The name alone sounds so encouraging: HDL, the "good cholesterol." The more of it in your blood, the lower your risk of heart disease. So bringing up HDL levels has got to be good for health.

Or so the theory went.

Now, a new study that makes use of powerful databases of genetic information has found that raising HDL levels may not make any difference to heart disease risk. People who inherit genes that give them naturally higher HDL levels throughout life have no less heart disease than those who inherit genes that give them slightly lower levels. If HDL were protective, those with genes causing higher levels should have had less heart disease.

Researchers not associated with the study, published online Wednesday in The Lancet, found the results compelling and disturbing. Companies are actively developing and testing drugs that raise HDL, although three recent studies of such treatments have failed. And patients with low HDL levels are often told to try to raise them by exercising or dieting or even by taking niacin, which raised HDL but failed to lower heart disease risk in a recent clinical trial.

"I'd say the HDL hypothesis is on the ropes right now," said Dr. James A. de Lemos, a professor at the University of Texas Southwestern Medical Center, who was not involved in the study.

Dr. Michael Lauer, director of the division of cardiovascular sciences at the National Heart, Lung and Blood Institute, agreed.

"The current study tells us that when it comes to HDL we should seriously consider going back to the drawing board, in this case meaning back to the laboratory," said Dr. Lauer, who also was not connected to the research. "We need to encourage basic laboratory scientists to figure out where HDL fits in the puzzle -- just what exactly is it a marker for."

But Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, who is helping conduct studies of HDL-raising drugs, said he remained hopeful. HDL is complex, he said, and it is possible that some types of HDL molecules might in fact protect against heart disease.

"I am an optimist," Dr. Nissen said.

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My heart sank. Was this obviously humane African-American actually advocating a "separate but equal" solution--a form of marital segregation like the one that made his own parents' marriage a felony in many states when he was born? Hadn't he already declared he supported marriage equality when he was running for the Illinois Senate in 1996? (The administration now claims that the questionnaire from the gay Chicago paper Outlines had been answered in type--not Obama's writing--by somebody else.) Hadn't Jeremiah Wright's church actually been a rare supporter of marriage equality among black churches? The sudden equivocation made no sense--except as pure political calculation. And yet it also felt strained, as if he knew it didn't quite fit. He wanted equality but not marriage--but you cannot have one without the other. On this issue, Obama's excruciating nonposition was essentially "Yes we can't." And yet somehow, simply by the way he answered that mother's question, I didn't believe it. I thought he was struggling between political calculation and his core belief in civil rights. And it was then that I realized he was both: a cold, steely, ruthless, calculating politician who nonetheless wanted to do the right thing in the end.

Last week he did it--in a move whose consequences are simply impossible to judge. White House sources told me that after the interview with ABC News, the president felt as if a weight had been lifted off him. Yes, he was bounced into it by Joe Biden, the lovable Irish-Catholic rogue who couldn't help but tell the truth about his own views on TV (only to be immediately knocked down by David Axelrod on Twitter). But Obama had been planning to endorse gay marriage before his reelection for a while. White House sources say that if Obama had been a state senator in New York last year when the Albany legislature legalized gay marriage, he'd have voted in favor. But no one asked. The "make news" reveal was scheduled for The View. In the end, scrambling to catch up with his veep, he turned to his fellow ESPN fan, Robin Roberts, a Christian African-American from Mississippi, to quell the sudden kerfuffle. Even this was calculated: to have this moment occur between two African-Americans would help Obama calm opposition within parts of the black community.

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JENNIFER KHAN

One day last summer, Anne and her husband, Miguel, took their 9-year-old son, Michael, to a Florida elementary school for the first day of what the family chose to call "summer camp." For years, Anne and Miguel have struggled to understand their eldest son, an elegant boy with high-planed cheeks, wide eyes and curly light brown hair, whose periodic rages alternate with moments of chilly detachment. Michael's eight-week program was, in reality, a highly structured psychological study -- less summer camp than camp of last resort.

