Professor Sir Ludwig Guttmann
Ludwig Guttmann was born on the 3rd of July 1899 in Tost, Germany At the age of 3 his family moved from the little village of Tost to Konigshutte, a town with a large foundry in a coal-mining district. A strapping young coalminer with a fracture of the spine was his first encounter with paraplegia. That was in 1917, when after school, he used to work as a volunteer in an accident Hospital for coalminers. When he began to write up his notes he was told: "Don't bother, he'll be dead in a few weeks." So it was. After five weeks, urinary infections and massive pressure sores led to fatal sepsis. Guttmann remembered that patient for the rest of his life.
From 1919 until 1924 while he was studying medicine in Freiburg he became active in a Jewish fraternity, whose purpose was information and awareness against anti-Semitism in the Universities. This fraternity gradually evolved into a centre of physical training and sport, to acquire body strength, skills, confidence and self-esteem so that "nobody needed to be ashamed of being a Jew". When Guttmann graduated medical school in1924, financial reasons forced him to return in Breslau. There was a position in the neurological department of a distinguished professor named Otfrid Foester, which Guttmann was happy to accept. From 1928 he worked as a neurosurgeon in a 300 bed psychiatric clinic at Hamburg University and in 1929 became Foester's assistant. In 1930 he published a paper which made him a lecturer in Breslau University.
In 1933 it was prohibited for Jews to practice medicine in public hospitals. Guttmann was fired on the 30.06.1933 but immediately took over as the director of the neurological and neurosurgical department of the Breslau Jewish hospital. After Hitler's rise to power, the position of Germans with Jewish origin was getting more and more difficult. He had plenty of proposals to migrate abroad so he could carry on with his career. He did not accept any because he believed that Nazism would not last for long. He became president of the Jewish Medical Community and many times he exposed himself to danger by helping refugees and patients. In September 1938 he was ordered by the Gestapo to discharge all non-Jewish patients from the Jewish Hospital that he was managing. Later that same year, when thousands of Jews were taken to concentration camps, Guttmann was summoned by the local Gestapo Commisar to justify the presence of 63 patients that were admitted to his Hospital. He managed to save all but three that were sent to concentration camps. It was then that he realised that he would have to leave Germany.
The Queen at the opening of the Stoke Mandeville Stadium on 2nd August 1969
He arrived in Britain on the 14th March 1939, after he was invited by the "Society for the Protection of Science and Learning", with his wife, two children and no money. With the sponsorship of Hugh Cairns, one of the leading neurosurgeons of that period, he started his research in Oxford. This would have proved almost impossible without the help of CARA (Council for Assisting Refugee Academics).
The mortality rate of traumatic paraplegia in British and American Armies during World War I was still very high reaching 80%. The few survivors carried on living as useless and hopeless cripples, unemployable and unwanted, condemned for the rest of their lives to institutions for incurable patients with no encouragement to return to a useful life. Life expectancy was a mere 3 months following injury.
In December 1941, Guttmann presented a review, required by the "Medical research council of England", with regards to the way patients suffering from spinal cord injuries, were dealt with and rehabilitated. As a result of that presentation the Medical Research Council of England decided on the creation of a special centre for patients with spinal cord injuries. That decision was also a part of the greater preparation for the planned attack of the Second Front, the spring of 1944, as the number of such patients was anticipated to rise.
In September 1943 the British government commissioned Guttmann as director of that Centre at Stoke Mandeville Hospital, in Aylesbury. Guttmann accepted under the condition that he would be totally independent and that he could apply his philosophy as far as the whole approach to the treatment of those patients was concerned.
Guttmann's goal was the integration of these patients into society as respectable and useful members despite their high degree of disability. The ever repeated question "Is it really worth while?" asked by all visitors during the first two years that the Centre operated was indicative as to how difficult it was to get over century old perceptions and prejudices. The defeatist attitude of the public was significantly expressed by one of Guttmann's early patients who wrote "One of the most difficult tasks for a paraplegic is to cheer up his visitors!”.
The Centre opened on the 1st of February 1944 with 26 beds and so a new era started for spinal injuries patients. Guttmann introduced a whole new approach to the way tetraplegic and paraplegic patients were treated from the initial stages of injury until final resettlement.
Although Guttmann did not think of himself as Psychologist, the whole structure of the rehabilitation programme, shows deep understanding of the psychology of the patient with spinal cord injury.
