The Silent Liver

The liver is the largest organ occupying the most extensive territory in the human abdominal cavity. Without any particular pathological factors, the liver generally maintains about 1.5 to 2 percent of one's body weight. Given its overwhelming size and its responsibility for over 500 complex chemical reactions and metabolic processes, it is undoubtedly the eldest among the organs that constitute our body.

What does it mean to be the eldest? Unlike today, when a single child is precious, if we rewind the clock one generation, the eldest child was a common sight in every household. In those days, the firstborns lived with responsibility and burden engraved in their hearts as synonyms, navigating the complex and subtle dynamics within the family. They endured in silence, again and again—for the well-being of the family and for a better future.

When body weight begins to exceed the appropriate range, the liver quietly stores excess nutrients as fat within liver cells, unbeknownst to its owner. Since fat has a relatively low density, the liver becomes far more enlarged than its weight would suggest. We often say someone has "a big liver" to describe a reckless person, but in reality, a liver enlarged this way barely feels pain from ordinary stimuli. It is a stubborn patience that sends no signals even as it destroys itself through enlargement—this is why we call the liver "the silent organ."

Most chronic liver diseases we know of have no noticeable symptoms. Only when the thin membrane surrounding the liver temporarily expands does one feel pain inside the right ribcage. The liver silently endures disease, revealing its accumulated wounds only when it reaches a critical point where it can no longer maintain function—through ascites, hepatic encephalopathy, or vomiting blood. After all those years of silent endurance, it announces its functional failure only when it finally collapses.

This is precisely why those with risk factors for liver disease must undergo checkups every six months. By the time symptoms appear, it is often too late to reverse the damage. The liver strives not to burden other organs to the point of appearing foolish and slow-witted, and only when it reaches a state of near-fatal exhaustion does it finally reveal its pain.

As a surgeon who operates on livers, I find the liver's silence—listening to other organs' suffering while remaining reticent about its own—both pitiful and frustrating. History has already taught us painfully well how silence that leads to indifference leaves behind ills in our society. As German theologian Martin Niemöller said during the Nazi era, the price of silence is unforgivably harsh.

Our society has protected the values of democracy through the active choice of raising voices in public squares, learning from the consequences of past silence. This logic applies to personal relationships as well. The movie "Architecture 101" was so poignant because its inexpressibly reticent protagonist remained silent until the end, leaving his first love as an incomplete period called unrequited love. Silence is that harmful.

Nevertheless, there are still moments when the old saying "silence is golden" remains valid. We must keep this maxim in mind when sitting face-to-face with family and relatives during the Lunar New Year holiday. Have you been digging into personal matters you're not even curious about, despite not even bothering to check in regularly? If you want to avoid the mistake of picking apart every answer with trivial advice and wounding someone's heart, silence is indeed golden. This Lunar New Year, let us offer warm gazes instead of interference disguised as affection. It is enough to raise our voices only when cheering for the athletes displaying their fighting spirit at the Winter Olympics.