Ludwig Guttman is one of the unsung heroes of our times, the man who transformed the life chances and expectations of millions of spinally-injured people throughout the world, and who — incidentally — was the founding father of the international Paralympic movement.
Here in the UK, as next year’s London Olympic and Paralympic Games draw steadily closer, news stories appear weekly about the athletes’ preparations for the event. Many of the stories feature disabled athletes, whose training regimes are just as gruelling as those of their able-bodied counterparts. These days, disability sport — particularly the Paralympics — enjoys a high profile, with better coverage on television and a greater appreciation generally of the dedication, commitment and skill of the participants. It wasn’t always this way, and the story of how this came to be sheds an interesting light on how society can, over time, change its stereotypical attitude towards entire sub-groups of people.
The name Ludwig Guttmann is not widely known, but he was responsible for starting the sporting movement that now spans the world, involves tens of thousands of sports men and women, and attracts increasingly mind-boggling amounts of commercial sponsorship. So who was he?
Ludwig Guttmann was a neurosurgeon, born in Germany in 1899 into an Orthodox Jewish family. At the age of 17, he began working as a volunteer orderly at a hospital treating victims of mining accidents, and it was here that he first met a patient whose spine had been irreparably damaged. He later recalled that as he started to write up some notes on the patient’s file, one of the medics told him not to bother: “He’ll be dead in a few weeks”. And that’s exactly what happened.
Until comparatively recently, a diagnosis of spinal cord injury was as good as a death sentence to the person involved; it was known that there was no way of repairing the spinal cord (still true today), but there was also no treatment of what seemed like inevitable physical complications; patients were quite literally left to die, and life expectancy after spinal cord injury was a mere 3 months. Those few who did survive longer were shut away in long-stay institutions for the chronically and incurably ill, with little or no expectation that they could ever again be fulfilled and productive members of society.
Ludwig Guttmann disapproved; he was not the sort of man to accept the received wisdom of his day, whether that meant questioning some of the orthodoxies of his Jewish upbringing or expressing doubts about the treatment of the spinally-injured patients he came across. Deemed unfit for service in the German Army, he trained as a doctor and spent the next few years working his way up the ranks of the medical profession, becoming a professor of neurology in 1930. Three years later, the National Socialists were elected to power in Germany, and Jewish doctors were banned from treating gentiles in the country’s hospitals. It was a sign of things to come.
Guttmann continued working as a doctor in Germany until March 1939, when he came to Britain with his family, escaping the danger of deportation to the concentration camps. Only three years later, as preparations were being made at the highest levels of government for the forthcoming Second Front offensive, Guttmann was invited to establish a specialist centre to treat the many anticipated cases of spinal cord injury amongst wounded servicemen. He agreed, on condition that he would have complete autonomy to treat his patients as he saw fit and using regimes and methods that had never been tried with spinal cord injury before. This would become what is now the National Spinal Injury Centre at Stoke Mandeville Hospital in Buckinghamshire.
And so sport entered the world of the paraplegic and tetraplegic patients whom Guttmann started treating. He firmly and passionately believed in the efficacy of sport in treating chronically ill individuals — not simply in the sense of physical therapy, but also in raising the person’s sense of self-esteem and emotional wellbeing, of making him (and virtually all of his early patients were men returned from the war) feel a sense of pride and achievement, rather than being condemned to a future of helplessness and dependency. He introduced new methods of team-working amongst his medical and nursing colleagues, developed specialisms and psychological approaches that saw each patient treated for all of the complications of their injuries if and when they arose. Guttmann’s patients began not just to survive, but to flourish.
Interestingly, Guttmann’s European Jewish heritage may well have contributed to his belief in the therapeutic value of sport. In 19th and early 20th century Europe, thousands of Jewish sports clubs sprang up all over the continent, formed by Jews who had either been banned from other sports clubs because of their religious affiliation, or who wanted to express a rising sense of Jewish national identity through the medium of sport. Sport was seen as a way of strengthening cultural bonds and of challenging society’s stereotyped views of Jews as physical (and often moral) weaklings. Guttmann was now using that same powerful medium to transform the lives of another misunderstood and stereotyped section of society — the disabled.
In July 1948, on the same day that the Olympic Games opened in London, 16 of Guttmann’s spinally-injured patients participated in the first Stoke Mandeville Games, with 14 ex-servicemen and two ex-servicewomen competing in archery in the grounds of the hospital. There may have been only a handful of athletes there, but it was the start of what would become an annual sporting event, attracting competitors from other hospitals and spinal units around Britain and, later, from abroad. And from those small seeds have grown the Paralympic Games (renamed as such in 1984) and, since 1960, held in the same year and in the same city as the Olympics themselves.
Guttmann was knighted for his services to medicine and specifically to the treatment of spinal cord injury. He never forgot that injured coal miner back in Germany when he was a young orderly learning the ropes in hospital. Guttmann’s achievement was not simply to change the life expectancy of people with spinal cord injury from three months to almost as long as their able-bodied counterparts; he was also responsible for transforming the social expectations and life chances of people, giving them back a sense of self-respect, self-worth and achievement. In doing so, he set in motion a gradual transformation of the way society itself views disabled people — as more than just victims of accident or illness, but also as individuals who can lead full and fulfilling lives rich in a sense of self-worth and achievement.