Ludwig Guttmann in office
Dr. Ludwig Guttmann

In 1917, at the age of 18, Ludwig Guttmann volunteered at a hospital and watched a young coal miner, who suffered a serious spinal injury and paralysis, wither away over a five-week period in isolation. Doctors could do nothing for him except encase him in plaster and watch him die. Six years later, Guttmann graduated from the University of Breslau in Poland in medicine, after which he took a position in Neurology and Neurosurgery, only because he could not find a placement in pediatrics, his first choice.

That decision was to have impact ripples that resonate powerfully today.

As the head of the National Spinal Injuries Center at Stoke Mandeville Hospital in Buckinghamshire, England, Dr Guttmann pursued a line of treatment novel at the time – rehabilitation of injured war veterans via sporting activities to build up not only their physical capacity, but also their mental strength. Likely recalling the demise of the young coal miner when he was 18, Guttmann believed that patients with such disabilities required a new form of treatment, a forward-thinking treatment, that would eventually prepare them for re-entry into society. As explained in this article:

Guttmann fundamentally disagreed with the commonly held medical view on a paraplegic patient’s future and felt it essential to restore hope and self-belief in his  patients as well as practical re-training so when they were well enough to leave they could once more contribute to society. He achieved this firstly by changing the way they were treated – he had them moved regularly to avoid the build up of pressure sores and the possibility of urinary tract infections developing – and secondly by engaging them in physical and skill-based activities. Sports like Archery improved their mental wellbeing while learning new skills, such as woodwork, clock and watch repair and typing, would ensure they would be employable. If staff, or patients, on Ward X thought they were going to have an easy time, they were in for a shock.

Guttmann was less innovator and more revolutionary, a man who’s powerful belief in the ability of disabled patients to recover from tremendous physical disabilities to re-enter society led to an incredible transformation at the spinal injuries center. According to this article, Stoke Mandeville had 24 beds and 1 patient when Guttmann arrived, but within 6 months the center housed close to 50 patients, all receiving his obsessive care. Said one Dr. John Silver,

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.

Inspired by the 1948 Olympic Games which were held in London, Guttmann held an archery contest on July 28, 1948, the day of the opening ceremonies of the London Olympics. A total of 16 disabled wheelchair-bound men and women came together representing two institutions: The Star and Garter Home in Richmond Surrey and Stoke Mandeville. (According to the Star and Garter site, their team won, not only in 1948, but also 1949.)

Javelin throw with Ludwig Guttmann watching
Javelin throw with Ludwig Guttmann watching

The archery contest was well publicized, for it was in the spirit of the Olympics, whose ideals of participation resonated with the disabled who yearned to participate and be included. Guttmann is quoted here as saying, “Small as it was, it was a demonstration to the public that competitive sport is not the prerogative of the able-bodied.”

And thus was born the Paralympic Movement.

If ever I did one good thing in my medical career it was to introduce sport into the treatment and rehabilitation programme of spinal cord sufferers and other severely disabled.

Dr. Ludwig Guttmann, in Scruton, ‘Stoke Mandeville, Road to Paralympics’. The Peterhouse Press, 1998
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031164 - Crown Prince and Empress meet teams Tokyo Games - 3b -
The Crown Prince and Princess greet athletes at the 1964 Tokyo Paralympics.

Today, Emperor Akihito is 83 years old, a revered father figure in Japan, looked upon kindly by old and young alike. The Emperor took the unusual step to ask the Japanese government for permission to abdicate in 2019 so he could hand over the countless royal duties to his son, the Crown Prince Naruhito.

In 1959, then Crown Prince Akihito married a wealthy commoner named Michiko, in a highly publicized and popular wedding ceremony, a television extravaganza in a time when Japan was just getting its footing back after years of post-war American occupation.

