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CHAPTER 1
2 Nursing and other paramedical staff such as physiotherapists and occupational
therapists sufficient in number to cope with the many details involved in the work, in
particular, avoidance of the usual practice of changing the nursing staff from one depart–
ment to another at short intervals.
3 Adequate technical facilities such as workshops for the social rehabilitation of these
long-term patients, in particular pre-vocational training.
4 Arrangements for domestic and industrial resettlement of paraplegics.
5 After-care by regular check-ups of patients discharged from hospital.
It is, therefore, not surprising that these early units did not prove satisfactory, indeed
no great encouragement was given to those medical men who were charged with the task
to run them. D.Allen (1964) recalled his appointment to the job as Medical Officer in
charge of the Spinal Unit at the E.M.S. Hospital at Leatherhead as follows: 'In the
spring of 1944,I was called to group headquarters for interview with the group officer, a
surgeon of formidable character. "Alien", he said to me, "I am sorry to have to inflict
this on you, but we have been ordered to open a spinal unit at Leatherhead Hospital,
and I want you to take charge of it. Of course, as you know, they are hopeless cases
most of them die, but you must do your best for them." With these words of encourage–
ment I returned home sadly. 5
T.B.Dick (1949, 1969) has given an excellent account of the unsatisfactory conditions
prevailing in the early years of the war, in one of the first spinal units to be set up, where
some 40 cases were treated. Although a neurosurgical team was in charge of the spinal
unit, he states 'no one member of that team devoted more than a part of his time to the
care of spinal injury cases'. Dick, describing two examples of inadequate treatment which
he has chosen at random, continues, 'It was not uncommon at this period on a ward
round to find virtually every case of paraplegia with persistent pyrexia. There did not
appear as yet to be any definite plan or end in view of the rehabilitation of even the more
fit patients'. From my own observations which I made during visits to other spinal units
at the request of the Ministry of Pensions, it can be stated that conditions were very
similar in that period of war. It was little consolation that, at that time, the results in
other countries such as Australia, Canada and U.S.A. were no better. Even as late as
1944, American authors (Everts & Woodhall) were still able to write: 'Certainly it
cannot be said that any striking advance has been made in the late care of spinal cord
injuries.'
