(Foto: Mané Espinosa)



Postscript, August 2014

Dear children:
Dr. Cholesterol has lost the battle, but won the war.
The British Medical Journal does not have to retract the two texts on cholesterol and primary prevention. They have only a minor error and was corrected (with respect to the adverse effects of statins). 
Therefore Dr. Cholesterol has lost his battle.

Meanwhile, the agency NICE (which determines the value of medicines in the UK) has recommended greater use of statins, as proposed by Dr. Cholesterol. Medicalisation of millions of healthy individuals is unjustified.  It is big business for the industry and a danger to the life of the English.
Therefore Dr. Cholesterol has won the war.
These are sad days for good doctors.
British general practitioners have called 1/ NICE not to make recommendations until it has all the data from the studies, and 2/ not to follow its recommendations.

NICE answered:

«We are not always in a position to obtain all unpublished data but we can make an assessment of the likelihood of any unpublished data affecting, our conclusions».

You do not know wheter to laugh or to cry.
These are sad days for good doctors. It appears that the adverse effects of statins have being used as a smokescreen to avoid the debate over its lack of effect in primary prevention.


 Juan Gérvas, MD, PhD, retired general practitioner, Equipo CESCA (Madrid, Spain) @JuanGrvas



Children sit down and be quiet, silence please!
Mara and Andrew, move to the the front row. Your parents are doctors and I do not want any trouble. I want you to write down word by word what I say. Tonight, when you get home, I want you all to read it, before dinner, and for your parents to sign it.

[That’s so unfair!]
[I have nothing to write with]
[Mara pushed me … ! ]
[Can we not just type it on the computer?]
[We are with grandma, our parents are divorcing…! ]
Everyone write down! Remember it is utterly important to copy exactly what I say.

