Intended for healthcare professionals

On The Case

Doctors, detectives, and common sense

BMJ 2005; 331 doi: (Published 22 December 2005) Cite this as: BMJ 2005;331:1495

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

When fantasy replaces common sense, life becomes farcical and even
Life is a series of ordinary events that follow the laws of logic and
These ordinary events are indifferent to our fantasies and require the
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
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
patient about using black cough drops. The patient smiled, opened the
of the night table, and took out a package of black cough

The intern's face turned red, and we all laughed. The intern was so
on being a doctor, that he forgot to ask his patient an obvious question.
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
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

Competing interests:
None declared

Competing interests: No competing interests

31 August 2006
Hugh Mann
Eagle Rock, MO 65641