A young doctor in Silesia
Ludwig Guttmann was born on July 3, 1899, into a traditional German Jewish family in Tost, a small town in Upper Silesia, then part of the German Empire and now Toszek in southern Poland. His father, Bernard, was a distiller, and his mother was Dorothy, née Weissenberg. When he was three the family moved to the industrial city of Königshütte, today Chorzów.
In 1917, while volunteering as an orderly at an accident hospital for coal miners in Königshütte, he met his first patient with a broken spine, a young miner. He was told the man would be dead within weeks, and he was: he died of sepsis five weeks later. In his memoirs Guttmann wrote that the picture of that young man stayed fixed in his memory. In those days a spinal cord injury was regarded as a death sentence. Guttmann studied medicine at the universities of Breslau and Freiburg, receiving his doctorate in 1924, and became a neurologist and neurosurgeon.
Under the Nazis
In Breslau (now Wrocław) Guttmann became first assistant to Otfrid Foerster, one of the pioneers of neurosurgery, and lectured at the university. When the Nazis came to power in 1933, he was expelled from his university post and his hospital job because he was Jewish, and his professional title was changed to Krankenbehandler, one who treats the sick, since Jews were no longer allowed to be called doctors. He was sent to the Breslau Jewish Hospital, where in 1937 he became medical director.
On the night of Kristallnacht, November 9 to 10, 1938, when Nazi mobs attacked Jews and their property across Germany, Guttmann ordered his staff to admit anyone who came to the hospital, no questions asked. The next day the Gestapo came. Guttmann justified each admission case by case. Of the 64 people admitted, 60 were saved from arrest and deportation to concentration camps.
Escape to England
His escape came through an unlikely route. The Nazi authorities gave him a visa and ordered him to Portugal to treat a friend of the dictator António de Oliveira Salazar. He was due to return to Germany through London, and the Council for Assisting Refugee Academics arranged for him to stay in Britain instead. British records show him entering the country from Lisbon at the end of December 1938; by March 1939 his wife Else and their two children, Dennis and six-year-old Eva, had joined him in Oxford. The council gave the family £250 to help them settle.
Guttmann continued research on spinal injuries at the Nuffield Department of Neurosurgery at the Radcliffe Infirmary. For their first weeks the family lived in the Master’s Lodge of Balliol College as guests of its Master, Lord Lindsay, a leader of the refugee council. They joined Oxford’s Jewish community, which was growing fast as displaced Jewish academics arrived from Europe. When war broke out he was granted full exemption from internment as an enemy alien.
Stoke Mandeville
In September 1943, prompted by the Royal Air Force, which wanted better treatment for airmen with spinal injuries, the British government asked Guttmann to set up a specialist unit at Stoke Mandeville Hospital in Buckinghamshire. The National Spinal Injuries Centre, Britain’s first, opened on February 1, 1944, with Guttmann as director, two nurses and eight orderlies. He ran it until 1966.
Guttmann identified the two great killers of paralysed patients: sepsis from pressure sores and infections of the urinary tract. He ordered nurses to turn every patient in bed every two hours, day and night, so that sores never formed, and he improved the way bladders were drained. Just as important, he refused to let his patients lie waiting to die. He believed that they had to want to live, and that the way to give them that will was to get them out of bed, into wheelchairs, into workshops and back into the world. A Ministry of Labour visitor in 1948 called him a skilled specialist doing magnificent work, determined to get his patients back to a self-supporting life. For the first time, people with spinal cord injuries stood a real chance of living, and many went home and back to work. He became a naturalised British citizen in 1945.
A government file from 1949 describes the method. Treatment began with healing sores and restoring the function of the body’s organs, while staff worked to convince each patient that his condition could be much improved and that he might again take his place in working life. Patients were trained to sit up, then to use a wheelchair, then given physiotherapy to strengthen the muscles of the upper body. Workshops prepared them for jobs. Not everything impressed the visiting officials, one of whom felt that the job-placement side lagged far behind the medical rehabilitation, but the direction was clear: the spinal unit was a place to rebuild lives, not to wait for death.
