How a Health Scare Led Me to Love My Liver

I thought veganism would save me from following in my father’s footsteps—I was wrong

Writer Shawna Kenney had been a vegan for decades when she was diagnosed with fatty liver disease.

I sat in a Beverly Hills doctor’s office, across the heavy wooden desk of a hepatologist, stunned by the words leaving his mouth. He was handsome, with olive skin and an array of framed degrees hanging behind his salt-and-peppered head of hair. After blood tests revealing elevated liver enzymes, an ultrasound and a Fibroscan, he spoke words I never thought I would hear: “You have Stage 1 fatty liver disease.” I was 49—a bike-riding and yoga-loving vegan who had never done recreational drugs and had not had alcohol since my early twenties.

My father had died ten years earlier of something similar—nonalcoholic steatohepatitis (NASH), a condition he didn’t know he had, but he’d been a heavy smoker until his heart attack in his forties, as well as a meat eater with a beer belly and all the stresses that I imagine came with raising two kids on his limited income and education. He suffered a myriad of health problems I never had—diabetes, heart disease, psoriasis. When my mom, sister, and I urged him to eat better, he would point to an iceberg lettuce salad topped with shrimp or fried chicken, drowning in ranch dressing, proud that his choice was no longer what he called his “Big Mac attack” of the old days.

As I contemplated my new diagnosis, I flashed back to my father’s pill box full of nine medications per day, his complaints of their side effects, and the slow death he endured over a week, intubated in the Georgetown University ICU where there had briefly been talk of a liver transplant—possibly using a piece of mine—until each of his organs gave out.

I asked the doctor what came next for me. “Statins are safe. All of my patients are on them,” he said.

“For how long?” I asked.

He shrugged and looked at me incredulously. “Until they find a cure,” he said. My heart fell, then he added, “I mean, it’s reversible at this stage, but most people won’t do that.”

“Try me,” I said, sharing my father’s medical history and cause of death. I expressed my hesitancy to rush to medication.

“You can try diet, exercise,” he said, closing his folder and heading out the door without eye contact. “I’ll give you six months to see what you can do. Come back and we’ll do another scan. If you can’t reverse it, we’ll have to do statins. The nurse will give you some literature.”

I left this doctor’s office, walking through his waiting room full of an ethnically diverse bunch of people mostly twenty years older than me. I gripped a three-page printout explaining fatty liver disease and offering a list of foods supposedly good for the liver: cheese, meats, fish—things I had not eaten in decades and wouldn’t be eating ever again. I felt helpless and scared, wondering if this was just my genetic destiny.

I had always been curvy yet had never been labeled as overweight by my BMI. But as a Gen X woman who came of age in the skinny-worshipping 1980s, I certainly knew how to lose weight the unhealthy way. Slimfast, the misfortunately-named Ayds diet pills, Jazzercise, the cottage cheese and grapefruit diet, meals of Diet Mountain Dew, repeated use of Cindy Crawford Workout VHS tapes, and briefly, bulimia.

I was very unkind to my body back then, but I assumed that mindset was well behind me. I had stopped eating animal products in 1989 out of compassion for animals and in protest of factory farming. At the same time, I thought this new way of eating was good for my body. I spent a good part of my twenties and thirties learning to undo media-driven body ideals. Punk rock, feminism, and therapy freed me from disordered thinking, while finding exercise I loved turned me from the asthmatic kid who couldn’t run into a yogi who did daily handstands for fun.

I married a man who was an active, food-loving vegan, too—someone who never struggled with weight himself and who has always loved me as I am. We both wondered about this new diagnosis, questioning whether losing weight would really solve my issue. And if so, could I do so without buying into diet culture, which had potentially hurt and killed just as many people as liver disease?

