The Energy Equation

From the Naked Ape to the Knackered Ape

Sarah Myhill, Craig Robinson

• Publisher: Hammersmith Health Books
• Year: 2021
• ISBN:
  9781781611869
• Topic: Medizin
• Subtopic: Allgemeine Gesundheit

In her NHS and then independent medical practice, Dr Myhill has increasingly specialised in helping patients with chronic fatigue syndrome and ME. Through her work with patients with pathologically low levels of energy she has learned of the centrality of having sufficient energy to live well and stay healthy and of balancing energy generation with energy use. In this, her simplest and most readable account of the fundamentals of good health, supported by editor and former patient Craig Robinson, Dr Myhill provides all we need to ensure the energy equation is resolving in our favour.

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PART 1

THE KNACKERED APE2

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CHAPTER 1

THE NAÏVE DOCTOR STUMBLES INTO THE REAL WORLD

I imagined becoming a doctor would be like being a mathematician – there would be interesting enigmas with a right answer and patients who’d live happily ever after in their solved state. Scientifically speaking, this should be possible.* If we could master all the schools of science and apply these specifically to each individual, we should see a satisfying result in all cases.

I left medical school on an intellectual high having qualified with honours. I felt I could face any patient with any problem and point them to a cure. This high was short lived. I quickly found out that medical education did little to prepare me for General Practice. Patients did not turn up with classic presentations of disease – indeed, 4such an occurrence was a rarity. They arrived with rheumatics, elusive headaches, malaises, and one, with his delightful Nottinghamshire accent ‘am going down t’ bank’. My fall-back position was to say that a blood test was needed and whilst awaiting the test results, I would anxiously leaf through my lecture notes or ask colleagues. Yes, this Naked Ape did not have the option of the Internet in those days. Only rarely did a clear answer present itself. Sometimes I would see the patient again and ‘impress’ them with the scholarly opine, ‘It’s a virus, variety: snuffly cold’. I might add in some complicated name for ‘snuffly cold’, such as ‘rhinovirus’ just for good measure. But by this time, they’d probably shaken off the ‘snuffly cold’. Anyway, I soon found out that medics had a mediocre reputation, best iterated by Tolstoy (Russian author of War and Peace, 1828-1910): ‘Though the doctors treated him, let his blood, and gave him medications to drink, he nevertheless recovered.’

It wasn’t an auspicious beginning, but it was to become much worse when I couldn’t find any answers whatsoever for the ‘tired all the time’ patient. There were no obvious armpit boils, no yellow faces, no peculiar spine curvatures or other such helpful pointers. Indeed, these patients looked distressingly normal. They were direct, intelligent and sincere. They looked at me straight in the eye expecting a rational explanation. Many held down-high powered, responsible jobs, some had been high-achieving athletes. When tests returned with normal results, it was very tempting to give an airy wave of the hand and blame the problem on age, the menopause, idleness or hypochondria. But I lacked the gravitas necessary for such a conjuring act. I was forced onto the defensive. I had to admit that I did not know what on earth was going wrong. Even worse than that, I had to admit that I myself experienced some of the symptoms my patients were describing, and I too had no idea of the cause. This was in spite of six years of expensive, intensive and supposedly scientific medical education. 5

‘Could it be something I am eating doc?’ My immediate reaction was ‘No’. I come from a long line of doctors, with my grandmother being one of the first women doctors in the UK, qualifying in 1922. Grandfather was senior registrar at Great Ormond Street under Sir George Frederic Stills, who described juvenile rheumatoid arthritis in children. My father and uncle were GPs. The dinner table conversation through childhood often dwelt on medical subjects and even before medical school I had a pretty good grasp of the major pathologies. Yes, I’d heard the very rare stories of peanuts causing acute collapse, but nowhere had the subject of food as a cause of chronic symptoms been aired. I even recall my father rubbishing a conversation with a family friend who maintained that a change of diet had allowed him to feel better. Father’s diagnosis was ‘deluded’. He had a reputation for being a good diagnostician so if he, all my other medical relatives and education determined that diet was irrelevant to pathology, then so it was.

