Dr. Wolfram Goessling: New Internal Medicine Chair Is a Liver Disease Pioneer

When you’re facing a serious illness, you may not think about how a tiny zebrafish could help you. But Wolfram Goessling, MD, PhD, Yale Medicine’s new chair of the Department of Internal Medicine, has been fascinated for decades by these slender fish with their blue and golden iridescent stripes. Zebrafish share much of their genetic makeup with humans, along with similarities in organs and cell types—making them powerful tools for medical research.

Dr. Goessling pioneered the use of zebrafish to study liver disease and conducted research that helped lead to clinical trials for the first medications for liver cancer. Today, when he sits at a patient’s bedside, he may be able to offer treatments that simply didn’t exist when he began practicing medicine.

“Today we have so many ways to diagnose, prevent, and treat disease thanks to the tools and technologies researchers have developed,” says Dr. Goessling. That progress is evident across internal medicine, he adds—especially at Yale. “So much here is connected to research, innovation, and new ways of thinking about disease. We want our patients to benefit from all of that.”

Dr. Goessling oversees the clinical, research, and educational missions of all Yale Medicine’s Department of Internal Medicine sections, including cardiology, oncology, geriatrics, rheumatology, and infectious diseases. A professor of internal medicine at Yale School of Medicine, he also serves as chair of medicine for the school, chief of internal medicine at Yale New Haven Hospital, and physician-in-chief for the Yale New Haven Health System.

He spoke with us about his new role, how playing the trumpet provides balance to his life, and, of course, zebrafish.

I was in Massachusetts for 32 years, most recently as chief of gastroenterology at Massachusetts General Hospital, professor at Harvard Medical School, and director of the Harvard–MIT Program in Health Sciences and Technology. I wanted to lead a department, and Yale is an extraordinary institution with national—and in some cases international—impact across internal medicine. I was also drawn to the people here: physicians and scientists who have made seminal contributions to modern medicine.

If you are a patient here, you receive more than standard care. We have deep expertise across specialties and hundreds of clinical trials in cancer alone, giving patients access to treatments that may become tomorrow’s standard of care. That’s what academic medicine is about—providing the best possible care today, while working toward even better care in the future through research, innovation, and education.

I’m a gastroenterologist and oncologist specializing in liver disease and liver cancer. During my training, I was drawn to patients with chronic liver disease who were at risk for liver cancer. Those are still my patients today, including people living with advanced disease.

Caring for patients who are critically ill or facing life-threatening conditions shapes how I think about leadership. It reinforces the importance of guiding patients through their illness with presence, commitment, and compassion. My colleagues here bring that same dedication every day.

Absolutely. So far, I’ve brought 150 zebrafish to Yale in small tubes. Once they are bred and distinct genetic lines are established, that will represent 150 families. Over time, we’ll fill thousands of aquariums.

Zebrafish were first identified in the Ganges River and its tributaries in the late 1800s. They share more than 80% of their genes with humans, and their organs and cell types are remarkably similar to ours. When they are young, they are transparent, allowing us to watch organs develop in real time under a microscope.

I study the liver—the one organ that reliably regenerates and repairs itself. By three days of age, a zebrafish has a functioning liver that performs the same essential tasks as an adult human liver. My focus is understanding how liver cancer develops and grows. As organs form, cells must know where to move, how to attract blood vessels, and sometimes how to change identity to perform new functions. Using advanced microscopes and genetic tools, we study how these signals guide cell behavior—and how they become disrupted in cancer.

When I began caring for liver cancer patients, there wasn’t a single approved drug to treat the disease. Not one. As a researcher, I was part of a team whose basic science discoveries helped lead to the first liver cancer drugs tested in clinical trials. Today, patients with advanced liver cancer have multiple treatment options and are living longer, better lives.

Patients often see only the clinical trial phase of research. But the knowledge behind those trials may begin in a laboratory studying a fly, a mouse, or a zebrafish.

Basic research has transformed care across internal medicine. When I was a medical student, we had no effective treatments for what was then called non-A, non-B hepatitis—later identified as hepatitis C. Today, hepatitis C can not only be treated but cured.

We’ve also seen major advances for people with diabetes and obesity, including GLP-1 medications such as Ozempic and Wegovy. These drugs are also showing benefits in heart disease and other conditions. There are many examples like this—where fundamental discoveries ultimately reshape patient care.

Find a doctor you trust—someone who listens and provides clear guidance. There is so much information, and misinformation, available today. Ask questions. Make sure you understand your diagnosis, your treatment options, and what lies ahead.

It’s also important to involve loved ones and others in your community to the extent you’re comfortable. Support matters when you leave the doctor’s office.

And it may help to know that we can effectively treat—or even cure—many more diseases than we could 30 or 40 years ago, and even compared to five or 10 years ago. We’re diagnosing conditions earlier and preventing more disease. Medicine is changing rapidly, and that progress will continue.

Many people have demanding jobs—I’m not unique in that. But it’s important, especially for medical students, to model that a meaningful life can include more than work.

I’ve played the trumpet since third grade. It’s a joy and a way to connect with colleagues and friends. My wife plays the violin—we met in high school while playing in the same orchestra.

People sometimes ask whether music makes me a better doctor. You certainly don’t have to be a musician to practice medicine well. But playing in an orchestra teaches teamwork. Each person brings a different instrument, and together you create something larger than yourself. In cancer care, our tumor boards work similarly—the surgeon, oncologist, radiologist, and liver specialist bring their perspectives to a shared goal. In that sense, music and medicine align for me.