Dot Tussler started at Stoke Mandeville in 1982 and is now one of the longest-serving physiotherapists working at the hospital.

Conversation with Dot Tussler February 2011

I came to work at Stoke Mandeville as a physiotherapist in May 1982. I wanted the experience of working in spinal cord injury rehabilitation and had the intention to stay for 18 months. SCI rehabilitation appealed to me as an area of work where my input as a physiotherapist would make a difference. I arrived as a rather nervous and shy person but soon integrated to the all encompassing and demanding role that each physiotherapist had with their patient caseload. I immediately became interested in the use of sport within rehabilitation. Sport was used as an integral component to the rehabilitation programme and provided the means to develop strength, balance and coordination for newly injured patients. The added benefit of socialising and competition through the medium of sport was an opportunity for both staff and patients to learn and develop new skills. The presence of a weekly sports club in the spinal centre attended by both staff and patients enhanced the interaction and use of sport and confidence building. At that time the spinal centre provided much of the social environment for staff. Tuesday night was sports club night, whilst Wednesday was the film evening, with films screened on a projector in the long open Nightingale wards. There was little need for staff to venture into Aylesbury for entertainment.

Within this backdrop of work and play there was the added role the physiotherapists had in the competitive sport that took place at Stoke Mandeville Stadium.

In those days the relationship between the hospital and the stadium was close and symbiotic in comparison to the more separate and independent organisations they are today.

The sports department in the hospital was run by Harry Metcalfe, a very enthusiastic Remedial Gymnast. (The Endeavour trophy awarded at the current inter Spinal Unit Games is named after him). He made the entire physiotherapist aware of the events that were occurring at the stadium. In those days Stoke Mandeville hosted, 3 years out of 4, the International Stoke Mandeville Games, there was the annual National Games and various other events that also took place. During the 2 weeks of the International Games limited annual leave was available to the physiotherapists due to the need for them to assist at the event. I can recall the instructions in what to wear for the Archery tournament and the correct procedure for marking, scoring and removing arrows from the targets. There was also the associated cultural awareness and social life that went with hundreds of disabled athletes visiting Aylesbury. On the stadium car park there were numerous cubicles highlighted the range of needs required from our international visitors such as banks, telephone booths, taxis, coaches, cafes, souvenirs etc.,. I can vividly remember having the thought ‘why do I need to travel around the world, when the world is actually travelling around me!’

My main professional involvement in the Games came as a classifier

This interest started during the National Games and grew into a role over several years. This gave me a chance to work with Charlie Atkinson, a former physiotherapist from the Spinal Centre, and someone who had worked closely with Sir Ludwig Guttmann in promoting the use of sport in rehabilitation as well as developing competitive disability sport. With the ignorance of youth, I was not really appreciative of the significance of his contribution, but could not fail to be impressed by his dignity, courtesy and kindness. His assistant in the processing of the classification system was Margaret Maughan, introduced to me as a former Paralympic athlete in bowls and archery. Again I didn’t appreciate the significance of the impact this individual had on disability sport, Margaret had won the first Paralympic gold medal in 1960 in archery. In the years that have followed I have had the privilege to meet Margaret on many occasions, and her story is special. She too, is a fantastic role model in regard to the fullness of living and independence which can be achieved following SCI.

My role in classification at that time was to assess the physical potential of athletes aiming to compete. The purpose of this is to group equally able athletes according to their neurological function. Games competition at these events was restricted to SCI, Spina Bifida and Polio. Classification has since evolved to group athletes according to functional abilities regardless of the cause of the disability. This role was fascinating and demanding; giving a chance to meet athletes prior to competition and gain an insight into the demands and aspects of the various sports. For example the impact of spasticity or lower limb flickers of movement in a swimmer, or the normal sensation and varied distribution of paralysis in an individual with polio. Informal classification was often known to continue during the evenings when exuberant or commiserating athletes let their hair down at the nightly entertainment in the ‘Beer Tent’. The ability to stand or dance provided additional insight into the ability to move.

One of the advantages of being a classifier was that your job was usually finished prior to the competition, (except for appeals and reviews). This enabled you to be free to watch any of the subsequent competitions. As a physiotherapist, it also gave me the opportunity or interaction with other physiotherapists and medical colleagues from all over the world. This gave me the chance for interaction and informal discussion with experienced clinicians involved in spinal injury rehabilitation from across the world. As the years went by I would meet regularly with these same people and get the chance to gain from their knowledge and experience, as well as socialising and dancing. As I myself became more established within this network the friendships and clinical respect grew into the forming of a ‘medical’ committee. Early morning meetings were held to discuss clinical issues relating to disability sport or sports science took place. I used to attend these at 7.30 and take the minutes before going on to my work at Stoke Mandeville. These early beginnings contributed to regular networking of clinicians being established during subsequent sporting competitions. In hindsight it is now possible to appreciate the rapid changes and growth that were insidiously taking place within the world of disability sport. At the time I was unaware of anything other than what was happening in front of me.

Political events which affected disability sports

Although my interest was in the sport and its link with rehabilitation, the political side of things taking place in the world was also acknowledged within the annual International Stoke Mandeville Games. Several events took place that reminded me that politics were also present in disability sport. Perhaps this represented its growing influence and stature on the world stage.

Three political events remain in my mind. The first was during one of the Opening ceremonies, (I cannot recall the year), and all the teams were parading behind their flags. The Technical Director, Cliff Last, was in his usual prime position and was primed to ensure everything ran like clockwork. Then as the Iranian team joined the parade a member of their delegation pulled out a flag of the Ayatollah and shouted something to the crowd. I saw Cliff sprint through the crowd and wrestle the poster from the man. It made me stop and think.

However, one of the most poignant moments took place in 1985. It was the day of the closing ceremony and it was pouring with rain. It was raining so hard that the closing ceremony had been moved inside into the sports hall. This in itself was strange. The teams all paraded in and an announcement was made that the ISMGF (International Stoke Mandeville Games Federation had banned South Africa from future competitions due to the continued presence of apartheid and the political pressure that required this to happen. The South African team were inclusive of both black and white athletes and it seemed a bizarre situation. For me it felt so confusing; I guess I was naïve and unaware of the reality of politics in my world. It was so sad. However, a thread going through the crowd was whether this reflected the growth and standing of disability sport in that the same political influences affecting able-bodied sport should be applied. I had taken for granted the exclusion of South Africa from the1964 Olympics. That gave me something to think over. But the sight of so many familiar faces showing their sadness and dejection as they left the Sports Hall made it difficult to be objective. In the years that followed I still maintained contact with the South African doctors who were still able to attend the games in their various medical capacities. It was a great event when the situation was resolved and the South African athletes were once again allowed to part pate when international sanctions were lifted in 1992.

The other political event that was entwined with my recollections of the International Games came in 1990, when Kuwait was invaded. This took place around the time of the International Games making it difficult for many members of the Kuwaiti team to return. They had to stay on at the stadium accommodation for several weeks until it was safe to return home. Again this episode brought home the realities of the wider world to me at Stoke Mandeville.

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