When the nascent Preparatory Committee began to seriously consider the hosting of a Stoke Mandeville Games in Tokyo after the Tokyo Olympics, the head of the committee, Yoshisuke Kasai, knew he needed powerful allies and influencers to build the awareness of disabled sports and a possible Tokyo Paralympics, as well as raise the organizational infrastructure and funds required to pull off an international sporting event successfully…in only two years.

As explained in this post, part of the plan to grow awareness was to send athletes from Japan for the first time to the annual Stoke Mandeville Games in London, in 1962. According to D. J. Frost and his article, Tokyo’s Other Games: The Origins and Impact of the 1964 Paralympics, Kasai appears to have leveraged the opportunity to celebrate Japan’s participation in the Stoke Mandeville Games to introduce the importance of sporting events for the disabled to the Imperial Family. He arranged for the Crown Prince Akihito to meet the returning athletes and members of the Preparatory Committee, which was heavily covered by the Press.

In addition to the Crown Prince’s expressed hopes for the Paralympics to come to Tokyo in 1964, the newspapers were filled with pictures of the Crown Prince, the Crown Princess, and the disabled athletes showing off their skills. Members of the government, including then Prime Minister Hayato Ikeda, pledged their support for the Tokyo Paralympics. As Frost wrote, thus began a long-lasting relationship between the Imperial Family and the Paralympic movement.

Although it remains unclear how the meetings with imperial family members came about, it seems likely that committee members, and perhaps Kasai specifically, mobilised their social connections to establish what proved to be a long-lasting and critically important link between the Paralympics and the imperial household. Associations with the Crown Prince, in particular, practically guaranteed the Games increased media attention. At a moment when the ruling conservative party in Japan, led by Prime Minister Ikeda, was looking to revive the influence and prestige of the imperial family, the potential power of the Crown Prince’s expressions of support should not be underestimated.

A cording to this paper called The “Legacy” of the 1964 Tokyo Paralympics, from the Journal of the Nippon Foundation Paralympic Research Group, Kazuo Ogoura explains that the involvement of the Imperial Family in the 1964 Tokyo Paralympics was significant, as “at least one of the members of the Imperial family went to see some events every day,” and that their commitment to disabled athletes was heartfelt:

Even after the Games ended, they extended full-scale cooperation and support to those involved. This experience helped them establish in-depth knowledge and interest in the Paralympics in general. It must be noted that the Imperial involvement came from their heart, rather than physical and systemic arrangement. A member of the Paralympics’ International Secretariat said, “When the Crown Prince and Princess unofficially invited the members of the Secretariat to the Imperial Palace, the Crown Princess Michiko told us that their young prince made a Teru Teru Bozu doll to pray for sunny weather during the Paralympics.”

The Japanese government was conscious now of the possibility of the Tokyo Paralympics, and the impact that such a successful international event right after a successful Tokyo Olympics would help boost Japan’s standing in the global community. They also understood that to succeed, the institution of the Imperial Family and the increasing star power of the Crown Prince and Princess were needed. That in turn would continue to enhance the Imperial Family as a fundamental pillar of Japanese society. As Frost wrote,

The Tokyo Paralympics, emerging from this same historical and cultural milieu, proved no less important as a tool for reviving national symbols and bolstering Japan’s international prestige. Indeed, viewed in this light, the Crown Prince’s oft-mentioned involvement with the Paralympics reflected more than a personal commitment on his part; it was a carefully cultivated and highly politicised link designed to benefit both the Games and the international reputation of Japan’s future monarch.

The Crown Prince and Princess, as you can see in the video below, were present during a good part of the 5-day Paralympics. Unlike Emperor Hirohito, whose appearance at the opening ceremonies of the 1964 Tokyo Olympics was most official and formal, the Crown Prince and Princess walked among the athletes, stopping to greet and talk with them. Their exit during the closing ceremonies of the Tokyo Paralympics was a stroll across the gymnasium flow, waving and smiling at the wheelchair athletes – a modern royal family for changing times.