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Sir Ludwig Guttmann.jpgIn August 2012 and March 2014, I posted about the Paralympics.

During the London 2012 Paralympic Games, the BBC broadcast a film which told the story of Dr Ludwig Guttmann and his radical physiotherapy which helped to give new purpose to paralysed soldiers at Stoke Mandeville Hospital in Aylesbury, Buckinghamshire during the Second World War.

The drama, based on Guttmann’s life and his patients’ experiences, is called The Best of Men. The Beeb rebroadcast it during the Sochi games. If you ever have a chance to see it in 2016 (no doubt the next time it will be shown), please don’t miss it. In fact, everyone should see it. (In the US, it might be shown on PBS or the BBC cable channel.)

Guttmann had been working in his native Germany with spinal injury patients since 1917. By 1933, he became the country’s best neurosurgeon. He practiced medicine there until he was forbidden by law, because of the Nazis. Even on Kristallnacht in 1938, he ordered his staff to admit Jews into the wards and provide them temporary sanctuary, even if they had only minor wounds. When the Gestapo eventually arrived, Guttmann told the officers the people were too seriously injured to be arrested. He saved 60 people from the concentration camps.

That anecdote, which appeared in the Daily Mail in August 2012, gives us the measure of the man whom the British Government invited to work at Stoke Mandeville Hospital. Before he reached Stoke Mandeville, he had escaped to Portugal in 1939 on a visa the Nazis gave him, treated a patient there and intended to return to Germany via London. However, the Council for Assisting Refugee Academics (CARA) arranged for him and his family to remain in England.

The Guttmanns settled in Oxford. Guttmann continued his spinal research for four years at the Radcliffe Infirmary. In 1943, the British Government offered him a post at Stoke Mandeville. They invited him to establish the National Spinal Injuries Centre.

As The Best of Men reveals, British medical care for paralytics was shockingly primitive. This is surprising, given that the UK has given the world some of the greatest physicians over the past few centuries.

Essentially, the British medical establishment viewed these men as nothing more than ‘cripples’ who would soon die. This reminds me of the Belgian paediatrician I quoted yesterday, Dr. Gerlant van Berlaer, in my post on children’s euthanasia. In fact, if euthanansia had been legal in Britain, I have no doubt that many doctors would have put these men forward.

When Dr Guttmann first entered his new spinal injuries ward, he was shocked and angered by what he saw. Men were lying in a room which was black as night. In the film, Guttmann rushes to open these heavy blackout curtains and let in sunlight which dazzled the men. They had not seen daylight for some time.

The patients were bound in heavy plaster casts and fitted with catheters. Any nurse will tell you that this produces bedsores and fatal infections of the urinary tract. One young soldier pleaded with Guttmann to kill him. He was in that much pain.

The film shows Guttmann wasting no time in cutting away the plaster casts. What he sees shocks him: huge bedsores on every man’s back. He also removes the catheters surgically.

The spinal injury nurses find his behaviour shocking. One wants to leave. Dr Cowan, the surgeon from whom Guttmann must borrow supplies, is appalled at the notion that physiotherapy could save these men. He expects them to die, as their families have been told routinely.

After painstaking nights of personally turning over the patients every two hours to swab their bedsores, Guttmann develops a way of rehabilitating the men to give them a purpose in life.

As his daughter Eva told the Daily Mail in 2012 (emphases in bold mine):

My father’s big thing was that he was determined to make his patients taxpayers.

After their wounds were healed, the next step was to get the men to sit up at a 90-degree angle. The film shows that if you’ve been propped up at a 45-degree angle for weeks on end, once you fully sit up you also throw up.

Guttmann procured wheelchairs for his patients. He also installed a large worktable at which they sat potting plants and constructing birdhouses.

As they built up their activity levels, the next thing on Guttmann’s agenda for them was physical fitness. According to the film, he had a tough time persuading a PT instructor posted to the hospital to work with the paraplegics. ‘I deal in fitness, not disability,’ the instructor said.