Sport as medicine
Guttmann believed sport was one of the best forms of therapy: it built strength, coordination and endurance, and it restored self-respect. At Stoke Mandeville patients played basketball and badminton, and Guttmann introduced archery because he found it excellent for developing the muscles a wheelchair user depends on. As a young man in Germany Guttmann had been a fencer, and historians suggest that the German Jewish student fraternities, which used sport to build confidence, shaped his belief in its power.
On July 29, 1948, the day the London Olympic Games opened, he staged an archery competition on the hospital lawn for 16 paralysed servicemen and women, the first Stoke Mandeville Games. He held them every year. In 1952 a team of Dutch ex-servicemen took part and the games became international. In 1956 the International Olympic Committee awarded him the Sir Thomas Fearnley Cup for the social and human value of wheelchair sport.
The Paralympic Games
Guttmann’s dream was a games for disabled athletes that would stand alongside the Olympics. In 1960 the ninth International Stoke Mandeville Games were held in Rome after the Olympic Games there, with about 400 athletes from 23 countries. They are now recognised as the first Paralympic Games, and Guttmann was there. Since then the Paralympics have been held every four years; Winter Games followed in 1976, and since 1988 the Summer Paralympics have used the same cities and venues as the Olympics. The International Paralympic Committee was founded in 1989.
The games grew from wheelchair athletes to include people who are blind, amputees, and people with cerebral palsy and other impairments. Today thousands of athletes from around the world compete before huge crowds and television audiences, and the Paralympics have changed how societies see disability: not as the end of a full life, but as one of many ways of living one. Guttmann also founded the British Sports Association for the Disabled in 1961.
A world authority
Guttmann’s influence on medicine was as large as his influence on sport. In 1961 he founded the International Medical Society of Paraplegia, now the International Spinal Cord Society, serving as its first president until 1970, and he was the first editor of its journal, Paraplegia, now Spinal Cord. His 1973 textbook, Spinal Cord Injuries: Comprehensive Management and Research, set out the Stoke Mandeville model of comprehensive care, from nursing to rehabilitation to return to work, that spinal units around the world adopted.
Britain honoured him with an OBE in 1950, a CBE in 1960 and a knighthood in 1966, and he was elected a Fellow of the Royal Society in 1976. In 1974 a street in Heidelberg was named after him, and German newspapers described him as the famous Englishman from Germany.
Jewish refugee
Guttmann’s life was shaped by the persecution of Germany’s Jews. He lost his career to the Nazi race laws, risked his own safety on Kristallnacht, and survived because a refugee organisation and British academics gave him a way out. He remained part of the refugee community all his life: he served on the board of the Association of Jewish Refugees for more than 25 years, and in 2013 the association unveiled a plaque in his honour at the National Spinal Injuries Centre.
Patients remembered him as demanding, even a tyrant, who could be both liked and resented, but whose results earned respect. His daughter, Eva Loeffler, was appointed mayor of the athletes’ village at the London 2012 Paralympic Games, where the mascot was named Mandeville after the hospital where it all began.
Death and legacy
Guttmann retired from clinical work in 1966 but remained devoted to disability sport, developing the Stoke Mandeville Stadium, now the national centre for disability sport. He had a heart attack in October 1979 and died on March 18, 1980, aged 80. He is buried at Bushey Jewish Cemetery near London. The British Medical Journal wrote that he was loved and would be remembered by paralysed patients throughout the world who understood what he had done for them.
His legacy is twofold. In medicine, he showed that people with spinal cord injuries could survive and live long, active lives, and the principles of his unit underpin spinal injury care everywhere. In society, he created the Paralympic movement, which has given disabled athletes a world stage and changed millions of minds about what disabled people can do. A neurorehabilitation hospital in Barcelona, the Institut Guttmann, bears his name, and a statue of him stands at Stoke Mandeville.
Sources & further reading
Sir Ludwig Guttmann and the birth of the Paralympic Games, The National Archives (UK) · Paralympics History, International Paralympic Committee · How Nazi persecution of a Jewish doctor led to Paralympics, The Times of Israel (JTA) · Ludwig Guttmann, Wikipedia · Researched from the sources above and checked against them. Spotted an error? Tell us.
A life of tikkun olam. This is part of tikkun olam, the Jewish idea of repairing the world, and every one of us can add to it.