Episode 478 – RLR – Decompensated Cirrhosis
The Clinical Problem Solvers
October 7, 2026
Case description Reza and Rabih discuss a case of cirrhosis Sponsor This episode is sponsored by Amazon Pharmacy. Learn more at pharmacy.amazon.com/prescribers.
Speakers Reza Manesh, Rabih Geha
Reza Manesh (0:00)
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Welcome back, Clinical Problem Solvers.
Rabih, how are you? I don't want to embarrass a person who... I love how I ask you a question and don't even let you answer it, and then go straight into what I want to discuss. Do I live like this world is all about me?
Rabih Geha (0:50)
No, not at all, bro. You're the exact opposite, man. You're the guy who cries at the smallest, slightest emotional tone of another person. This is definitely not true. The exact opposite. In fact, the only reason you think that is because you're so vigilant at making sure that you're not self-centered, that you even begin to entertain at the slightest hint.
Reza Manesh (1:10)
What were we talking about? So I was going to share. Someone just messaged us a really nice message, but I'll save that for later. I wanted to share with you a conversation I had with my brother about Lionel Messi.
My brother's birthday is coming up on Monday, and he just flew to Miami today to watch Messi play. And that's like a dream come true for him because Messi is his favorite. In fact, he was like reflecting with me saying he wished when he was younger, he like really appreciated him more. And I said, tell me a little more about that. He's like, you know, when we were younger, like we loved the style of Cristiano Ronaldo, the flair of David Beckham, but we didn't pay enough attention to Lionel because he wasn't flashy. And then he was comparing him to Lameen Yamal, and how like when Yamal scores or Mbappe scores, they do this fancy dance, and they're like, it just very, it exudes arrogant confidence, whatever it is. And then I said, you know, Ali, you know what's so interesting about Messi? And like basically his point is that you have the best that has ever played the game, but one of the most humble people, and like usually when you think of that alpha athlete, man or woman, you think of someone who's loud, beats their chest, yells, scream.
Messi's exterior couldn't be any softer, but if you look at his like strength in his legs, his ability, it's as good as anyone. And I think he's like one of the first people I've ever seen where showcase, you don't need to be flashy, you don't need to be loud. You can be a quiet, gentle giant of a human being.
Rabih Geha (3:01)
Yeah, I think that's so powerful man. Oh my god, you're making all my nerves tickle because I just love that guy. Your brother, of course, and Leo Nimesi.
Yeah, I mean, he is an idol, both on the field and also off the field. He had a great father to his kids, a great husband to his wife, a great son to his now-law, past father.
Reza Manesh (3:24)
It sounds like a movie is about to start, like you're nearing the beginning of a movie. Gladiator was the general who became a slave, who became the fighting empire.
But you know, the pre-Dollywall, I think also reflects this. And then I would say you also reflect this. Like, you guys are not loud, you guys are so soft. But then when it comes to the medicine, you're as loud as it gets.
Rabih Geha (3:56)
You know, what's funny is as soon as you said that you're not loud, I just remembered my old friend whose name I won't say, who used to completely constantly say, Rabih, I can't hear you. Your audio is too soft. Do you remember every third podcast episode? Like the audio is horrible.
Reza, you're great.
Reza Manesh (4:12)
Rabih, we can't hear you.
Rabih Geha (4:14)
Over and over and over again. So yeah, I definitely am not loud.
Reza Manesh (4:20)
Hey, good news. Brad, almost 2,000 books sold.
Rabih Geha (4:24)
Nice.
Reza Manesh (4:25)
This is huge. I think we're so grateful to all you listeners.
If you could take a moment to either leave a review on Amazon or just share the book with a friend, I can't tell you how impactful it is for our mission in CP Solvers. And we had the fun, Rabih's trip somehow, he's went a whole lot.
Rabih Geha (4:45)
Yes, 100 percent. Brad, are you going to tell them what they have to fund? My new obsession is to buy a yacht.
I decided that I should have an extreme obsession that I'll never, ever, ever even begin to think about. But it would be heaven for me, Prof. Rez, as a solitary, introverted human being who happens to love the water, to live a solitary, quiet life on the water.
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