Short abstract:

Liver disease is typically understood as a problem of an organ but attending to mundane practices highlights the importance of fluids. Fore-fronting fluids and fluidity reconfigures liver disease and its care, moving away from biomedical values and allowing what is neglected to become evident.

Long abstract:

Liver disease is typically understood as a problem of an organ, but a focus on everyday practices and concerns points us towards considering liver disease through a problem of fluids. Liver disease can disrupt usual blood flow and cause bleeds, and blood content is a key aspect of the gut:liver axis. For patients with severe disease, particularly those towards the end of life, fluid build-up in the abdomen can severely impact daily life and has the potential to become infected. Regular draining is necessary but not always easily available. Instead of exploring liver disease through a focus on a discrete organ and the highly charismatic process of liver transplantation, fore-fronting fluids allows another way into the disease, its relationality, and situatedness. Fluids are often neglected in the body, seen as ‘of the body’ rather than an intrinsic element. Attending to fluids shifts the usual hierarchy of biomedical framings, allowing what may be neglected to become more evident and raising consideration as to how (else) we might care (Puig de la Bellcasa, 2011). We are also moved away from understanding the body as static and bounded into working with movement, flow, and fluidity. These are, I suggest, more generative ways of situating liver disease in relation to its development, progression, and care, and to more recent developments in biomedical understandings and interventions around liver disease. Following what is for biomedicine a mundane focus on fluids, I explore these ideas drawing on my ethnographic fieldwork in specialist liver units.