An offer too good to refuse

“A surgeon should be young, a physician old…”

William Osler

You can teach an old surgeon new tricks. Goodsall’s Rule states that if the external opening of an anal fistula is anterior to a transverse line across the anus, it will open internally into the anterior wall of the anal canal, else it will open in the midline posteriorly. I have quoted that for years in exams and such. Only in the last few days have I learnt there is a qualifying clause. If more than 3cm anteriorly, the fistula may horseshoe and enter posteriorly. David Henry Goodsall was an English Surgeon, born in 1843. He was not particularly keen to study medicine. However, his father had previously been a medical student at St Bartholomew’s Hospital. Tragically he had died from a wound received during an autopsy. As the wound was inflicted by a member of the hospital staff, the hospital felt obliged to extend an offer of free medical school tuition to his son. Goodsall junior excepted their generosity. #bethankfulfortheimageichose #letsmakelemonade