Michael's problems started, according to his mother, around age 3, shortly after his brother Allan was born. At the time, she said, Michael was mostly just acting "like a brat," but his behavior soon escalated to throwing tantrums during which he would scream and shriek inconsolably. These weren't ordinary toddler's fits. "It wasn't, 'I'm tired' or 'I'm frustrated' -- the normal things kids do," Anne remembered. "His behavior was really out there. And it would happen for hours and hours each day, no matter what we did." For several years, Michael screamed every time his parents told him to put on his shoes or perform other ordinary tasks, like retrieving one of his toys from the living room. "Going somewhere, staying somewhere -- anything would set him off," Miguel said. These furies lasted well beyond toddlerhood. At 8, Michael would still fly into a rage when Anne or Miguel tried to get him ready for school, punching the wall and kicking holes in the door. Left unwatched, he would cut up his trousers with scissors or methodically pull his hair out. He would also vent his anger by slamming the toilet seat down again and again until it broke.

When Anne and Miguel first took Michael to see a therapist, he was given a diagnosis of "firstborn syndrome": acting out because he resented his new sibling. While both parents acknowledged that Michael was deeply hostile to the new baby, sibling rivalry didn't seem sufficient to explain his consistently extreme behavior.

By the time he turned 5, Michael had developed an uncanny ability to switch from full-blown anger to moments of pure rationality or calculated charm -- a facility that Anne describes as deeply unsettling. "You never know when you're going to see a proper emotion," she said. She recalled one argument, over a homework assignment, when Michael shrieked and wept as she tried to reason with him. "I said: 'Michael, remember the brainstorming we did yesterday? All you have to do is take your thoughts from that and turn them into sentences, and you're done!' He's still screaming bloody murder, so I say, 'Michael, I thought we brainstormed so we could avoid all this drama today.' He stopped dead, in the middle of the screaming, turned to me and said in this flat, adult voice, 'Well, you didn't think that through very clearly then, did you?' "

Anne and Miguel live in a small coastal town south of Miami, the kind of place where children ride their bikes on well-maintained cul-de-sacs. (To protect the subjects' privacy, only first or middle names have been used.) The morning I met them was overcast and hot. Seated on a sofa in the family's spacious living room, Anne sipped a Coke Zero while her two younger sons -- Allan, 6, and Jake, 2 -- played on the carpet. So far, she said, neither of the younger boys exhibited problems like Michael's.

"We have bookshelves full of these books -- 'The Defiant Child', 'The Explosive Child,' " she told me. "All these books with different strategies, and we try them, and sometimes they seem to work for a few days, but then it goes right back to how it was." A former elementary-school teacher with a degree in child psychology, Anne admitted feeling frustrated despite her training. "We feel like we've been spinning our wheels," she said. "Is it us? Is it him? Is it both? All these doctors and all this technology. But nobody has been able to tell us, 'This is the problem, and this is what you need to do.' "

At 37, Anne is voluble and frank. She had recently started managing a food truck, and the day we met, she was in Florida business mufti: a Bluetooth headset and iPhone, jean shorts and a fluorescent green tank top emblazoned with the name of her business. Miguel is more reserved. A former commercial pilot who now works as a real estate agent, he often acted as the family's mediator, negotiating tense moments with the calm of a man who has landed planes in stormy conditions.

"In the beginning, I thought it was us," Miguel said, as his two younger sons played loudly with a toy car. "But Michael defies logic. You do things by the book, and he's still off the wall. We became so tired of fighting with him in public that we really cut back on our social life."

Over the last six years, Michael's parents have taken him to eight different therapists and received a proliferating number of diagnoses. "We've had so many people tell us so many different things," Anne said. "Oh, it's A.D.D. -- oh, it's not. It's depression -- or it's not. You could open the DSM and point to a random thing, and chances are he has elements of it. He's got characteristics of O.C.D. He's got characteristics of sensory-integration disorder. Nobody knows what the predominant feature is, in terms of treating him. Which is the frustrating part."

Then last spring, the psychologist treating Michael referred his parents to Dan Waschbusch, a researcher at Florida International University. Following a battery of evaluations, Anne and Miguel were presented with another possible diagnosis: their son Michael might be a psychopath.

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Sen. Dianne Feinstein talks national security; Sen. John Thune on Romney veepstakes

This week Senator Dianne Feinstein discusses national security and Senator John Thune discusses 2012 politics