• Despite all the gathered knowledge available to physicians, sometimes we are helpless.
• She was in her mid-80s, a normal-sized classy-dressed lady, who walked into my office with yellow eyes. She stated her urine had turned dark and the stool turned light about a week ago, was feeling "ishy" now for a couple of weeks, and had lost five or ten pounds over the last month. She noted her belly was bloated, her skin was itching, and her get-up-and-go had got-up-and-gone.
• My patient reminded me she was a farm-wife who, after her husband's death, moved to town and lived in an apartment alone, although kids lived nearby. She had lead a careful life without exposure to excessive alcohol or drugs, was only taking a multiple vitamin, no herbal supplements, and had only one lifetime sexual partner. She had never received a transfusion, never

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