Thank you and Farewell

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It’s been 40 years since I started medical school and 13 years since I was fortunate enough to become Editor-in-Chief of Genetics in Medicine. Both medicine and GIM have taught me many things, including the indispensable importance of team work. Doing almost anything worthwhile in this life means relying on others. A journal like ours is an effort in the service of a community that includes medical geneticists, laboratory geneticists, genetic counselors, clinicians from an increasingly broad range of specialties, and most importantly, patients. Many are responsible for the success the journal has enjoyed, including expert Section Editors and myriad reviewers who have painstakingly adjudicated the work of colleagues, collaborators, competitors, and frenemies. Any success of GIM is in no small part due to Jan Higgins. Her diligence, care, and expertise have been indispensable—all delivered with wry (and sometimes withering) Scottish wit. Katie Murphy and Kathy Moran have dragged the journal (and me) into the age of social media and it’s been a privilege to serve on the American College of Medical Genetics and Genomics Board, witnessing a long series of dedicated individuals guide our growing organization. Finally, GIM’s readers and authors are the most important members of the team, indeed the very reason it exists. My most difficult job as Editor was saying no—and with our success came the need for a burgeoning number of rejections. Please know that I never rejected a submission without painfully visualizing the author as a real person on the other side of the manuscript, who took time and effort to pursue an interest and submit their work in hopes of saying something worthwhile to the GIM community. Disappointing them was always difficult and I hope every manuscript we rejected found a good home in the medical literature.

Besides tangible success, teamwork also leads to deep satisfaction and fun. I learned many years ago that while I truly love science (I still get a warm fuzzy feeling when I see the Periodic Table), it is the human relationships forged along the way that are most important. I will miss my more-than-daily interactions with staff, authors, Section Editors, reviewers, and colleagues. But it’s time to move on! For 40 years I’ve gone “deep,” learning as much as I can about medicine and genetics. Now it’s time to go broad—it’s a vast world out there, full of things (believe it or not!) as fascinating as genetics and medicine. And another grim—but ultimately liberating—lesson that our profession relentlessly teaches us is that life is short, fragile, and unpredictable. I have the opportunity to explore this world while healthy (with Joan Evans, the love of my life, no less!); wisdom dictates I avail myself of that opportunity before it’s no longer on offer.

I see great things for our field. We are increasingly relevant to the broad practice of medicine, we have developed stunningly sophisticated diagnostic tools, and I hope that relatively soon treatment may rival diagnosis as our forte. But I (predictably) have a few parting words of advice. Promises of medical genetics “revolutionizing all of medicine” have been vastly premature and transparently silly for decades, now having reached their apotheosis in ill-considered advocacy for exome or genome sequencing in healthy individuals as part of routine clinical care. Seeking vast amounts of poorly understood information in patients is bad medicine. Period. We must be guided by solid evidence of benefit, not wishful thinking. So insist on (better yet, generate) rigorous evidence of tangible benefit to health before advocating (or selling) wide implementation of any given test or therapy. Medicine faces a significant challenge in that we are highly reliant on technology that has been developed by market forces. But once marvelous technologies have been developed, the pursuit of profit must not rule their implementation. There’s nothing market forces want more than wide deployment of any technology that generates profit—but implementation must be guided by meaningful benefits to health. We aren’t in the business of selling widgets or consumer electronics, we serve patients and the broader population.

I’ll now climb off (this particular) soapbox and put a permanent “out of office” message on my work email account. You are in wonderful hands as Bob Steiner takes over as Editor and a host of young colleagues take medical genetics into a bright future. I look forward to watching from afar as GIM and our field reach new heights. I will think of you often, I will miss you all, and I hope to carry the many important lessons I’ve learned during my tenure as Editor-in-Chief into the next exciting phase of my life. Please accept my sincere and heartfelt thanks for the inestimable privilege and honor of having been allowed to help guide GIM for these past years.