Facies

I (W. Wertelecki, M.D.) see a face that is a facies because it “speaks” to me. Such reaction implies that I think I see a message (signal). Interpretations of signs as signals are hypothetical. Medical prudence also speaks of “caviat … caviat” – mistakes of judgement loom large. Clinicians pride in their skills is an enemy of “caviat” and should be tamed. This is particularly important in the current context, because the signs I see (pointed forehead often associated with microcephaly; a short nose resulting in quite visible nasal openings (nostrils); and a flat upper lip (lack of philtrum) suggest  to me that these concurrent signs may be due to teratogenic impacts of alcohol. Should I say so to the mother who may not be a consumer of alcohol, it would represent a serious mistake – “caviat … caviat” suggests that instead I could strive to gain the confidence of the mother and others to jointly explore not only alcohol but other known teratogenic factors to establish a firm basis for a diagnosis, treatment and prevention of recurrence.

Please, see a series of modules on the subject.