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Sustainable Medicine: the path to a patient-centred future

I have worked with Sarah Myhill for over 15 years, both as a Chronic Fatigue Syndrome (CFS) patient and also academically. As such, I have witnessed the crystallisation of the ideas that led to the concept and writing of Sustainable Medicine from both sides of the fence. These ideas were applied to me personally and I also saw them develop in my role as editor of Sarah’s writings, and also of her website –

Sustainable Medicine: swinging the pendulum back in favour of the patient

Sustainable Medicine follows a logical path, with the ultimate goal of empowering readers to take charge of their own health. This empowerment will not only help to heal diseases already present in readers, but also, and equally crucially, will lay down a route map for the healthy to remain healthy. It is for everyone.

Sustainable Medicine by Dr Sarah Myhill
Sustainable Medicine by Dr Sarah Myhill

The starting point of this journey was the realisation that 21st Century Medicine is not working for the benefit of the patient. So much of modern medicine is driven by vested financial interests that the patient is almost completely forgotten in this process. The patient, the one who knows their body, and the one who is suffering from the symptoms and diseases, is often ignored or, at best, side-lined or even patronised, in the diagnosis and treatment of their disease. Worse than this, modern medicine is not “sustainable”, either for society or the patient, because the use of powerful symptom suppressing drugs often escalates the disease process, rather than reversing it.

Sustainable Medicine has the simply stated objective of swinging the pendulum back in favour of the patient and away from those vested interests.

Sarah Myhill is an inquisitive person. As a patient, you notice this the very first time you speak with her or meet her. She is not like other doctors; there is a genuine desire to know you, and your life, and where you have worked and lived, and so on. In short, Sarah wants to know the ‘whole’ you; she is not a “Symptom List” doctor, by which I mean a physician who asks for your symptoms and then “replies” with a prescription pad. Put crudely, by knowing you better, Sarah can treat you better, although this underplays her most endearing quality; she likes her patients and treats them as equals.

This innate inquisitiveness naturally led Sarah always to ask the question ‘why?’ and in the practice of medicine this question is translated into a quest to find the root causes of disease and symptoms.

This is where Sarah’s 30 years of clinical experience made its mark known and also where the “logical path” was laid down.

First, Sustainable Medicine discusses symptoms, not as something to be immediately squashed with powerful prescription drugs, but rather as signposts as to what may be going wrong. Symptoms are the early warning system of the body that all is not right.

The next step along this logical path is an exposition of what mechanisms may be causing these symptoms and how one can identify which particular mechanisms are at play in this patient. The identification of these mechanisms is achieved by tests and clinical signs and symptoms.

At this point along the logical path, the reader will have identified their symptoms and also isolated the mechanisms causing those symptoms. The next step is to lay out the “tools of the trade”, that is the interventions, that can be put in place to treat those mechanisms as identified. These interventions are “sustainable” in that they reverse, not escalate, disease processes.

The logical path is now complete:

Symptoms => Mechanisms of disease => Sustainable Treatments (“tools of the trade”) to treat and reverse these Mechanisms

By way of example, Sustainable Medicine then looks at very many individual diseases, identifies the underlying mechanisms of these diseases and then applies the “tools of the trade” required to reverse these disease processes. To further illustrate this logical path, Sarah concludes with some case studies of her own patients, ranging from diseases such as chronic lymphatic leukaemia to inflammatory arthritis to CFS.

Sustainable Medicine was launched at a Biocare Advanced Education Day on 13 July 2015, where Sarah detailed her views on the mechanisms and sustainable treatments as applied to CFS, as well as discussing the critical roles played by inflammation and immune system issues in many modern diseases.

Craig Robinson, Editor, Sustainable Medicine.


Read the first chapter of Sustainable Medicine for free here or order your copy. Want to tell us what you think of the book? Leave a review on Amazon, and if you have any questions you can contact Craig and other followers of Dr Myhill’s protocol for CFS in the Facebook group.

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Chronic Fatigue Syndrome seminar

Dr Sarah Myhill will launch her new book Sustainable Medicine on Monday 13 July 2015. The launch will coincide with a seminar on Chronic Fatigue Syndrome as part of Biocare’s Summer 2015 Advanced Education programme. The seminar will explore the causes of CFS, assessment techniques, and a ‘sustainable medicine’ approach to treatment. Read the event flyer below for more info.

