Neurologists, try using your brains first! Horowitz'1 enthusiastic advocacy of aggressive competition with less well-trained physicians for the tissue-type plasminogen activator treatment market should not, I hope, lead us toward the tactics of used car salesmen. I agree that treatment with tissue-type plasminogen activator should be offered to the patient with fresh stroke whose computed tomographic scan shows no blood. But I believe that an ethical explanation to him/her and his/her family (not a sales pitch) should indicate the following: