A crime has been committed and it’s what we feared most: murder. A healthy young woman struck down in her prime. Thankfully, a suspect is in custody and there’s enough evidence to prosecute. Although it seems strange that this seemingly well mannered, good intentioned and innocent suspect would commit a crime like this, the investigators found this so called innocent suspect at the scene of the crime and all the circumstantial evidence supports the accusation. Once highly respected and important in the medical world, this hideous felon was put through a trial, convicted and is guilty as charged. The case is closed, now off to jail to pay for the crime…

The suspect screams “I’m innocent” and demands the authorities find the real culprit that was there, committed the crime and escaped from detection. What if this story is true? Another perpetrator snuck in under the radar, struck the victim down and despite the accused’s fighting to stop it, vanished almost without a trace, leaving only this innocent bystander to take the fall? No… it couldn’t be. The evidence was clear, the system went through its process and worked appropriately, this case is closed and the criminal is already in custody. Pursuing blindly after a mysterious ghost is simply a waste of time and energy. Let it go and move on. Time to be proactive and get this convict put away for good.

But on the way to being locked up there’s a problem: the convict gets free. Now this dangerous perpetrator has escaped and is on the run, trying to both avoid being caught and to gather proof of innocence. This is no easy task as the authorities are in hot pursuit- they must catch this convicted felon before more people get hurt. Perpetually running to survive, every twist and turn along the journey reveals new challenges and revelations. Unexpected evidence and hidden clues start to pop up as the convict on the run starts finding pieces to the puzzle that weren’t seen before but shed new light on the case. Maybe there is indeed some evidence that the fugitive is indeed innocent and another mysterious figure did have something to do with this.

The closer the fugitive gets to solving this puzzle, the closer the authorities get to making a capture. Time is of the essence, this mystery gets more detailed and deceptive with every new analysis. Just as a breakthrough is within reach the journey gets trickier as a new pursuant enters the game: the drug industry. Once upon a time, the convict thought of the medical science, research, drug and pharmaceutical industry as a trusted ally and helper but now it seems they are not only involved in this crime but are behind it all and care the most that the truth doesn’t come out. A once highly trusted friend becomes the fugitive’s worst enemy…

So the chase gets more intense. The fugitive runs faster, gathers more clues and comes closer to the truth. The authorities and Big Pharma close in. Finally they corner the suspect. The authorities are trying simply to capture the fugitive but Big Pharma sees this as a battle to the death. In one big climax it all comes out: Dr. Richard Kimble is innocent and a powerful drug company was the real culprit. He was right all along: another man killed his wife. He was there and tried to stop it but couldn’t. Now justice will be served and although his wife can’t be brought back an innocent suspect is no longer being blamed for a crime he didn’t commit.

The Medical Fugitive
This movie, although fictional (and one of my favorites), serves as a tale of how easy it can be to convict someone based on what evidence you see immediately, while not having access to or being aware of the whole picture. Life is full of these situations as it is human nature to assess responsibility, blame or causation to nearly everything we experience, particularly when something bad happens. We are often quick to come to conclusions based off presumptions, correlation and coincidence, despite our common sense and better judgement which should be telling us to take a step back, take our time and see the whole picture before coming to a conclusion.

In this fictional tale, the fugitive gets absolved from blame and everything works out. But what about other incarnations of this same situation? Take the story above and replace the words “suspect/convict/fugitive” with “cholesterol”…

A crime has been committed and it’s what we feared most: murder. A healthy young woman struck down in her prime. Thankfully, cholesterol is in custody and there’s enough evidence to prosecute. Although it seems strange that seemingly well mannered, good intentioned cholesterol would commit a crime like this, the investigators found this so called innocent cholesterol at the scene of the crime and the circumstantial evidence supports their case. Once highly respected and important in the medical world, cholesterol was put through a trial, convicted and is guilty as charged. The case is closed, now off to jail to pay for the crime…

Cholesterol screams “I’m innocent” and demands the authorities find the real culprit that was there but escaped from detection. What if this story is true? Another perpetrator snuck in under the radar, struck the victim down and despite cholesterol fighting to stop it, vanished almost without a trace, leaving only cholesterol to take the fall? No… it couldn’t be. The evidence was clear, the system worked, case is closed and cholesterol is already in custody. Pursuing blindly after a mysterious ghost is simply a waste of time and energy. Let it go and move on. Time to be proactive and get cholesterol put away for good.

