The new Spinal Unit was opened at Stoke Mandeville Hospital in March 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.
Treatment for paraplegics in England was still rudimentary. Patients with spinal injuries had a two-year life expectancy. It was not the injury itself that was life-threatening but the twin dangers of pressure sores and urinary tract infections. In The US in the 1930s Dr. Munro had begun to transform the treatment of spinal injuries by ensuring that patients were turned every two hours to prevent bedsores; this was a regime that Guttmann quickly copied.
“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.” Dr John Silver
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 a 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.
“My eyes were opened when we received one particular patient in 1956… He had had to wait eighteen months before he could get transferred to Stoke; and when he came to us he had every complication in the book; he was covered in pressure sores; his kidneys were full of stones; he was practically dead. And this man, working with poor staff who he had welded into a team that he could rely on (he had done it all himself): he cured him, sent him out into the world and back to a meaningful life. For me it was one of those Damascus moments; The stories about him were true.” Dr John Silver