It was thanks to Ludwig Guttmann’s drive and personality that the Spinal Injuries Centre at Stoke Mandeville Hospital developed rapidly. Starting with six beds in a twenty-bedded ward, it expanded over some fifteen years to a hundred and ninety-two beds, with an international reputation second to none. Guttmann saved and made worthwhile the lives of many thousands of severely disabled people all over the world, for he and his staff trained a very large number of colleagues from many countries in the specialized treatment of the paraplegic and tetraplegic patient.
Ludwig was born at Tost in Upper Silesia, Germany, the son of Bernhard Guttmann, a manufacturer, and his wife Dorothy, daughter of Marcus Weissenberg, a farmer. He was educated at the Grammar School in Königshütte and the University of Freiburg, Breslau, obtaining his MD in 1924. His first intention was to be a paediatrician but, by lucky chance, the one solitary job available in this specialty at Freiburg Hospital attracted a large number of applicants. He made a lightning decision and walked upstairs to apply for, and obtain, a junior post in the department of neurology where he worked under the distinguished neurologist, Otfrid Foerster. Foerster was a demanding boss, expecting complete dedication from his colleagues seven days a week, and this training was reflected in the demands and expectations which Ludwig Guttmann always exhibited throughout his working life.
From 1928 to 1929 he worked in the department of psychiatry at Hamburg University, and founded the first neurosurgical department in a German mental hospital. He returned to Breslau to be Foerster’s chief assistant, also becoming a reader in neurology, but he relinquished the position four years later as a protest against the Nazis. He was then elected reader of the department of neurology and neurosurgery at the Jewish Hospital, Breslau, and by 1937 had become medical director and was responsible for medical and nursing education, as well as being chairman of the Jewish Medical Association.
During the years that followed, he was able to help many people — Jews and Christians — to leave the country. After the 1938 pogroms, in which the Jewish Hospital was involved, and during which the Gestapo arrested many doctors, Guttmann was ordered by the Nazis not to leave Breslau. He left in March 1939.
Before the outbreak of the second world war, he had spent some time in Oxford, working with Trueta, and researching on peripheral nerve lesions under the auspices of the Medical Research Council. Later, he and Whitteridge published an original paper on the pronounced cardiovascular changes in patients with lesions at or above the level of T5 during distension of the urinary bladder. All this was to prove the prelude to his life’s work, which began in 1944 when the Government asked him to start the first special centre for spinal injuries at Stoke Mandeville Hospital, on the recommendation of George Riddock, then neurologist to the British Army. Shortly afterwards, paraplegic patients from the D-day landings were admitted, and the National Spinal Injuries Centre was launched.
It is as well to remember that all the great advances in this field have been made since the second world war, before which an injury of the spinal cord was virtually a death sentence. Ludwig tackled this unpromising subject and, at first by himself and later with a small but increasing group of colleagues, effected a complete transformation of the dismal scene. The centre at Stoke Mandeville became the Mecca for all those interested.
Ludwig Guttmann had the vision to realize that these patients could not only be kept alive but also rehabilitated to earn their own living, fulfil themselves, and not be ‘confined to the scrap heap’. In 1948 he founded the Annual Stoke Mandeville Games for the Paralysed, which in 1952 achieved renown as an international sports event for paralysed people. During the Olympic Games in Melbourne in 1956, the Olympic Committee awarded the Fearnley Cup to the organization of the Stoke Mandeville Games. It was the first time this particular Olympic award had come to Britain, and the first time it had been given to a sports organization for the severely disabled.
Coincident with the games, a scientific meeting was inaugurated, and from this developed the International Medical Society of Paraplegia, of which Ludwig was the first president and the first recipient of the annual medal. Carried forward by his enthusiasm and dedication, the next logical step was the journal Paraplegia, of which he was editor until his death. In 1979, the May edition of this journal was entirely devoted to special papers and appreciations from present and previous colleagues to commemorate his 80th birthday. In this volume are numerous stories of his many kindnesses.
Guttmann was truly indefatigable; his hard work and dedication to Stoke Mandeville did not prevent him from finding time to lecture and advise on the treatment and rehabilitation of paraplegia in over thirty countries. As a result, special centres for the treatment of spinal cord injuries were set up in many of them; the centres in Spain and Germany bear his name, as does a street in Holland. He was appointed OBE in 1950, CBE in 1960 and knighted in 1966. He received numerous decorations and honours from all over the world, and was elected a Fellow of the Royal Society in 1976.
After his compulsory retirement from the NHS in 1966, he continued to devote his energies to the service of paraplegic patients, and still worked a sixteen hour day. His research interests continued to the last, and he made some 150 contributions to medical literature.
In 1927 Ludwig Guttmann married Else, daughter of Solly Samuel, and they had a son and a daughter. Throughout his life he was supported by his wife, a woman of considerable personality and a great humanitarian. His son, Dennis, also became a specialist in medicine.
Ludwig Guttmann was a man of dedication of purpose, a tireless searcher after truth, and intolerant of carelessness, inefficiency, or low standards. He was a fighter in any cause in which he believed, and he did not usually lose a fight. At the same time, he had a kind and genial personality, always responding generously to appeals for help or advice. He was also a brilliant neurologist; his policy set the standard by which other methods were judged, and his results were unrivalled. He was an excellent psychiatrist with a profound insight into the effects of disability. Affectionately known as ‘Poppa’, his opinions were respected and his displeasure feared. It is said that when Sir William Osier was leaving the United States to take up the chair at Oxford, he remarked: ‘I have loved no darkness, sophisticated no truth, nursed no delusion, allowed no fear’. These words well describe the life of Ludwig Guttmann. Men of his calibre are rare.
Sir Gordon Wolstenholme
† The list of honorary degrees is too lengthy to include in entirety.
[Biogr.Mem.Roy.Soc., 1983, 29, 227-244; Brit.med.J., 1980, 280, 950, 1021, 1057, 1233; Lancet, 1980,1, 724-5; Paraplegia, May 1979; Koroth, June 1980, 7, 11-12; Times, 20 & 29 Mar 1980]