Most people with CF know their lungs better than anyone. But the liver? It’s rarely front and center. In this episode, Ahmet, Lauren and Andrea talk all things liver with Dr. Jay Freeman, a hepatologist at Nationwide Children’s Hospital and a leader in the GI and liver complications of children and adults with cystic fibrosis. Joining that conversation is Sarah Richards— who received a double lung and liver transplant at Duke—to talk about one of CF’s most overlooked complications: liver and biliary disease.

Sarah shares what it’s like to live through end-stage liver failure and come out the other side, while Jay explains how CFTR affects the liver and what screening for liver and biliary disease looks like—as well as early warning signs for people with CF.

We cover scoring systems, swollen bellies, ultrasound screening, and we search for answers beyond “bad luck” as the best explanation medicine has to offer.

Also tucked into the episode: a spirited debate over sandwich geometry, Batman, and a karaoke moment of brilliance.