Delhi<\/a>, he chose to return to Kochi where he works at the Rajagiri Hospital so that he can save ordinary lives from what is becoming the top 10 causes of death nationwide \u2014 liver disease. Yet it is silent and very few understand it. \u201cThere is a huge challenge in medicine and healthcare today, both for doctors and patients. I call it the loss of the true heart of medicine, which is humanism. The heart of medicine is empathy, and that is what medical training is actually supposed to offer. Now medicine is mostly business. I want to teach people how to live life,\u201d he says.<\/p>\nWhat modern medicine should be<\/p>\n
With the burden of healthcare being shouldered by the private sector rather than the public sector and patients feeling like commodities, Dr Philips says he wants to reclaim that space where medicine feels the way it is supposed to feel \u2014 deeply caring, empathetic and compassionate. \u201cThere are very few diseases that doctors can truly cure. Infections are one example because we have antimicrobials. But beyond that, what can we cure completely? Most diseases we can only reverse, slow down, halt, manage, or improve life expectancy for. That is where the true practice of medicine shines. Treating a patient is not just diagnosing and prescribing medicines. It is about going on a journey with them. In my field, chronic liver disease patients stay with you for years \u2014 sometimes for life, until they die or undergo liver transplantation,\u201d he says.<\/p>\n
The second reason for writing was personal. \u201cThe book became a way of decompressing emotionally. As a doctor, one of the hardest things is understanding limits. Patients come with expectations, but there are limits to what medicine can do. Sometimes you know the patient is not going to survive. First, you have to accept that yourself, and then you have to help the patient and family accept it too. That is how clinical medicine works for many diseases. For me, this book became a way to depersonalize all those emotions I had internalised over the years,\u201d says Dr Philips.<\/p>\n
Why does the liver seem fickle?<\/p>\n
Is sudden deterioration something unique to the liver? Someone can seem perfectly healthy and yet collapse suddenly. \u201cThis is what we call acute liver failure \u2014 where a perfectly healthy person suddenly develops severe liver failure and may even require ventilation support. Because the liver is the most resilient organ, has huge functional reserves or backup tissue and masks early distress, a person seems healthy until vital functions \u2014 detoxification and blood clotting \u2014 collapse, triggering sudden, life-threatening complications. This is triggered by sudden, severe damage rather than long-term wear and tear as a result of drug toxicity, viral infections and autoimmune disorders,\u201d says Dr Philips.<\/p>\n
The second is acute-on-chronic liver failure, where someone already has chronic liver disease or cirrhosis (scarred liver because of hepatitis or alcohol use) and then suffers another injury or insult that pushes the liver into failure. \u201cThe first category of patients finds it harder to reconcile emotionally because they are otherwise healthy individuals who suddenly become critically ill,\u201d he adds.<\/p>\n
Story continues below this ad<\/p>\n
Which hepatitis virus is most harmful?<\/p>\n
Dr Philips sees a geographic pattern. \u201cIn north India, Hepatitis E is one of the commonest causes of acute liver failure followed by drug-induced liver injury. In south India, Hepatitis A is more common. Meanwhile, chronic viral hepatitis patterns differ geographically. Chronic Hepatitis B is very common in north India, whereas in Kerala, where I work, chronic Hepatitis B and C are less common,\u201d he says.<\/p>\n
Misinformation is bigger than the disease<\/p>\n
Many liver diseases are actually preventable which, Dr Philips believes, become serious because of misinformation and lack of awareness. That\u2019s because the liver is the only organ capable of regenerating itself and even a slight lifestyle modification in the early stages of damage \u2014 such as mild fatty liver or early-stage hepatitis \u2014 is enough. \u201cPeople think only alcoholics develop liver disease, but that is not true. I have seen patients who drank only socially or two to three times a week developing cirrhosis. That\u2019s because even a safe amount of alcohol can be an accelerator if liver disease runs in the family. And Indians are predisposed genetically,\u201d says Dr Philips.<\/p>\n
That\u2019s the reason why food and lifestyle matter too, topped with exercise. Dr Philips says that exercise doesn\u2019t mean signing up at a gym but 150 minutes of simple brisk walking, jogging, cycling or swimming a week. Obesity, diabetes, hypertension, hypothyroidism, and metabolic disorders increase liver risk too. \u201cSome factors are modifiable \u2014 sleep, exercise, diet, weight management. Genetics is not. If you control the modifiable factors, you reduce your risk significantly,\u201d says Dr Philips.<\/p>\n
Why LFT is more misleading than accurate<\/p>\n
He also warns against being content with just a Liver Function Test (LFT). \u201cIt is actually a misleading term. The liver has more than 500 functions and a LFT only provides limited information about inflammation or severe dysfunction. It does not measure liver performance. People need to pay attention to silent metabolic risk factors. Family history is extremely important because liver disease can skip generations. We have identified multiple families where cirrhosis appeared across generations due to genetic mutations combined with metabolic disorders. So, watch out for diabetes, obesity, hypertension, high cholesterol, high uric acid and thyroid disorders. If these are present, the minimum screening should include blood count, LFT and ultrasound. If platelets are low, LFT is abnormal, or ultrasound shows fatty liver, further evaluation is needed, including Fibroscan.\u201d<\/p>\n
Story continues below this ad<\/p>\n
Never ignore Hepatitis B and C<\/p>\n
Everyone should test for Hepatitis B and C at least once in their lifetime. North India has a high burden of chronic Hepatitis B. While Hepatitis B is preventable through vaccination, Hepatitis C is treatable with proper medications.<\/p>\n
Paracetamol vs drug-induced liver injury<\/p>\n
When it comes to drug-induced liver injury, Dr Philips cites several instances of paracetamol abuse. \u201cIt is actually one of the safest medicines available for pain and fever when used properly. Problems arise only when people take extremely large doses at one time \u2014 usually 8 to 10 grams or more \u2014 often in cases of poisoning or suicide attempts. That is how it damages the liver. In the UK, paracetamol overdose is one of the commonest reasons for liver transplantation. Sometimes parents accidentally overdose children because they panic when a fever doesn\u2019t come down,\u201d says Dr Philips.