Guttmann pressed on. The film shows us how the nurses began relating to the men as people, not vegetables.

The PT instructor, with Guttmann’s guidance, got the men on the hospital grounds, playing catch and moving on to archery. The unthinkable became routine.

The men built up muscle and energy. They also regained their sense of self.

The film shows them preparing for a competition. Guttmann asks the young man who wanted to die if he was ready to face one of his opponents. The young man replied jovially:

I’ll kill him!

Guttmann smiled wryly and said:

A short time ago you asked me to kill you. Now you’re ready to kill another man. We’re making progress.

However, as one can imagine, Guttmann had to personally deal with areas of deep-seated resistance from his patients and their families.

One example shown in the film was that of the cranky Welsh Cpl Wynne Bowen (Rob Brydon), who adamantly insists on a divorce because he fears he will no longer be able to satisfy his wife. It takes Guttmann a long time to persuade him not to do so.  When Mrs Bowen visits with their two children and says she has put their name on the waiting list for a new one-storey house, Wynne is unimpressed. Guttmann sees how much she loves her husband. Yet, it takes a lot of doing for him to persuade a bitter Wynne to return to Wales for a weekend at home. That Sunday evening, Guttmann, the nurses and the men apprehensively await Bowen’s return. Suddenly, in he rolls singing Men of Harlech at the top of his lungs! He has a future.

Another example — and the film has more — is the time Guttmann spent with parents of a young soldier who will never walk again. The father sees life in a nursing home as the only route. Guttmann has to persuade them that their boy can live in the outside world.

Guttmann’s daughter Eva told the Daily Mail about another patient:

One of them told me he was lying in a corner of the ward feeling sorry for himself and my father came along and asked, “What are you doing?” He said he was waiting to die. So my father said that, whilst you’re waiting for the Good Lord to take you, go to the workshop and do some carpentry, do some work, start a career.

So he did. And this chap told me that after leaving hospital, he actually became the head of a building firm and did very well.

Guttmann referred to his patients as ‘the best of men’ and was eager for them to rejoin society. He believed in the power of sport as a means of physical and mental rehabilitation. The film shows brief newsreel footage of the first two Paralympic Games. The first was held in 1948 and was called the Stoke Mandeville Games. They ran whilst London hosted the Olympics that year.

Wikipedia says:

Dr. Guttmann used the term paraplegic games to National Games held in order to encourage his patients to take part. This came to be known as the Paralympics which only later became the parallel games and included other disabilities.

Four years later:

more than 130 international competitors had entered the Stoke Mandeville Games. As the annual event continued to grow, the ethos and efforts by all those involved started to impress the organisers of the Olympic Games and members of the international community…

His vision of an international games the equivalent of the Olympic Games themselves was realized in 1960 when the International Stoke Mandeville Games were held alongside the official 1960 Summer Olympics in Rome. Known at the time as the 9th Annual International Stoke Mandeville Games, and organised under the aegis of the World Federation of Ex-servicemen (an International Working Group on Sport for the Disabled), they are now recognized as the first Paralympic Games. (The term “Paralympic Games” was retroactively applied by the International Olympic Committee in 1984.)[16]

In 1961, Guttmann founded the British Sports Association for the Disabled which would later become known as the English Federation of Disability Sport. In the same year, he became the inaugural President of the International Medical Society of Paraplegia (now the International Spinal Cord Society (ISCoS)).

Guttmann became a British citizen in 1945. A few years later, Guttmann’s efforts received official recognition. He was appointed an Officer of the Order of the British Empire (OBE) in 1950. In 1957, he became an Associate Officer of the Venerable Order of St John. He received another honour, that of a Commander of the British Empire (CBE). Queen Elizabeth II knighted him in 1966.

Guttmann died in 1980. Fortunately, his legacy lives on and has expanded around the world.

May the Lord give us more Guttmanns, not only in spinal research and physiotherapy but also in general practice, psychiatry and psychotherapy. We desperately need them.

I hope and pray that we turn away these horrific notions of euthanasia and abortion.

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