Research led me to learn more about the liver, the organ to which Nobel Prize-winning poet Pablo Neruda wrote an ode, addressing it as “Modest, organized friend, underground worker…” In Greek mythology, Prometheus was punished for stealing fire from the gods by being chained to a rock, where each day an eagle came to eat his liver, which would regenerate daily, perpetuating the punishment. A Persian friend told me that to say “jeegaré man-ee” in Farsi roughly translates to you are my liver, a deep expression of affection. Then a traditional Chinese medicine doctor told me the liver holds our anger, stating that mine was “hot,” then prescribed some herbal tea. It looked like a pile of leaves and tasted like bile, but I gave it a shot for a couple of weeks.

What I learned was that being vegan wasn’t enough to combat my liver problems. I had to cut processed food out of my diet, now eating for my life. I had once enjoyed all the new plant-based products coming onto the market, and by my forties, maybe I’d enjoyed them a little too much. Just as foie gras (French for “fatty liver”) is produced by overfeeding ducks and geese for the harvesting of their innards, humans, it turns out—even vegan ones—can do the same to ourselves.

Eating plants wasn’t a new thing for me but giving up mock meats, chips, and vegan ice cream seemed a small sacrifice to avoid medication. I shunned all cooking oils—yes, even “the good ones”—learning to read packages more closely, finding they made their way into unexpected places like plant milks and dried fruits. My husband was on board, happy to jump in to help with the cooking, though also enjoying cookies and my other off-limits foods while at work during the day, far from me.

I learned I was far from alone in this health crisis. The American Liver Foundation calls fatty liver disease a silent killer, estimating at least one in three adults in the U.S. have it, many who are as unaware as I was, with NAFLD (non-alcoholic fatty liver disease) affecting up to one billion worldwide and being the most common form of the disease in children. It’s increasingly common around the world thanks to the exportation of the Western diet via fast-food outlets. There is no cure once it reaches later stages but in early stages, like mine, it can be reversed.

By the time I went back to get my labs done six months later, the COVID pandemic had the country on lockdown. While my bloodwork showed the normal AST and ALT enzyme levels of a healthy liver, the hepatologist said we couldn’t be sure of the absence of disease until another scan could be done.

I returned to his office in February 2022. When the nurse weighed me, I didn’t look at the scale, but she asked if I knew I had lost fourteen pounds. I said I knew I had slimmed down, but I didn’t care about that particular number right now.

I laid on the table and lifted my shirt for the doctor to move the Fibroscan under my right ribs and around the area of my liver. He left and I waited in his office, where he returned within minutes to declare, “Your liver is normal sized!” He went over my numbers with me, showing me the earlier “liver stiffness score” versus the new one. I don’t think he noticed the tears in my eyes.

He said I could come back annually to check on things if I wanted to or he could discharge me with “No Return.” I chose the latter. I eat whole, unprocessed foods now, with a focus on nutrition and caloric density, determined to avoid the fate of my father.

I don’t have the sexy “before and after” pictures of reality-TV-style transformations. I look pretty much the same as I always have. But I have my health, along with a newfound appreciation for this organ, this filter of the body with the capacity to heal after all the damage I’ve inflicted upon it. I have peace of mind, something as invisible in photos as the liver itself.

I only wish I could have saved my father, though even if given the information I have now, it’s unlikely he would have used it. As he often liked to say: “We all have to go someday.” That’s true. There will come a time when I can’t outdance death, but I will do my best to make that later rather than sooner.

Until then, on some mornings in bed, just before I rise, I place my hand beneath my right rib, in a gesture of gratitude, citing the end of Neruda’s poem “Ode to the Liver:”

I love life: Do not betray me! Work on!

Do not arrest my song.

Shawna Kenney is the author of the award-winning memoir I Was a Teenage Dominatrix (Punk Hostage Press), co-author of the oral history Live at the Safari Club: A History of harDCore Punk in the Nation’s Capital 1988–1998 (Rare Bird Books), editor of the anthology Book Lovers (Seal Press) and co-author of Imposters (Mark Batty Publisher). Shawna is a contributing editor at Narratively Magazine while her nonfiction work has appeared in The New York Times, Playboy, Ms., Brevity, Vice, Pitchfork and many other outlets. She hosts Hamlet's Hideaway, an annual writing retreat in Denmark every summer, and teaches creative writing with the UCLA Extension Writers’ Program.