CHAPTER 2
THE STOKE MANDEVILLE NATIONAL
SPINAL INJURIES CENTRE
INTRODUCTION OF A COMPREHENSIVE TREATMENT AND
REHABILITATION SERVICE
In 1943 I was given the task by the British Government authorities to set up a new Spinal
Unit at the Ministry of Pensions Hospital, Stoke Mandeville in Aylesbury, as one of the
medical preparations for the Second Front planned for the Spring Offensive in 1944,
when an increased number of spinal cord casualties was anticipated.
With the opening of this unit on i February 1944 with one patient and 26 beds, a
concept of comprehensive treatment and rehabilitation was introduced for spinal cord
sufferers. The basic principle of the new concept was the aim to provide for spinal
paraplegics as well as tetraplegics a comprehensive service from the start of their injury
or disease and throughout all stages to rescue these men and women from the human
scrap-heap and to return most of them, in spite of their profound disability, to the
community as useful and respected citizens. The chief object was not just to preserve
the lives of paraplegics and tetraplegics, but to give them a purpose in life. To achieve
this object it was a fundamental task to establish a synthesis between all clinical proce–
dures and all measures to be taken for the social resettlement of these patients, which
were not considered as separate entities but,
a priori,
and throughout all stages to be
planned and carried out as one common operation.
Naturally, the practical application of this philosophy was no simple task, considering
the thousands of years' old prejudice towards spinal cord sufferers. Moreover, although
Stoke Mandeville Hospital, built on ground level without steps or stairs, and with a wide
open space around the hospital, appeared to be most suitable for a Spinal Injuries Centre,
the facilities available for a comprehensive management of these patients were hopelessly
inadequate, and the paramedical staff delegated to the unit quite unprepared and
untrained. My first nursing staff consisted of a young registered sister, commanded by the
Matron to take on the job as sister-in-charge of the ward, a female auxiliary nurse and
eight medical orderlies seconded from the Army. When I enquired of the first orderly
about his experience as a medical orderly in the Army, his answer was 'Shovelling coal.
Sir,'! The attitude of physiotherapists in those days towards spinal paraplegics was as
defeatist as that of most members of the nursing profession, and an illuminating account
has been published in 1949 by one of my former physiotherapist-pupils in
Cord,
the
journal of paraplegics founded in 1947 at Stoke Mandeville by Captain P.F.Stewart and
five other patients of the unit 'to promote the best interests of all those suffering from
spinal troubles and to employ the influence and machinery of the British Legion in all
Pension matters and such problems as Housing and Employment; to spread abroad
all information of particular interest to paraplegics; and to foster in civilian life that spirit