For a healthy adult, a dose of about 4\u20136 grams per day for 3\u20134 days is generally safe. For someone with chronic liver disease, the intake should be around 2\u20133 grams per day for 3\u20134 days. \u201cMost people never come close to dangerous levels. A standard tablet is 500 mg. Even during a fever, most people only take four or five tablets a day, which is usually safe. The danger comes from consuming very large doses,\u201d he explains.<\/p>\n
Supplements and wellness culture<\/p>\n
Dr Philips admits to being at the receiving end of bullying, harassment, trolling and enormous pressure for upholding science and taking on unproven efficacies of herbal supplements and unregulated concoctions. \u201cI begin the book with the case of a woman who died after having unregulated protein powder supplements thinking they would supplement her diet. She was just caught unawares. Ever since blind faith in herbalists has been waning over the past five or six years because we now have data to prove everything. Data is the only way to fight belief systems. The challenge is that alternative medicine is tied to culture, religion, politics, and tradition. So, when you criticise it, people think you are attacking identity itself,\u201d says Dr Philips.<\/p>\n
He has often been asked that if modern drugs originate from plants and natural compounds, why criticise ayurveda? However, drug makers use scientific methods to isolate beneficial compounds, determine safe doses, study side effects and test efficacy rigorously. \u201cPeople lack critical thinking and some doctors do too. Critical thinking should be taught in schools and also be part of MBBS education. My biggest hurdle was not just fighting alternative medicine promoters, but dealing with members of my own profession who endorse it. Integrative medicine is just business, not patient care and functional medicine is nothing but sophisticated packaging of fringe medicine,\u201d he says.<\/p>\n
Story continues below this ad<\/p>\n
Dr Philips rates alcohol and alternative medicine as equal risks for liver health, the only difference being people know that alcohol is a known poison and carcinogen while supplements are marketed as beneficial, healthy, and natural \u2014 often without evidence. \u201cNowadays makers even quote very small studies which aren\u2019t even peer-reviewed. This false sense of safety is dangerous.\u201d<\/p>\n
From a liver toxicity perspective, he has seen abuse of ashwagandha, giloy and turmeric supplements. \u201cTurmeric in food is fine because absorption is naturally low. But the supplement industry modifies formulations using pepper extracts or nano-formulations to increase absorption dramatically \u2014 and that can become hepatotoxic. Italy has actually banned turmeric supplements because of liver injury cases,\u201d says Dr Philips. India\u2019s liver crisis is not merely about alcohol, Hepatitis or obesity but about a society increasingly vulnerable to misinformation, commercialised wellness and delayed diagnosis.<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cI remember every patient I have lost and I have always put myself in their position, swapped their…\n","protected":false},"author":3,"featured_media":820459,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_share_on_mastodon":"0"},"categories":[34],"tags":[337334,337338,337330,337337,53835,210,306150,337332,337335,2395,337333,337336,1060,337339,337331,67,132,68],"class_list":["post-820458","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-acute-liver-failure-vs-cirrhosis","tag-ayurveda-and-liver-health-debate","tag-dr-cyriac-abby-philips-the-liver-doc","tag-drug-induced-liver-injury-paracetamol","tag-fatty-liver","tag-health","tag-healthy-liver","tag-hepatologist-kerala-scientific-medicine","tag-hepatotoxicity-herbal-supplements","tag-liver","tag-liver-disease-symptoms-india","tag-liver-function-test-accuracy","tag-medication","tag-rajagiri-hospital-kochi-hepatology","tag-the-liver-doctor-book-2026","tag-united-states","tag-unitedstates","tag-us"],"share_on_mastodon":{"url":"","error":"Validation failed: Text character limit of 500 exceeded"},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/820458","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=820458"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/820458\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/820459"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=820458"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=820458"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=820458"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/06\/track_1x1.jpg\"){kind=spacer}
<\/p>\n