But on the way to being locked up there’s a problem: cholesterol gets free. Now this dangerous perpetrator has escaped and is on the run, trying to both avoid being caught and to gather proof of innocence. This is no easy task as the authorities are in hot pursuit- they must catch this cholesterol before more people get hurt. Perpetually running to survive, every twist and turn reveals new challenges and revelations. Unexpected evidence and hidden clues start to pop up as cholesterol starts finding pieces to the puzzle that weren’t seen before. Maybe there is indeed some evidence that cholesterol is indeed innocent and another mysterious figure did have something to do with this.

The closer cholesterol gets to solving this puzzle, the closer the authorities get to making a capture. Time is of the essence, this mystery gets more detailed and deceptive with every new analysis. Just as a breakthrough is within reach the journey gets trickier as a new pursuant enters the game: the medical industry. Once upon a time, cholesterol thought of the medical science, research, drug and pharmaceutical industry as a trusted ally and helper but now it seems as if they are not only involved in this crime but are behind it all and care the most that the truth doesn’t come out. A once highly trusted friend becomes a new worst enemy…

So the chase gets more intense. Cholesterol runs faster, gathers more clues and comes closer to the truth. The authorities and Big Pharma close in. Finally they corner cholesterol. The authorities are still trying simply to capture cholesterol but to Big Pharma this is a battle to the death. In one big climax it all comes out: cholesterol is innocent. It was right all along: another culprit killed his wife. It was there and tried to stop it but couldn’t. Now justice will be served and although his wife can’t be brought back an innocent suspect is no longer being blamed for a crime it didn’t commit.

Sounds a little like the story that’s playing out in medicine right now. Cholesterol is like Harrison Ford, being pursued by Tommy Lee Jones and a massive web of agents (in this analogy they are the medical industry). As time goes on, Jones keeps chasing Ford but starts to see clues of his innocence, just as the medical field is starting to see it may have prematurely convicted cholesterol. As Ford edges closer to proving his innocence and figuring out the drug company is behind this murder, pharma steps up to fight and to stop him, just as the drug companies are fighting hard to keep cholesterol convicted. In the end the FBI learns of the real culprit and lets Dr. Kimble go free. What happens in cholesterol’s story is yet to be seen.

What is the metaphorical “one armed man” that cholesterol took the blame for? My theory is it’s “inflammation” (or something related to it) which stems from a number of causes, of which chronically elevated blood sugar and oxidized polyunsaturated fats are two big players. The problem is that this is another ultra complex and often misunderstood process. It is intricate and our understanding of this rapidly evolving realm is changing on a monthly basis. To get into details and theory on inflammation is another gigantic post (that will definitely come some day but I summarized it a little while back). So right now it remains a theory that needs quite a bit of contemplation. Will we ever convict? Maybe, but probably not. The human body is complex enough that I think there’s another underlying force at work that we haven’t noticed lurking in the shadows, puppeteering all the other players in this game. Time will tell in this and many other mysteries.

More Fugitives
How many other fugitives are out there? Fat, especially saturated fat, has certainly had a Dr. Richard Kimble experience in relation to several crimes. Salt and hypertension? Glucose and diabetes? Protein and kidney problems? The sun and skin cancer? The list goes on. The more we establish “certainty of” something the more likely I am to add it to my list of Fugitives. The lesson to be learned is that in an organism as complex as the human body that exists in a environment as complex as our modern world we need to be prepared to accept that the faster and more aggressively we pursue and prosecute something the more likely we are to misunderstand it and falsely presume a causation or relationship. Although we have the best intentions our habitual jumping to conclusions based off the limited scope we truly know is getting us into trouble. I’m not suggesting we stop chasing after suspects or trying to figure out crimes I’m simply urging us to not be so quick to convict and be willing to pardon a convict if we realize we were wrong.

The Bare 5 Bottom Line on Fugitives:
1. We don’t know anything with certainty and our knowledge continues to change.
2. Being at the scene of the crime does not make something guilty.
3. Detain for questioning (extensive if necessary) but don’t convict and lock up.
4. Always keep looking for clues. Be willing to pardon and/or excuse from guilt if proper evidence arises.
5. Look at the bigger picture no matter how convinced you are of the details.

Thanks for reading, have a great day!

P.S. Cholesterol is protecting its arteries from attack (among other jobs) and shouldn’t be blamed for heart disease. Many things are involved here and clues are popping up constantly with every new case we investigate that reinforce the idea that we may have misinterpreted things. Did you know they are now telling us some HDLs are bad?…