Chronic Fatigue Syndrome: It’s mitochondria, not hypochondria

Dr Myhill’s new book Sustainable Medicine aims to empower readers to heal themselves through addressing the underlying reasons for ill health. It is based on the premise that contemporary Western medicine is failing to address the root causes of disease processes. She spells out her programme for maximising health and keeping lifestyle illnesses at bay without recourse to pharmaceuticals.

Her previous book, Diagnosis and Treatment of Chronic Fatigue Syndrome is one of our most popular titles and tells sufferers that ‘CFS is all in our cells, not in our minds…it’s mitochondria, not hypochondria!’ You can read the opening chapter of each book for free using Book2Look:

Read the first chapter of Sustainable Medicine for free

Read the first chapter of Diagnosis and Treatment of Chronic Fatigue Syndrome for free

Chronic Fatigue Syndrome seminar Dr Sarah Myhill
Dr Sarah Myhill Sustainable Medicine book launch at Diagnosis and Treatment of Chronic Fatigue Syndrome seminar with BioCare, at Cavendish Conference Centre in London.

About Dr Myhill

Dr Sarah Myhill qualified in medicine (with Honours) from Middlesex Hospital Medical School in 1981 and has since focused tirelessly on identifying and treating the underlying causes of health problems, especially the ‘diseases of civilisation’ with which we are beset in the West. She has worked in NHS and private practice and for 17 years was the Hon Secretary of the British Society for Ecological Medicine (renamed from the British Society for Allergy, Environmental and Nutritional Medicine), a medical society interested in looking at causes of disease and treating through diet, vitamins and minerals and through avoiding toxic stress. She helps to run and lectures at the Society’s training courses and also lectures regularly on organophosphate poisoning, the problems of silicone, and chronic fatigue syndrome. She has made many appearances on TV and radio. Visit her website at

For more information and books on CFS and other chronic health problems, including thyroid problems, fibromyalgia, ME and Pernicious Anaemia visit Books on Chronic Fatigue Syndrome.


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Where has the patient gone?

An Amazing Murmur of the Heart by Dr Cecil Helman

We believe in evidence-based holistic medicine and approaches to health that recognise the individual in treatment and in care – things that we feel are all too often overlooked in mainstream medicine. That is why we are passionate about the books we publish. Our authors are dedicated to helping people help themselves through difficult health conditions, often challenging received wisdom to look at problems in new ways.

We have spent many hours poring over all the books on the Hammersmith bookshelf, but no matter how much we think we know about a subject we can still surprise ourselves by finding something new in the huge repository of knowledge represented in our books.

So what better way to celebrate, share and discuss our wealth of health information than to start a blog?

Rather than keeping all this invaluable information hidden away, we will share excerpts from different books, compare and contrast different ideas and ultimately (we hope) help more people enrich their lives through learning about their bodies and minds, and the emotions that tie us together as human beings.

Meet Dr Cecil Helman – GP, medical anthropologist and acclaimed writer

We are fortunate to have a hugely knowledgeable and talented network of authors, made up of health practitioners, researchers and expert patients from a wide range of backgrounds, but perhaps the one who best expresses our philosophy is the late Dr Cecil Helman.


Cecil Helman – GP, medical anthropologist and acclaimed writer – looks back in his final book An Amazing Murmur of the Heart on a life-time of encounters with patients to ask ‘Where has the patient gone?’ and answers that patients ‘are still here, waiting for their doctors to notice them again, to shift their attention away from all their magic machines and high tech tests, and to listen to their stories again. And hidden away in those stories, to hear the faint, almost inaudible, murmuring of their hearts.’

Here’s one of the most moving stories from the book, taken from Chapter 3 The Dybbuk of Eddie Barnett:

Some days the pain is ‘sharp’ and ‘intense’, on other days ‘dull and constant’, or merely a ‘vague ache’ or ‘discomfort’. In turn it is ‘heavy’, ‘shooting’, ‘burning’, ‘stabbing’, ‘shocking’ or ‘throbbing’.

Sometimes it is accompanied by other symptoms, such as a headache, vague tummy aches, or feelings of stiffness in his neck, shoulders, or in one leg or the other.

Mr Barnett speaks of his pain all the time. He seems obsessed with it. Consultations with him always leave me feeling frustrated, exhausted, drained of energy. He follows every suggestion I make with another question, and one after that. Asking him for more details of his pain provokes even more requests for help, and then more after that. He is insatiable, unsatisfiable – like an elderly bearded baby, sucking desperately at an emptied breast.

And yet every medical test he’s had so far has shown no physical abnormality whatsoever. He has been blood tested, X-rayed, scoped, scanned, monitored and probed by hospitals and pain clinics all over the
city. But each time the tests prove negative.

