At the Children's Hospital of Colorado's Precision Diagnostics Laboratory, I am grateful to be using my expertise as a trained physician and board-certified molecular geneticist to serve our youngest and most vulnerable patients with rare inherited disorders. The intent of my pursuit is to leverage large scale genomic testing strategies to gain insight into rare disease origin, mechanism, evolution, and cure. To achieve this goal, genomic testing should be more accessible, applied earlier in life, be amenable to portability with phenotype evolution, and genetic data stored and stewarded toward ethically acceptable use. I value a collaborative culture that combines unique perspectives with an overarching patient-first approach.