
Aside from eyesight issues, he's suffered significant hand, shoulder, quad and oblique injuries over the years too. But every time the Cardinals considered giving up on Pham, John Vuch, the club's director of baseball administration, would hold his hand up and say no, don't do that. The admiration in Mozeliak's voice is evident as he tells the story.
As for Pham, just two weeks ago, he finally brought himself to dispose of the cutting-edge lenses he experimented with in 2016. Even though they became useless to him, they cost $11,500.
He gulped big when tossing them, but it's the only way Pham knows: He must live his life looking forward, always.
Scott Miller covers Major League Baseball as a national columnist for Bleacher Report. Follow Scott on Twitter and talk baseball.