The Evils of Common Sense

Everyone yearns to understand their medical problem. In the absence of evidence, they use common sense which turns out to be a terrible way to get at the truth. It’s a good rule that any common sense explanation of a medical problem is wrong. Here are others that I hear all the time.

“I can walk on it, so I know it’s not broken.”

It turns out that the fibula, one of two bones in the lower leg, doesn’t bear weight. You walk on your tibia.

“I can move it, so I know it’s not broken.” You may know, but I’m not so sure.

“I have to let this run its course…”

Seeing smoke pour out of your car’s exhaust, no one explains that the engine is repairing itself by expelling bad things. Yet plenty of patients believe vomiting or diarrhea is the body’s attempt to cleanse itself. In fact, it’s a malfunction. It’s OK to suppress it although exceptions exist for a few serious diseases.

“Fever is your body’s way of fighting an infection.”

Google “does fever treatment help” for an avalanche of praise for fever's healing properties from doctors and medical sites as well as laymen – a good sign that it’s nonsense.

Here are questions that you might ask.

1. In what specific infections is lowering the fever harmful? I can’t think of any.

2. What infections do doctors treat by giving patients a fever?  The answer is none (doctors tried this about a century ago, but it wasn’t helpful).

3. Every day, across the world, a hundred million people take medicine for fever. How many end up at the doctor who explains that they made the problem worse?

More Perils of Common Sense

Fifteen years ago, I broke my leg. After I recovered, the doctor ordered a bone scan that revealed osteoporosis. That’s more frequent in women, but anyone skinny and elderly is at risk.

I began taking a drug for osteoporosis. Every year, I had another bone scan. Sometimes it showed a little improvement, sometimes a little deterioration. After ten years of not much change and a few different drugs, I grew discouraged.

“It looks like this isn’t working,” I said.

The doctor could have been honest (“these drugs usually help, but sometimes they don’t; we’re doing our best”) but instead I heard –

“If you hadn’t taken them, you’d be worse.”

That’s common sense. As I write regularly, if you hear common sense from a doctor it means he doesn’t understand what’s going on. 

It’s no different from the famous ad for a quack remedy: “Cures all but the incurable!”