Dr John Silver first worked for Sir Ludwig Guttmann at Stoke Mandeville in 1956 and then succeeded him as the director of the Spinal Injuries Centre.

An interview with Dr Silver

June 2011

Guttmann favoured physiotherapy over occupational therapy and the latter service was very under resourced at Stoke Mandeville. This was largely his personal belief; other hospitals took Occupational Therapy a lot more seriously. Part of the problem was what was on offer: basketry! If you give people useful things to do then they will enjoy it. When I subsequently became director I introduced the first computer room as part of OT and it was extremely popular.

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.

Extract of the conversation where Dr Silver talks about his initial interest in orthopaedics and his first encounters with Professor Sir Ludwig Guttmann at Stoke Mandeville…..

I qualified in 1954 and I had become interested in Orthopaedics while still a student. My first job was at Luton and Dunstable Accident Unit where there were lots of road accidents and I was working under a very hands-on and inspiring consultant, Laurence Plewes; I did six months there. When that finished, I said to the senior registrar I was working with, ‘Well I have seen a lot of acute Orthopaedic cases; where should I go to experience chronic Orthopaedic cases?’ He advised visiting either the National Orthopaedic Centre at Stanmore or to Stoke Mandeville. So  I visited Stoke Mandeville in 1956 and witnessed the quite superb spinal injury work that Guttmann was doing there. This was between jobs.

At this time spinal injuries was not a popular field to work in; it was seen as both too specialised and also as a bit of a dead-end job.

Also Guttmann already had a reputation as a man who was known to be very difficult to work with. One of the results of this was that he was surrounded by junior staff who were neither very good nor very committed.

Very few English doctors seemed prepared to put up with working under him. Ludwig Guttmann was always short of staff and invited me to work for him but I could not as I was not fully registered. I went to do my House Physician’s job. I did my 6 months medical job and had a very bad time of it. It was uninspiring; I was learning nothing; but working 100 hours a week, sometimes three nights in succession. I wanted to give up medicine, but I remembered how good it had seemed at Stoke Mandeville; and Guttmann had always said,’ Come back and work for me’.

So I went to Stoke and for the first six months he was wonderful: devoted to his patients, inspiring to his staff, a good teacher. I loved him; I wanted to be like him; I respected him; the work he was doing was quite fantastic.

My eyes were opened when we received one particular patient, who as it happened, was the nephew of the consultant Neuro-surgeon at the Middlesex. He had had a spinal injury accident abroad and she had supervised his transfer home to the Middlesex where he was cared for.


While I was a student at the Middlesex, I had seen him there at his arrival. He 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 little German Jew, 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.

Then I did a months’ full time research work which was very stimulating.

He had arranged things so that when I went off to do my military service in the RAF, I was stationed at the RAF hospital at Halton nearby so that I could cycle across and do research work at Stoke as well. I realised while I was in the forces that I wanted to make a career in spinal injuries but that I would have to obtain a higher qualification and further training before going back to Stoke Mandeville Hospital. I passed my membership and worked for the professor of neurology at the Middlesex Hospital for 2 ½ years and by then I had a very good training in orthopaedics in the air force and civilian practice and 6 months in neurosurgery. In 1962 when I went back to Stoke Mandeville, there was no registrar post for me; instead I worked as a researcher with the understanding that I would also have clinical work as well.

Download a pdf of Dr John Silver's full interview here