Physical training and sports played an essential role during the Jewish revival after the end of the 19th century. It was not just an expression of a new Jewish self-confidence but also a way for the integration of Jews into a non-Jewish environment. One can assume that Guttmann's involvement in sports activities during his youth in Germany, as a member of the Jewish fraternity, played an important part in the inclusion of sport in the rehabilitation programme for the spinal injuries patients. Guttmann's programme aimed at reintegration into a normal life which especially in a society such as the one of Great Britain included sport.
Besides sport’s therapeutic value as complement to the traditional physiotherapy (in restoring the disabled person's strength, co-ordination, speed and endurance) sports events have a great advantage because of their recreational and psychological value. At the same time sport according to Guttmann counteracts abnormal psychological and antisocial attitudes - a disabled person's attitude to himself deteriorating into an inferiority complex characterised by anxiety and loss of self-confidence and personal dignity, resulting in self-pity and self-isolation. The aims of sport are to develop self-discipline, self-respect, competitive spirit and comradeship - mental attitudes that are essential for the disabled person's integration into the community.
The team games that Guttmann incorporated in the rehabilitation programme soon developed into sports activities in which men, women and children could participate upon their discharge from the National Spinal Injuries Centre. Soon more patients from other Units all over Great Britain started participating. A sports movement was developed that became known as the Stoke Mandeville Games. The first Games, with 14 ex--Servicemen and 2 Ex-Servicewomen competing in Archery on the grass outside the hospital ward, were held on the 28th July 1948, the same day that the London Olympic Games started. The date was not chosen by accident. Guttmann wanted his games to have a larger forum. He envisioned international Games. Since 1948 the Stoke Mandeville Games were held every year. In 1952 a team of Dutch paraplegic war veterans crossed the Channel to compete with their comrades at Stoke Mandeville in the first International Games for athletes with disabilities.
The term "Paralympic Games" was adopted later in 1984 by the International Olympic Committee.
It was decided that the games should be held in the country hosting the Olympic Games. This happened for the first time in 1960 in Rome right after the Olympic Games. 350 athletes with disabilities, men and women, from 24 countries, participated. At the 1964 Games in Tokyo, Mexican observers were present with the purpose of staging the Games together with the IXX Olympic Games in Mexico City. There was some surprise when two years prior to the 1968 event, the Mexican government backed out of the commitment to host the Paralympics because of technical difficulties.
Wanting to keep the tradition going, Sir Ludwig Guttmann accepted the invitation of the Israeli government to host the 1968 International Stoke Mandeville Games at Ramat Gan near Tel Aviv. Israel’s offer to host the Games was motivated by its wish to mark its 20th anniversary of independence. The Opening Ceremony on 4 November was held at the Hebrew University stadium in Jerusalem, before a crowd of more than 10,000. The Games were declared open by the Deputy Prime Minister, Mr. Yigal Allon. A total of 750 athletes from 29 countries participated.
The Paralympic Games have become a world wide phenomenon, watched and followed by millions. This has achieved a tremendous admiration and understanding of disabled people, especially in countries who previously denied and hid disability.
2012 will see the Paralympics in London return to their country of birth with The Guttmann Stadium at Stoke Mandeville playing an important part welcoming many teams especially as a training centre.
Guttmann directed the National Spinal Injuries Centre for 22 years and when he retired from his clinical work in 1966, the Centre had increased to 200 beds. The question today is would a Stoke Mandeville Centre have been created without the events and consequences in Germany? Would rehabilitation of spinal cord injured people have been his lifetime's work without emigrating? Would the world's negative prejudices about the "incurable" paralysis have changed without the refugee Guttmann? Guttmann himself answered these questions by referring to Winston Churchill: "Since the Nazis drove out Jewish scientists, British science has got ahead of the Germans"
Joan Scruton MBE (“Secretary General of the International Stoke Mandeville Games Federation”), Poppa, Charlie Atkinson MBE (“Technical Director of the International Stoke Mandeville Games Federation”)
Today Guttmann is internationally recognised as a pioneer in the field of rehabilitation of spinal injury patients. Since 1948 he was council for many governments in the world in matters of paraplegic rehabilitation and he promoted the creation of many Paraplegic Centres. The Stoke Mandeville Centre became an example for 40 other rehabilitation centres around the world. In1966 the 1st Paraplegic Centre in a German University in Heidelberg was set up bearing his name "Ludwig Guttmann's home”. In Barcelona the spinal centre is known as The Guttmann Centre.
A life size bronze statue of “Poppa” has been commissioned and will be unveiled in June 2012 to stand outside his National Spinal Injuries Centre in recognition and celebration of his groundbreaking and vital work for all those with what he described as “Of the many forms of disability which can beset mankind, a severe injury or disease of the spinal cord undoubtedly constitutes one of the most devastating calamities of human life”.
