Thankful for what we have

Brushfield spots. If you don't know what they are, look it up.

General practice certainly is a different kind of work to hospital medicine. The community comes to you with their health concerns. For certain, some people are unwell. Some need antibiotics, most don't. Most are happy just to be checked over and reassured. In hospital, you order every conceivable test in the hope that something rare will show up so you can impress your boss. In general practice, you avoid ordering unnecessary tests in case something shows up that wasn't clinically related to the patient.

You have to bear in mind that if you're born and raised in the UK and have a moderate income, you're probably part of the healthiest 0.1% in the world. Dr Genesis considers himself part of the most privileged 0.1% in the world: very healthy, intelligent, financially pretty well off and the proud owner of a happy and loving family. But then again, Dr Genesis has a huge ego. He has nurtured it carefully since attending an expensive secondary school.

Every now and then something happens in GP which makes Dr Genesis glad he is in his job. Just the other day a busy mum of 2 came in for a relatively minor enquiry. Her young baby looked a bit odd. Cute, but odd. He had Down's syndrome. Mum was quite happy to talk about it. She had used IVF, and was told her risk of Down's syndrome was "moderate" (less likely than 1 in 800) and didn't proceed to amniocentesis wisely enough. She still had her little bundle of joy and thankfully baby didn't have any major cardiac abnormalities. She pointed out to me the baby's Brushfield spots, wide gap between big toe and second toe, and prominent medial epicanthal folds.

What a cutie.