It started with my fussing about how all you can find in the shops is swimsuits and sports shirts even though it’s cold enough to freeze the male gonads off a copper and zinc alloy primate.

                                                                                                                                                                                                      This is what’s missing

Then Mrs.Gagg jumped in with her anecdote about how when she was stationed in Panama, with her previous old man (who was in the army), all you could find in the commissary was down parka’s.

Why swimsuits in January and down parkas in the tropics?

Because of a lack of common sense. And unfortunately that extends to medicine.

A lack of common sense in individual doctors - I am always telling patients that doctors don’t have the monopoly on mental health. We’ve had some serious flakes get recruited to the medical group I’m part of. And lack of common sense is a distinct part of their flaky-ness.

  So often the lightbulb’s not lit!

Another instance was during a particularly sadistic part of my induction into American medicine when doing a residency at University Hospital at SUNY at Stoneybrooke, where we got sent on a rotation to the VA hospital in Smithtown. Here we had the misfortune to be under the auspices of the Internal Medicine residents - who thought Family Practice residents were just a bunch of morons who couldn’t do anything better. These Internists were stuffed full of information and factoids and would shit on us from a great height. But they were totally lacking in common sense.

There is also a lack of common sense in the medical system as a whole - not to mention all the vested interests - that keep us focused on treating already present diseases, rather than putting more emphasis and money on prevention (may I commend www.commonsensemedicine.org).

Thomas Paine might have rallied the American people around the theme of his pamphlet on Common Sense in the American Revolution, but sadly the country seems to have lost the message.

I always like the phrase of the Car Guys (Click and Clack of ‘Car Talk’) about “unencumbered by the thought process”.

I am from a country with a nationalized health care system - but everyone in the US is so used to government agencies being so totally lacking in common sense they cannotconceive of a national health turning out as anything but a dogs dinner.

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