The UK is an island country, member of the European Union.
[Both in capitals? «Union» and «European»?]
[Not so fast , you are going too fast…!]
[Tessa threw me a paper ball!]
[My aunt has gone to live in the UK, she says that everyone speaks English!]
The UK has a very old and very tolerant democracy.
In the UK there are doctors who are general practitioners whom everyone respects a lot.
[Are there no paediatricians? Great! That means they are not vaccinating and weighing children all day!]
[Are they rich, the general practitioners?]
[I saw a movie and a doctor was a very bad person!]
[I’ve been to London and I have never seen a general practitioner]
[My grandfather was a rural general practioner]
In the UK there are also medical specialists.
General practitioners and specialists together form the British Medical Association .
There are more than 150,000 physicians.
Drop the pens just now and come over the computer to see what a nice building they have, it is in central London, in Tavistock Square.
[Oh yes! It is beautiful]
[It has a clock and a flag! Is it the doctors’ flag?]
[There is a large gate, do they fear getting robbed?]
[Are British doctors rich?]
[My father has a friend who is a doctor there, was born in Pakistan and is working in a village. We went to see him. He had a very large house, a fatty dog, a Siamese cat and six children]
Doctors at the British Medical Association have many journals and scientific activities.
But there is a fantastic scientific journal, which knows all the doctors in the world .
It’s called «British Medical Journal».
I’ll write on the blackboard the name of the journal.
[Very easy name, I know the «New York Times»]
[Is it in English?]
[Is it free?]
[Peter threw me a bogey, that’s yucky!]
The «British Medical Journal» is very popular because it publishes many papers that help clinicians to treat their patients better.
The journal is free for doctors from poor countries and the most important papers are also free to all doctors in the world, available online .
Since 2005 the editor of the «British Medical Journal» is a general practitioner, Fiona Godlee, who studied medicine at Cambridge, became general practitioner in London and then she went to the U.S. to Harvard.
Fiona is married and lives with her husband and two children.
She is 52 years old.
I will write down these names on the blackboard and we will go online to see some pictures of Fiona.
[When I grow up I will be the editor of the «British Medical Journal»]
[Does Fiona earn a lot of money?]
[Why did she go to Harvard? Is she an U.S. spy?]
[She is very old! Do you have to be old to be an editor?]
[I have to pee. Can I go…?]
[I am tired of writing, why don’t you just tell us and we will tell our parents?]
Last year, 2013, the «British Medical Journal» published two articles about cholesterol .
The two studies showed that cholesterol is not a problem.
As a Spanish general practitioner says: «Do not measure cholesterol. Be happy»
In those two papers there was a little error because they noted that cholesterol drugs harms 18 % of patients.
Actually it was 17.4% and the authors published a correction, also they stated that this result was only a study done in the United States and perhaps elsewhere would be different.
But in the UK there is a «Dr. Cholesterol» that meets up with his friends everyday and scares everyone talking about cholesterol, about food, about sitting and watching football games on TV and all, he thinks about all day is to sell more and more drugs for cholesterol.
[Can I get a drink? I’m so thirsty…!]
[Does «Dr. Cholesterol» make a lot of money?]
[Charles is bothering me!]
[There’s a pigeon on the window!]
[Is «Dr. Cholesterol » like a pig? My mother says that pork is full of cholesterol]
[I think that the more cholesterol things have the more I like them. Specially my grandmother’s bacon bites. She has promised to make them tonight, Yummy!]
[My aunt says that cholesterol is terrible and she’s all day taking blood tests]
«Dr. Cholesterol» went to visit Fiona and told her that she must delete those two papers, which were really bad for cholesterol drugs.
Fiona explained that the mistake had been corrected and that he could write a letter to the «British Medical Journal» if he disagrees about cholesterol not being a problem.
«Dr Cholesterol» was outraged and left Fiona’s office and went straight to see the tabloid journalists.
[What is it, what is a tabloid journalist?]
[My father says Ben Goldacre is a tabloid journalist, but my uncle, my mother’s brother, said he is very good and very brave]
[Perhaps «Dr Cholesterol» has a high cholesterol because he was so angry. To be stressed is bad for the heart]
There are many friends of «Dr Cholesterol» making money with cholesterol drugs, and they want Fiona fired.
Cholesterol drugs are called statins and are very good when given to you after you have had a heart attack.
But statins are worthless if you have no coronary artery disease (heart disease).
You do not need to check your cholesterol. You just have to be happy.
[As my parents are divorcing my mother said she is very unhappy. She goes to visit the doctor who orders her blood tests and tells her: «you have have high cholesterol you need pills». Would it be better to find her a boyfriend so she will be happy?]
[My father says that he finds happiness in Buddhism, he is silly]
[Happy doctors earn more money?]
[A friend of mine says her father eats everything he likes and then a pill for cholesterol so that way he does not get ill]
[My aunt wants everything cholesterol free and low in calories]
[Peter is bothering me again]
Coronary artery disease (heart disease) is a frequent problem amongst poor people who suffer it because they are unhappy, eat poorly, have no money, smoke a lot, have a lower level of education and do not know what are their future expectations. Coronary artery disease (heart disease) it is mainly a social and psychological problem, not a biological one.
Do not measure your cholesterol.
Be happy.
You have to enjoy life, even with its drawbacks.
The cholesterol drugs, statins, are only for those who have had coronary artery disease (heart disease).
Statins sometimes produce serious harms, even deaths.
My mother died because she took Lipobay (cerivastatin), she had high cholesterol but without coronary artery disease (heart disease).
Lipobay «ate» my mother’s muscles away and «collapsed » her kidneys, and she died.
Then Lipobay was banned but by then my mother was already dead.
Statins harm the muscles, the liver and pancreas and they can cause diabetes.
You do not need to check your cholesterol, just be happy
[You are crying. Is it for you mother?]
[My mother died , and I cry when I remember her. One day she was drowned on the beach]
[Do not cry, we love you very much!]
[We’re going to be good and you will be very happy and that way your cholesterol will not rise]
[Tonight I will read this to my grandmother, she will appreciate it very much]
This problem relates to power, money and censorship. This problem is about scientific freedom that seeks to put limits to Medicine. This problem relates to industries that put the profit of shareholders before the health of patients and populations. It is a problem that concerns us all.

To know more:
Adverse effects of statins as weapons against British Medical Journal

On the problem of cerivastatin , which had to be removed in 2002 after causing hundreds of deaths (funny enough, not one in clinical trials)
About the excesses of statins. Statins prevent domestic and traffic accidents, in addition to burns and wounds