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I have to get a new goat

There are so many things about the way we deal with health in general and liver disease specifically that get my goat that the poor thing has the blind staggers from all of the abuse.


Our society has become a case study in death by excess.  We have too much food, too much leisure, too much convenience, too much marketing, too much image manipulation, too much feckless government, too much misinformation, too much profiteering.  I should stop as I've probably already said too much.

Our focus here may seem too limited to justify sweeping comments like this.  It paints me as a wild eyed crazy man for some. In my defense, my perspective comes from the very un-glamorous view from the liver.  Since there have been no treatments for the most common cause of liver failure and death, the glamor diseases like diabetes, heart failure, cancer, various genetic problems, and so on get the attention.  The problem, in its simplest form is that the liver is like an abused but uncomplaining spouse who lives under constant threat but perseveres in silence.  Our body is bio-chemically very complex and could not exist without the quiet workhorse that is the liver going about its 500 or more jobs.

Think of that.  A liver cell that is about one fifth as wide as a human hair is constantly involved directly or indirectly in 500 different functions and you will suffer some health consequence if any of them are not done.  This also explains why we have no treatments.  It is so complex that we simply have not had the ability to act against a problem without doing harm somewhere else. I'll expand on this in a future article but for now just keep it in mind as you think about liver disease.

I'm optimistic that a new goat will have a better chance.  There is a tremendous pressure for more and better patient advocacy and it is happening when medicine is simply exploding with innovation and discovery.  We have a vast array of current problems to deal with but I am convinced that we are on the brink of a golden age for medicine and patients.  Our biggest challenge will be taking what we know and delivering it in a useful way to the population as a whole.  A key to that will be patients who are engaged in their own care and who actively participate as their own advocates.  It will not always be pretty but the future is bright in spite of the great confusion within the government right how.