Photos courtesy of Michael Pimentel

William Copeland, who swam at Rockbridge County before attending Cal, will swim in NCAAs.

Unlike some of the people who undergo surgery for Pectus Excavatum, William Copeland wasn't obsessed with his appearance.

Maybe Copeland does like the look of his rebuilt chest, but his surgery was purely competition-motivated.

Copeland, a 2004 Rockbridge County High School graduate, enters the Division I men's swimming and diving championships this weekend as the No. 2 seed in the 50- and 100-yard freestyle events.

A University of California senior, he also has realistic Olympic hopes less than a year after a team of pediatric physicians cracked open his chest and inserted a steel bar.

Pectus Excavatum is the clinical name for a sunken chest. It is a defect that pulls the breastbone inward and affects one in 800 children in the United States and is three times more common in boys than girls.

"I remember looking it up when he was in middle school and, boy, it looked like such an invasive procedure to correct it," said Copeland's father, David, a physician with ties to athletic programs at VMI and Washington and Lee.

"It's a pretty common condition. Most people just live with it. It doesn't bother them that much. You know how you are as a dad. He's your boy. You don't notice what he looks like, but, as he got older, it became more pronounced."

After an outstanding sophomore season, Copeland hit a plateau in 2007 and even stopped wearing the full body suit that is designed to make sprinters feel more dynamic.

"He commented that, because of the way his chest was formed, that the water was coming underneath the suit and was almost slowing him down," the older Copeland said.

"So, I did some research on Pectus Excavatum and found that, in a severe case, the sternum can press against the heart."

He also learned that corrective surgery was available through Children's Hospital of the King's Daughters in Norfolk, which featured a procedure developed by Dr. Donald Nuss and his partners.

"I communicated with them and they said, 'Yeah, you can have the procedure done, but you have to go through these tests to see if your son has a severe enough case," Copeland's dad said.

A CAT scan revealed that the back of the breastbone was pushing against Copeland's heart to such a great extent that the heart was oval-shaped instead of round.

"It's not something that would be fatal," Dr. Copeland said. "If he were not a college athlete, aside from the cosmetics, it wouldn't have bothered him. He's very competitive. He was in favor of it from the start, but he told the doctors, 'This can't interfere with my swimming.' "

A surgical team headed by Dr. Ann Kuhn cracked all of Copeland's ribs and inserted the steel bar, which served to propel the chest away from the heart.

Copeland was in such discomfort over a two-month recovery period that he could not raise up in bed and would use a cellphone to summon one of his parents to assist him.

He eventually started working out with his old Rockbridge County coach, Leslie Ayers, and within a short time was up to 5,000 yards per day.

"I didn't come from a big-time swimming program, obviously," Copeland said.

"I was always better at sprinting, at least compared to my competitors, but once I got to the 200-yard range, I would start to fall off. I could never keep up with the other guys in the longer, aerobic stuff."

Dr. Kuhn said there are records of 1,200 operations for Pectus Excavatum in the CHKD database, 100 of which she has performed personally. She said she has never operated on an athlete with Copeland's credentials.

"Kids are told by their pediatricians or family doctors that, 'Hey, this is just cosmetic; it doesn't affect you,' " Dr. Kuhn said. "Unfortunately, that attitude is still prevalent because you used to have to crack the chest open and break the sternum. Now, with this minimally invasive technique, it's much easier to fix."

Some of Copeland's contemporaries might not have known that he had a sunken chest because he would invariably cross his arms in front of his body, a fairly common trait for people with that defect.

"Some kids can almost get suicidal because they're so unhappy with the way they look," Kuhn said.

"They get very depressed, they won't take their shirt off in public. They become very introverted. [The surgery] really helps them to become more confident."

Copeland's father said that just a 5-percent improvement in his hemodynamics has helped turn William from a nice college swimmer into a world-class athlete. He was seeded seventh before winning the 50 and 100 freestyle events at the Pac-10 championships.

"I'm having kind of the dream season," Copeland said. "Part of it is, we got a new coach with a different philosophy, but to drop that much time when I'm not even fully rested, I'd have to say that I'm in a really good spot."