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Candidate Performance Measures for Screening for, Assessing, and Treating Unhealthy Substance Use in Hospitals

Richard Saitz, MD, MPH
[+] Article and Author Information

From Boston Medical Center, Boston University School of Medicine, and Boston University School of Public Health, Boston, MA 02118.


Potential Conflicts of Interest: None disclosed.


Ann Intern Med. 2011;154(1):73-74. doi:10.7326/0003-4819-154-1-201101040-00018
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What is common sense?
Posted on March 22, 2011
Hugh Mann
Eagle Rock, Mo 65641
Conflict of Interest: None Declared

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 at a Veterans Affairs (VA) hospital 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 if he uses black cough drops. The patient smiled, opened the drawer of his night table, and took out a package of Smith Brothers 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 forty 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-five 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.

Conflict of Interest:

None declared

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