Made in Britain: How the Paralympic ideal was born
At an NHS hospital 64 years ago, a doctor had a revolutionary idea. Peter Popham tells a story that began at Stoke Mandeville
In March, Edward Ho, a 26-year-old barrister, lost his balance doing a snowboarding jump on holiday in Austria. "As soon as I stopped sliding I knew I was in trouble," he says. "I couldn't feel my legs. It was very odd, there was no pain, no concussion, I was able to speak – I said a few words in broken German to the people who called the helicopter to get me out – but it felt like I was trapped in a very large person's body, like the Michelin man."
Mr Ho had fractured his spinal cord, damaging the anterior artery, which had bled on to the cord. Today he has sensation down to his feet, but he cannot walk, can only sit up with difficulty, and is unable to make a fist. After three weeks in a general hospital in Austria he was flown to Stoke Mandeville Hospital, outside Aylesbury in Buckinghamshire – the spiritual home of the Paralympics.
It was in this sprawling NHS Trust hospital 64 years ago that the Paralympic idea was born, when the doctor who had revolutionised the treatment of spinal injuries here, a German Jewish refugee called Dr Ludwig Guttmann, launched the first small prototype of the Paralympics that start tomorrow, involving 16 patients with damage not much different from Mr Ho's, many of them D-Day veterans.
It is disturbing to contemplate that only five years before that pivotal if little-noticed event, patients with injuries like this were regarded as beyond hope. They were routinely put under heavy sedation, encased in plaster and left to rot, often quite literally. And when they died, often quite soon, it was not the injuries that killed them but the treatment: lying immobile for months on end, they developed bedsores that festered and stank; permanently cathetered, they developed bladder and bowel infections which ended up killing them. "Back in those days," says Dr Claire Guy, from the rehabilitation programme at Stoke Mandeville, "life expectancy was often only a couple of years."
As a young man in Upper Silesia, now part of Poland, Ludwig Guttmann had already seen the results of such institutionalised neglect first-hand. He had volunteered at a hospital which had received an intake of injured miners, and found himself in front of a huge, strapping miner, encased in plaster from head to foot. "Don't bother with this one," the doctor said as Guttmann began to take notes, "he will be dead within weeks." The man duly died. Guttmann never forgot him.
When he arrived at Stoke Mandeville in 1944, he found the same dismissive attitude towards patients described by some doctors as "moribund incurables". "No one wanted these patients, who smelled of urine and whose flesh was rotting," says Dr Alison Graham, today the director of the unit. "They were left in bed for months at a time. Their pressure sores were ignored on the grounds that spinal patients had no sensation."
Guttmann, stocky, arrogant and bloody-minded, decided to do things differently. In the teeth of fierce resistance from nurses, doctors and sometimes the patients themselves – shocked at being taken off their medication, indignant at being required to exert themselves – he began to treat these recumbent cadavers-in-the-making as men who still had everything to play for. "I want to turn them into taxpayers," he famously snapped. He made the nurses turn them in their beds every two hours throughout the night, to stop bedsores developing – "what a bloody pantomime!" moaned one of the patients – and he got them out of plaster, then to sit up, and brought in an army quartermaster to build up the muscles of their upper bodies. And gradually he coaxed them to develop skills such as woodwork and typing which could eventually put them back into work.
It was when Guttmann saw a group of wheelchair-bound patients knocking a puck around with upended walking sticks in the hospital grounds that it dawned on him that the competitive spirit had survived the men's injuries unscathed. He introduced them to archery and throwing javelins, and when London hosted the first post-war Olympics, he staged Stoke Mandeville's games in tandem. The seed of the great Games that start tomorrow had been planted.
While the therapies available to people like Edward Ho are a vast improvement on 50 years ago, some of the hazards patients face today are unchanged. During his three weeks immobile in the Austrian hospital Mr Ho developed bedsores which, on arrival at Stoke Mandeville, required being two months' immobile to cure.
He admits that he has at times been reduced to tears of frustration by his limitations. But soon after his arrival, he and his doctors agreed on a set of goals for him to achieve, and he is steadily meeting them. "Now I can go from lying down to sitting up," he says, "I can get in to and out of bed, I can wash myself and go to the toilet. You need a lot of patience. The only thing I can't do by myself so far is put on my socks.
"There is very good peer support here," he says, "from the many people who have been in wheelchairs for a long time. You think, 'How am I ever going to do such-and-such a thing' – then you see someone doing it and you say, 'If he can then so can I'. It reminds me of learning apparently impossible tricks in snowboarding."
Mr Ho does not plan on returning to the slopes – "I think it would make me a little depressed," he admits – but he admires the example of Stoke Mandeville graduates like double wheelchair tennis Olympic champion Peter Norfolk, the captain of England's wheelchair rugby team Steve Brown and Nikki Emerson, the track Paralympian, and is planning to take up running or archery when he is a little further down the road.
But his over-riding desire once he is discharged, perhaps in late October, is to go back to work. "I'm desperate to get out of this place and back to my life," he says.
And with wheelchair access to courts of law and voice recognition software to take the strain off his hands, there is nothing to bar him from the bar.
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