Luis NicaloskiPhysician
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Medicine, with time.
Genetics

What was already written

Knowing your genetics is not reading your fate. It is reading a map.

November 2026 · 4 min read
A lone tree on the horizon
Tree in winter. Photo: Jan Huber

“What you have inherited from your fathers, earn it, in order to possess it.”

Goethe, Faust

You inherited more than a surname.

You inherited the colour of your eyes and the shape of your hands, and with them, tendencies: a heart that asks for more attention after fifty, a metabolism that changes early, your own way of handling alcohol, coffee, certain medicines. Perhaps a mind that will age much like that of someone in your family.

For a long time this inheritance was a subject of conversation at the table. “In our family, everyone has high blood pressure.” “My father started forgetting things at seventy.” It was a vague knowledge, made of memories and some fear.

Today it is possible to read that inheritance directly. And the question almost everyone asks, sooner or later, is the same: is this my fate?

It is not.

Identical twins are the simplest proof. They are born with the same code, letter by letter. At seventy they often have very different health. One smoked and the other did not; one slept badly for decades and the other did not; one lived under constant strain and the other found some peace. The text was the same. The reading life made of it was not.

Aristotle separated what a thing is in potential from what it is in act. The acorn is an oak in potential; whether it becomes one depends on the soil, the water, the time. Genes are, to a large degree, potential. They say what may happen. What actually happens depends on how that potential meets a life.

Used well, genetics is not a sentence. It is a map. It shows where the ground is steepest; it does not say which way you will walk. But whoever knows the map chooses a better trail and knows which stretch to take slowly.

A map read well tends to change three things. The order of priorities: two people with the same routine tests may need to watch, one the heart, another metabolism, another memory, and earlier. The choice of medicines: some people process certain drugs too quickly, and they do not work, while others process them too slowly, and they accumulate. And the family: a finding in you is often valuable information for a sibling, a child, your parents. Genetics is the only part of medicine that is never entirely individual.

This calls for care. Genetic information changes how a person sees themselves, and sometimes how they see their parents and children. That is why the order matters: first the question, then the test, then a conversation about the result, with time. The decision to tell the family always belongs to the person who was tested. And testing a child for tendencies that will matter only in adult life takes away their right to decide, later, whether they want to know.

The value, however, is not in the test. A genetic report, on its own, is a list of probabilities: it can frighten without cause or reassure without reason. What gives it meaning is being read alongside your history, your tests and your way of living, and revisited when life changes. At forty the question is one thing; at sixty it is another. The map stays the same. The stretch of the path does not.

Goethe, who spent his life between poetry and science, wrote that what we inherit must be earned to be truly ours. So it is with genes. The inheritance is given. The care of it is not.

Some people prefer not to know, and that choice deserves respect. But for those who have spent their lives deciding with information, knowing one’s inheritance usually brings less fear and more freedom. What has no name frightens more than what has one.

You did not choose what you inherited. You choose, every day, what to do with it, and what you will leave.

Luis Nicaloski · Physician