CINCINNATI - Nothing Tommy Joseph did during his first big-league opening day Monday afternoon at Great American Ballpark was particularly extraordinary. On his way to an 0-for-4 season debut, the Phillies first baseman struck out twice and left three runners stranded on base, including two in scoring position.

The one bright moment came in the bottom of the seventh on the defensive side. After reliever Edubray Ramos walked the leadoff hitter with the Phillies holding a 4-1 lead, Joseph gloved a scorching line drive off the bat of pinch-hitter Scooter Gennett and quickly gathered himself to tag out Tucker Barnhart for a double play. The DP became even more significant when Billy Hamilton followed with a triple in a game the Phillies won, 4-3.

That play, however, did not make any highlight reels. Nothing short of four home runs could have eclipsed the most remarkable thing of all about Joseph's first opening day in the big leagues anyway. The best part of his story is that he was there at all after the odds against him had become so stacked.

Five concussions and the diagnosis of a severe vision ailment that took intense therapy to correct forced the Phillies to remove Joseph from their 40-man roster after the 2015 season. The onetime top catching prospect was moving to first base and into an uncertain future.

"It was a difficult decision," said Joe Jordan, the Phillies' director of player development. "You're trying to balance the human side with the business side. We weren't kicking him to the curb. We were just changing his roster status. It was a tough deal because we all care about him and there's obviously an investment on the personal side."

The fifth concussion of Joseph's career, which occurred after he took a foul tip off his mask in a May 11, 2015, game with triple-A Lehigh Valley, simultaneously threatened and saved Joseph's career. Jordan was convinced a position change would be required at the very least. Doctors, meanwhile, delved deeper into Joseph's concussion-filled past and discovered they could save his future.

A CSNPhilly.com story last July detailed how Robert Franks, a concussion specialist at the Rothman Institute, discovered that the several brain injuries had disrupted Joseph's normal eye movement. With rehab assistance from Michael Gallaway, a vision specialist in Marlton, and Joe Rauch, the trainer who oversees rehab assignments at the Phillies' spring-training facility in Clearwater, Fla., Joseph started the long road back.

Joseph had a successful rookie season last year, hitting 21 home runs and posting an .813 OPS. No hitter in baseball had more home runs in fewer plate appearances (347).

"Credit to Tommy," Jordan said. "Of course we had a concern for him and his health, but the reality is this: we have 150-plus players playing every day in our system . . . and at some point in time [rehab] becomes a really lonely deal. The rehab staff and the medical staff did a great job of keeping this guy sane and he's the one who found the strength to do it."

Help also came from his fiancee, Ali, whom he married last year at the all-star break. The onetime star high school soccer player became his primary source of mental support even as she worked as a delivery nurse for the Air Force in the Florida panhandle. Ali was not in attendance when Joseph made his big-league debut May 13 of last season against the Reds at Citizens Bank Park, but she did see his first hit and first home run and now she has seen her husband play on opening day.

That's quite amazing considering that Joseph had played in only 121 games since 2013 before last year. But he was a quick study at first base and, with his improved eyesight, he got off to a white-hot start with Lehigh Valley to push his way past Darin Ruf on the depth chart. Even while sharing the first-base job with Ryan Howard, he still played in a career-high 134 games.

Now, manager Pete Mackanin says Joseph can hit 30 home runs and drive in between 80 and 100 runs this season.

"I think he's going to do something like that," Mackanin said.

Joseph's primary goal for this season is far more narrow but hardly simple.

" A healthy one," he said. "One where I'm able to play 162 games. That is obviously the most important thing. The hardest thing to do in baseball is stay focused and be healthy for 162 games."

For so long that seemed like an impossible dream for Tommy Joseph, but now his improbable rise to the big leagues seems to have endless possibilities.

bbrookover@phillynews.com

@brookob