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ON THE CASE: Alexander McCall Smith Doctors, detectives, and common sense BMJ 2005; 331: 1495-1497 [Full text]

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Using good evidence

Lalitha D'Souza   (3 January 2006)

What is Common Sense?

Hugh Mann   (31 August 2006)

Using good evidence 3 January 2006
Lalitha D'Souza, Researcher University of York, YO10 5DD Send response to journal: Re: Using good evidence	There was no sugar on Mma Ramotswe's dress (no evidence). Doctor Modisapodi knew of the doughnut shop near the Ladies No. 1 Detective Agency (good evidence), of her traditional build (good evidence) and her weight on the scale (good evidence). This is creative use of evidence, and makes delightful reading! Competing interests: None declared
What is Common Sense? 31 August 2006
Hugh Mann, physician Eagle Rock, MO 65641 Send response to journal: Re: What is Common Sense?	Common sense means paying attention to the obvious. This is not as easy as it sounds. We all have vivid imaginations, and we tend to get lost in our fantasies. When fantasy replaces common sense, life becomes farcical and even tragic. Life is a series of ordinary events that follow the laws of logic and probability. These ordinary events are indifferent to our fantasies and require the careful, accurate navigation of common sense. I learned the lesson of common sense as a third-year medical student. I was doing an internal medicine rotation and working with interns, residents, and attending physicians. One day, on morning rounds, we examined a patient with a black tongue. The intern assigned to that patient had researched all the causes of a black tongue and was eager to demonstrate his new knowledge. As the intern started to lecture us, the attending physician interrupted him and asked the patient about using black cough drops. The patient smiled, opened the drawer of the night table, and took out a package of black cough drops. The intern's face turned red, and we all laughed. The intern was so focused on being a doctor, that he forgot to ask his patient an obvious question. It's been thirty-five years since I was a third-year medical student, but I still have a vivid memory of that day and that lesson: use common sense and pay attention to the obvious. My thirty years of medical practice have taught me the lesson of common sense again and again. Eventually, I realized that society in general, and modern medicine in particular, lack common sense. This is why societal and medical problems are rarely solved. Let's apply common sense to healthcare. hughmann@organicMD.org Competing interests: None declared