Professor Sir Ludwig ‘Poppa’ Guttmann CBE FRS is known as the father of the Paralympic movement; he was the medical pioneer who proved that disabled sport could be as competitive and exciting as a non-disabled sport. In September 1943, he took charge of the National Spinal Injuries Unit at Stoke Mandeville in England. He implemented his own theories on how best to treat patients who had paraplegia by introducing rehabilitation through sport. This led to national competitions, then to the International Stoke Mandeville Games and finally the Paralympic Games, which has become the third largest sporting event in the world.
Courtesy of Psychology Today New Zealand
Early years to 1944, from Germany to Stoke Mandeville.
Ludwig Guttmann was born on July 3, 1899 to a German Jewish family, in the town of Tost, Upper Silesia in the former German Empire (now Toszek in southern Poland), the son of Dorothy (née Weissenberg) and Bernard Guttmann, a distiller. When Guttmann was three years old, the family moved to the Silesia city of Königshütte, (today Chorzów, Poland).
In 1917, while volunteering at an accident hospital in Königshütte, he encountered his first paraplegic patient, a coal miner with a spinal fracture That same year, Guttmann passed his Abitur at the humanistic grammar school in Königshütte before being called up for military service.
Guttmann started his medical studies in April 1918 at the University of Breslau. He transferred to the University of Freiburg in 1919 and received his Doctorate of Medicine in 1924.
Escape to Britain
By 1933, Guttmann was working in Breslau (now Worclaw, Poland) as a neurosurgeon and lecturing at the university. Guttmann was expelled from his university appointment and his job in 1933 under the Nuremberg Laws, and his title was changed to Krankenbehandler (one who treats the sick). With the arrival of the Nazis in power, Jews were banned from practicing medicine professionally; Guttmann was assigned to work at the Breslau Jewish Hospital, where he became medical director in 1937. Following the violent attacks on Jewish people and properties during Kristallnacht (The Night of Broken Glass) in November 1938, Guttmann ordered his staff to admit any patients without question. The following day, he justified his decision on a case-by-case basis with the Gestapo. Out of 64 admissions, 60 patients were saved from arrest and deportation to concentration camps.
Ludwig Guttmann, eldest child of four, in Tost, Upper Silesia in Germany (which is now Toszek in Poland), and raised in the Jewish faith. He started studying medicine at the University of Breslau in 1918 after he was turned down for military service on medical grounds. He continued his studies in Würzburg and Freiburg and received his Doctorate in Medicine in 1924, writing his thesis on tumors of the trachea.
Return to Breslau
Having returned to Breslau, he worked with Europe’s leading neurologist Professor Otfrid Foerster from 1924 to 1928. In 1928, Guttmann was invited to start a neurosurgical unit in Hamburg but this post only lasted a year as Foerster asked him to return to Breslau as his first assistant – a job Guttmann felt he could not refuse. He remained in this job until 1933 when, under the Nuremberg Law, the Nazis forced all Jews to stop practicing medicine at Aryan hospitals. Under such oppression, Guttmann became neurologist to the Jewish Hospital in Breslau and was elected Medical Director of the whole hospital in 1937.
On November 9, 1938 (Kristallnacht), Guttmann gave orders that any male person entering the hospital was to be treated, despite the racial laws specifying that Jewish doctors could only treat Jewish patients. The following morning, he had to justify the large number of admissions (64 patients) to the SS and the Gestapo.
Eva Loeffler, Guttmann’s daughter: “He took the Gestapo from bed to bed, justifying each man’s medical condition. He pulled faces and grimaced at the patients from behind their back, signaling to them to pull the same expressions and then saying, ‘Look at this man; he’s having a fit!”
Like all Jews, Guttmann’s passport had been confiscated, and he was not allowed to travel; however, in December 1938 he was ordered by von Ribbentrop to travel to Lisbon, Portugal, to treat a friend of the dictator, Salazar. On his return journey he was granted permission to go to England for two days. He was already in contact with the British Society for the Protection of Science and Learning and was offered a grant. He decided to emigrate with his wife and two children.
To Oxford and Stoke Mandeville
Eva Loeffler, Guttmann’s daughter remembers: “It was 1939 and I was six years old. I remember I was abnormally frightened at the time; I used to cry a lot. Even as a small child I picked up the fear and sadness felt by my parents.”
His daughter continues, “Although Jews were allowed to take out some furniture, clothes and linen they were not allowed to take any money, gold silver or jewelry. But the official who was supervising us came round the day before and told my mother “I shall be an hour late tomorrow’. It was obviously a hint that we might pack what we wanted, but my mother was too frightened to take anything forbidden as she thought it could be a trap.”
The Guttmann family left Germany on the 14th of March 1939, and went to Oxford where the family found a small house to live in. Guttmann was working at the Radcliffe Infirmary and at St Hugh’s College Military Hospital for Head Injuries. In 1943 he was asked by the Government to become Director of the new National Spinal Injuries Centre at the Emergency Medical Services Hospital at Stoke Mandeville. He accepted the post on the condition that he could treat patients in his own way with no interference.
1944-66 The National Spinal Injuries Centre
The new Spinal Injuries Unit was opened at Stoke Mandeville Hospital in February 1944 with Dr Guttmann in charge. It had 24 beds and one patient. It was initially very poorly resourced, but the medical need was clear; within six months Guttmann had nearly 50 patients.
