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been to a foreign country, no family history of liver disease or cancer, never been treated for diabetes, and no immune condition like lupus.
• Her husband had worked with farm chemicals and insecticides, and although they worked together sometimes moving cattle or with fieldwork during harvest time, her jobs mostly involved outside dealing with chickens and inside preparing for meals, without much exposure to chemicals.  In short, she gave no clue to anything, which may cause inflamed liver or "hepatitis."
• We admitted her to the hospital where we obtained blood tests, imaging tests, a liver biopsy, all the while monitoring her carefully especially for bleeding problems. The biopsy report described fulminant or raging hepatitis, the viral test was positive for cytomegalovirus or CMV, and everything else was negative. We then discussed her case at length with the infectious disease and liver specialists by phone, and kept her in our hospital as we were advised there was no advantage gained by referral to a larger hospital.
• Despite following every recommendation of the experts and the textbooks, we observed how our patient's liver function continued to deteriorate. Over the next week and a half she slipped away from our grasp and died in a coma, surrounded by her children and their families. This was some twenty years ago and it taught me how our lives truly depend on a functioning liver.
• But I still wonder about the case. Why did this common virus found in 80 percent of the adult population kill her? What could I have done differently to save this lovely lady?
• Despite all the gathered knowledge available to physicians, sometimes we are

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