Some Naked Apes, however, had made the connection that diet was important. In the 1920s, the nutritionist Victor Lindlahr was a strong believer in the idea that food directly affected health. That view gained some adherents and the earliest known printed example of his followers expressing this can be seen from an advert for beef in a 1923 edition of the Bridgeport Telegraph, for ‘United Meet [sic] Markets’: ‘Ninety per cent of the diseases known to man are caused by cheap foodstuffs. You are what you eat.’

There is something about medical training which starts with intelligent, enthusiastic and caring young students and turns them into narrow minded, arrogant and emotionless physicians.

They have the intelligence educated out of them.

Anon 6

This is further encouraged by the development of a language to prevent the patient from understanding and answering back. A wag of a registrar at the Middlesex Hospital London, where I trained, explained to us that dermatology is the art of choosing an unpronounceable name and then slapping on a steroid antimicrobial cream. Fungal infection of the penis is called balanitis xerotica obliterans or lichen sclerosus et atrophicus; smelly infected armpits are called hidradenitis suppurativa; heat rash is milaria rubra. But this is not diagnosis – this is a clinical picture. In looking at the stars, our distant Naked-Ape ancestors linked them together into familiar shapes and gave them Latin names like Aquarius, Capricornus and Ursa Major. But this is not science either – we call this astrology. I soon discovered that my patients were more incisive than I was. They were looking for the root cause of their symptoms. They were not content with an astrological clinical picture – they expected real science and the application of such. They did not want to consult an astrologist; they wanted a logical explanation for their constellation of symptoms from an astronomer. And I was found wanting at the first hurdle.

One of the early lessons I learned was that I was practising medicine in a lovely and forgiving community. They did not mind that I did not know the answer; they were very happy with me not knowing and saying so. They were happy that I could rule out serious illness, accept their suggestions for progress (because I did not have any of my own) and also, they were prepared to be willing guinea-pigs. And then, in the midst of these agonies and ignorance, occurred a life-changing experience.

Ruth was born. She, of course, was going to be the perfect baby, breast-fed and expertly managed by this highly qualified doctor recently furnished with the best of medical educations from one of the top London teaching hospitals. Within a few days of birth Ruth started howling and crying. Inconsolably. Nothing I could do made one jot of difference. Nothing anyone else could do made one jot of difference 7either. Various nostrums were recommended, including gripe water (alcohol), Calpol (paracetamol and sugar) and mebeverine (atropine like), but even at that stage of my education I knew this was symptom suppression. ‘Oh Ducky, it’s only three-month colic – it will pass.’ I was suddenly aware that I was on the receiving end as a patient being fed astrology when I needed astronomy. I recall my then-husband Nick, overwhelmed by the screams, saying ‘You’re the effing doctor – you sort it out’. These days and nights were turning into the most miserable, confidence-sapping weeks of my life. I was exhausted, embarrassed by my inadequacy and had no idea what was going on.

At that point in time I would have been the ideal subject for any old Quack wielding snake oil – happy to try dancing naked at midnight with vestal virgins if there was a promise of a cure. Perhaps it was that memory of my father’s ‘deluded’ diagnosis of the ‘change-of-diet friend’ that prompted me to think of food? Instinctively I cut out all dairy products. This was not easy because I lo...

Table of contents

• Title Page
• Copyright
• Contents
• About the Authors
• Dedication
• Preface
• Introduction
• Part 1: The Knackered Ape
• Part 2: Energy generation
• Part 3: Energy expenditure
• Part 4: Get your act together
• Appendices
• 1: The paleo-ketogenic (PK) diet and essential micronutrients
• 2: Groundhog Basic
• 3: Groundhog Acute
• 4: Groundhog Chronic
• 5: Vitamin C
• Resources
• Index