I offer to refer him to a psychiatrist, a therapist, a counsellor, even a priest, but he always refuses.
‘There’s nothing wrong with me up here,’ he says emphatically, tapping his forehead. ‘I’m not mad. It’s just that I’ve got this terrible pain that will not go away. Do you understand? It’s the pain that’s giving me depression. Not the other way round.’

Months go by. Pointless, frustrating months. None of my treatments seem to work, none of my pain-killers. And then, as time goes on, I begin to notice something about the unusual way he refers to his pain. It is that he always groups his disparate symptoms into a single, painful entity, and then describes this malign essence as an ‘It’. As if it were a foreign Thing, an abstract being with its own volition, its own malevolent personality.

‘Now it has moved to my other shoulder,’ he says, or, ‘Now it’s boring right through my chest.’ ‘It won’t let me sleep at night,’ he says, ‘and it’s making me depressed,’ ‘It’s driving me mad.’ He speaks as if this entity has singled him out. For some unknown reason, it has chosen to enter his body, and to take up residence among his organs and cells, and then to torture him mercilessly for so many years. ‘It’s killing me, doctor,’ he says, again and again, ‘It’s really torturing me.’

More pain-killers, more futile advice. Still no improvement. But despite this apparent lack of success, I gradually become aware that something is happening to the pain during our meetings. Something of what I say to him is being heard – at least on the bodily level. For I notice that often, in response to one of my suggestions (especially one that is particularly emphatic), the pain suddenly comes to life. It seems
for a while to go berserk. It begins to leap frantically around his body, like a caged animal trying to escape. It appears first in one part of his body, then swiftly in another. Burrowing in and out of different areas of his head or chest or abdomen with amazing rapidity – sinking then emerging, chewing its way out of this joint or that limb like a demented beaver.

If Eddie Barnett and I had been living in one of those more traditional, tribal societies – the ones I’d learned about during my anthropology studies, shortly after medical school – I might have called in an exorcist or a shaman to remove his pain, and not a psychotherapist. But instead of a ritual of feathers, drums or holy relics, he has had to make do with a young, inexperienced family doctor. And also with all those white-coated specialists at the hospital to whom he’s been referred, and who have also brandished their stethoscopes, syringes and tablets at him – all without effect.

A year goes by, without any change. My treatments are pointless, my medical textbooks quite useless. I begin to delve instead into all those books on my shelf on folklore and anthropology. And to pay much more attention to the characteristics of the pain itself, for when I do so a sort of identikit slowly emerges. A profile of the ‘It’. One day I sit down and write out a list of every one of the attributes of its complex, and rather unique ‘personality’ that have manifested themselves in my office over time. And then I understand why that pain had sometimes seemed so familiar. For as Eddie Barnett described it – and as the pain itself spoke, indirectly, yet audibly through him – it was actually the mirror-image of his own
personality. In fact, everything that Eddie Barnett is, the pain is not.

Where Eddie is rigid, his body hardly moving beyond its tense, frozen posture – the pain is mobile. It moves here, dances there, flying swiftly from one part of his body to another, quicker than the eye could
follow. Where he is uncreative, unable to formulate any new ideas or new ways of living his life – the pain is cunning and intelligent. It is endlessly creative in its invention of new forms, new appearances, new ways of dancing among the limbs and organs of his body. Where he is dull and boring, his voice flat and monotonous – the pain seems to live an exciting life. It clearly has a temperament that is vibrant and versatile, one full of surprises. Where he is almost moribund, in an emotional and social sense – the pain is very much alive. In fact, it seems to be looking forward to an even longer life, within its warm, mobile, comfortable home. Where Eddie is frozen in his unhappiness, unable to make any decisions, or decide what to do – the pain is endlessly innovative. There is no end to its ingenuity, and to the strategies that it has designed to defeat the doctors. Where he is passive, fatalistic and defeated by life
and its many vicissitudes – the pain fights back. Its survival instincts are evidently powerful, and never seem to slacken. It is active in self-defence. It intervenes in history. It outwits – again and again – those like myself who would drive it out into the wilderness. And finally, where Eddie is stifled and often inarticulate – the pain is garrulous. Nothing can halt its talkativeness, its endless flow of colourful images in its chosen language – the dialect of symptoms.

Like so many other symptoms in medical practice, that pain is telling a

To read the rest of Eddie Burnett’s story and the legend of the dybbuk order An Amazing Murmur of the Heart as paperback or ebook. You can also preview the first chapter for free.