When Ludwig Guttmann started work at the Spinal Injuries Centre at Stoke Mandeville, life expectancy for paraplegics was only two years from the time of injury. Guttmann refused to accept that a spinal injury was a death sentence, and his advancements in the treatment of paraplegia have revolutionized the field. He influenced and taught a whole generation of physicians from all over the world in his methods, and centers were established worldwide (including those named after him in Barcelona, Heidelberg and in Israel).
Dr John Silver: “Essentially if they went anywhere else for care, the spinal injuries patients died. He exerted a total, obsessive control over all aspects of care at the hospital, whether it was him coming round in the middle of the night to make sure that the nurses had turned patients, or checking on the quality of the cleaners’ work, or that of the food served on the wards. Everything was his responsibility. This was such an enormous contrast with consultants in other hospitals.”
Professor Wagih El-Masri: “His philosophy of dedicated management of spinal injury patients from injury to the grave is still credible today and has whenever possible been adopted around the world…Guttmann made Stoke Mandeville into a successful model for others to copy. Sir Ludwig Guttmann’s vision for changing the lives of those with spinal cord injury has achieved so much, but his lasting legacy is that you must always ask yourself, ‘What needs to be done now?’ That is the challenge he has handed down to each of his successors.
Rehabilitation
An important part of the treatment was to ensure that patients maintained some hope of making progress and returning to their previous life. Patients took part in activities to keep them active – a social rehabilitation as well as a medical one. Workshops where the patients could do woodwork and clock and watch repairing were set up in the hospital. But it was the encouragement of sporting activities that was to make the greatest impact on the wards. The first sport was wheelchair polo using walking sticks and a puck, but this was soon replaced by wheelchair basketball. Archery was also popular; it relied on upper body strength which meant that paraplegics could compete with their non-disabled counterparts, and it was archery that was the first competitive sport at the Stoke Mandeville Games in 1948.
At the 1956 International Stoke Mandeville Games, the International Olympic Committee (IOC) awarded Guttmann the Sir Thomas Fearnley Cup for his service to the Olympic movement.
In 1960 Guttmann met Dr Nakamura from Japan when he visited the National Spinal Injuries Centre for a few months. He was interested in learning about Guttmann’s work in rehabilitation, using sport as a method of treatment and therapy which led to a much shorter time of recovery for patients. This concept had not reached Japan at this stage where bed rest and immobilization were still common for those with spinal injuries. This meeting was instrumental in the overall history of the Paralympic Games and key to bringing the Paralympics to Japan, which was the second country to hold the Paralympic Games in 1964 and then went on to hold them for the second time – hosting the 2020 Paralympics in the summer of 2021.
1966-80: Retired but still active
Following his retirement from the Spinal Injuries Centre in 1966, Guttmann continued to be heavily involved with the Games and the national and international organisations, both sports and medical. That year he was knighted by Her Majesty the Queen, becoming Sir Ludwig Guttmann. In 1969, following fundraising to cover the cost of the building works, a new sports center was opened by Queen Elizabeth II on the Stoke Mandeville Hospital grounds, later renamed ‘Ludwig Guttmann Sports Centre for the Disabled’ after his death.
As well as his involvement with the Games, he continued to travel and lecture on spinal injuries all over the world, continuing to educate and influence others with his theories and methods. However, it was his leadership of the disabled sports organizations that occupied him through the late 1960s and 1970s. It was in the 1970s that Guttmann spear-headed the conversations with the International Olympic Committee about the use of the term ‘Olympic’ and the name of the various organizations – conversations that directly led the way to the close relationship with the IOC and the later establishment of the International Paralympic Committee.
Caz Walton, patient of Dr Guttmann and subsequent GB athlete at 5 Paralympic Games: I think Sir Ludwig just changed the world for us; it was a complete step change… He came in, he had a vision… As far as disability and disabled sport was concerned he did change the world.
The aim of the Stoke Mandeville Games is to unite paralysed men and women from all parts of the world in an international sports movement, and your spirit of true sportsmanship today will give hope and inspiration to thousands of paralysed people.
Forty-five years on the terminology may have changed but the core message remains the same. That statement of intent was first unveiled for the International Stoke Mandeville Games in 1953; it hung in the new sports stadium when it opened in 1969; and then in the archery room at the hospital.
It was Sir Ludwig Guttmann’s drive and determination for disabled sportsmen and women to be included in the Olympics that gives us the Paralympic Games today. The London 2012 Paralympic Games showed how close the world has got to Guttmann’s vision with the Olympic Games and Paralympic Games being organised in tandem. However, there is still a way to go to see the two events combined into one sporting event where disabled athletes compete alongside their non-disabled counterparts.
Martin McElhatton, Chief Executive, Wheelpower – British Wheelchair Sport: “Ludwig Guttmann once said, “If I ever did one good thing in my medical career it was to introduce sport into the rehabilitation of disabled people”. This is still true today and manifests itself through the organisation WheelPower, the national charity for wheelchair sport whose base is at Stoke Mandeville Stadium, which he established as the British Paraplegic Sports Society and which aims to transform lives through sport. Providing opportunities for young and newly disabled people to benefit from participation in sport is key to their rehabilitation and personal development. “
Tanni Grey-Thompson, Paralympian: “If I could say anything to Sir Ludwig it would be, ‘Thank you’… Before he did his rehab work at Stoke Mandeville, if you broke your back or your neck you were just left in hospital to die; it was that simple.”
Professor Sir Ludwig Guttmann died on the 18th of March 1980 of heart failure following a heart attack some months before. He did not live to see his vision realized, but his work continues through the current disabled sports organizations and through the National Spinal Injuries Centre at Stoke Mandeville, which continues to be a world leader in the treatment of spinal injuries.
