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It had been Timothy's eighth birthday and a wonderful day. He'd had a party in the afternoon with all his friends there. The sun had shone all day, so rare in a typical English summer, so they could play games in the garden and there'd been jelly, trifle, cobs, orange juice and a lovely birthday cake in the shape of a train at the end of the tea. He'd received some smashing presents including the clockwork Hornby 'O' Gauge train set he'd hoped for, but never expected to get. After the party was over his dad had got down on the floor with him and they'd set it up between them. The locomotive was painted black with 'LNER' on the side with two trucks and a guard's van. His grandmother had given him a water tower and his older sister had given him a signal. His dad and he played together with the train set for hours after the party until mum had come to say that it really was Tim's bedtime. Dad even offered to pack it away for him. He gave his dad a big hug and thanked him and then a hug and kiss for mum both for the train set and for all her work for the party. He went to bed that night very, very happy. Surprisingly, in view of his excited state, he was so tried that he dropped off to sleep almost immediately.
In the middle of the night, mum was woken to the sound of a plaintive little voice calling, "Mum, I feel sick!" She got out of bed and picked up the enamel bowl from the top of the stairs, put there in case of emergencies as Tim and the other children had eaten rather well at the party, and went into Tim's room, turning the light on as she did so. She held the bowl out and Tim sat up only to be very, very sick in it. She thought that he'd brought it all up when he was sick again and again. When the poor little lamb appeared to have finished, she took the bowl away to empty and to fetch both a flannel to wash his face and a glass of water for him to wash the foul taste which she was sure must have been in his mouth.
When she returned, Tim was lying there exhausted. To her eyes it didn't look like over-eating as his pyjamas were wet through with perspiration and it was dripping off his face so she put her hand to his forehead. He was burning up with fever. She washed his face for him and gave him the water to sip slowly. He had a couple of sips of water and promptly brought it straight back again. She had had the foresight to bring the bowl back with her, so saved the bedclothes, but she was very concerned. She called her husband who, sleepily, got out of bed to see what the problem was. "I think we need the doctor. Tim's not at all well. Have a feel of his head yourself." Tim's dad put his hand on his forehead and looked at his wife. "I'll go and phone straight away." He went to get dressed to go round the corner to the telephone box. This, by the way, is the late 1950's where few homes have a telephone. When he got through and explained the problem, the doctor said that he would come at once. In fact, as the doctor had just returned from another call, he had pulled up outside the house just as Tim's dad arrived back from phoning. He was led upstairs to Tim's bedroom and looked at the poor boy lying there, soaked in perspiration. "Have you taken his temperature yet?" asked the doctor. "Sorry, doctor, we don't have a thermometer in the house." "That's all right. I'll start with that." The doctor explained to Tim that he would have to take it rectally as Tim had been sick. Mum was asked to arrange Tim on his side and remove his pyjama bottoms so the doctor could insert his thermometer. Tim, by now, was in rigor – shaking uncontrollably from the effects of the high temperature on his body. He was past caring what was happening to him. The doctor dipped the thermometer in a little pot of Vaseline which he had specially for that purpose and gently inserted the thermometer in Tim's rectum, leaving it there for four minutes to get an accurate reading. When he took it out, he wiped the bulb and looked at the thread of mercury. "105.4oF. He needs to be in hospital, I'm afraid. With him unable to keep down fluids and sweating like he is, he's already showing signs of dehydration. Let's have a look at you, old fellow." With that, the doctor turned Tim onto his front and gently palpitated his abdomen. The doctor's probing hands felt the very enlarged liver and noticed as well the yellowish tinge to Tim's flesh. "I'm afraid he's got hepatitis, so it'll be the Isolation Hospital. He's a good strong lad, so he should be all right, but I must warn you that the outcome isn't certain." Tim's mum burs into tears at this and was comforted by her husband. "I'll go back to my surgery to phone for an ambulance and to contact the hospital to expect Tim. Don't bother packing any clothes for him as he'll have to wear the hospital clothing because of infection risk. You'll need to boil his bedclothes and disinfect this room. I also suggest that you don't go with him in the ambulance. It'd be better if they get him settled first and you can visit later 9 o'clock in the morning. May I wash my hands now?" Tim's dad showed the doctor where to wash his hands and gave him a clean towel. Tim's mum stayed with Tim, holding his hand and crying quietly. The day had be so wonderful and this was such a black night.
The ambulance came some twenty minutes later. The crew came to the front door, wearing cotton face masks and white gowns, and Tim's dad carried him downstairs to the waiting ambulance. Tim was placed on a stretcher, covered with a thin blanket and then the crew set off for the Isolation Hospital. This was in the grounds of the district general hospital. It consisted of wards with individual rooms for each patient containing a bed, two chairs, a bedside cabinet and a wash basin. Each ward was separated by an open air corridor designed to prevent germs spreading form ward to ward. They were bleak Victorian single storey buildings on the hillside above the main hospital. Tim was taken to one of the wards and carried in, wrapped in the blanket. The ward sister indicated where Tim was to go and he was placed on the bed. The ambulance men went outside Tim's room where they removed their gowns and masked and thoroughly washed their hands before going out to disinfect their ambulance.
Sister was helped by another nurse, both enveloped in their white gowns, masks and rubber gloves. Each put on one of the two rubber aprons hanging from a hook inside Tim's room and went to strip off Tim's pyjamas and put him instead in a hospital gown. Before they put him in the gown, however, they took out from the bedside cabinet a pile of thick terry towelling nappies, nappy pins and a pair of amber coloured transparent natural rubber pants. Tim was expertly placed in the thick nappies and rubber pants. He protested weakly that he wasn't a baby and didn't wet the bed, but Sister shushed him, telling him that he was very poorly and that's why he was in the nappies. If he needed to 'go' he was to be a good boy and use his nappies.
After the nurses had got Tim into his nappies, rubber pants and gown, the doctor arrived to examine him. He concurred with the G.P.'s diagnosis of hepatitis and asked Sister to fetch him the equipment for a saline drip. Sister hung up the apron, went outside where she placed her mask and gown in the bin provided and thoroughly washed her rubber gloved hands, drying them on one of towels which was then dropped into the bin with the gown. She went to fetch a drip stand, hung a bottle of saline from it, and placed all the equipment needed in a stainless steel tray. She returned to Tim's room where she put on mask and gown before entering. Once inside, she put her rubber apron back on and handed the tray to the doctor. He inserted the needle into a vein in the skin of Tim's forearm and held it there while Sister taped it down. The other nurse took a crepe bandage and wrapped it around Tim's arm to secure the tubing and needle in place. The doctor then set the drip running. "I want him to have a pint of saline alternating with a pint of glucose with each bottle running through in five hours. That's be roughly five pints a day, but we need to keep him hydrated and wash the poisons out of him." With that the doctor left. The nurse pulled up the cot sides around Tim's bed while Sister further bandaged Tim's arm with the drip in it to the cot side so that he couldn't thrash around in his sleep and accidentally pull the needle out. Tim was then left to sleep the rest of the night away.
The next morning two nurses came into the room and woke Tim who was feeling really rotten. To his horror, he' discovered that he'd wet his nappy overnight without realising it. He started to cry. "What's the matter, Timmy?" asked one of the nurses, anonymous behind her gown and mask. Tim looked up and mentally called then 'fair' and 'dark' from the colour of their hair. "I wet my nappy last night and I've been dry at night for ages. And why am I tied up?" "Don't worry about, Tim," said 'dark', "Your arm has a tube with a needle in it to give you water as you can't drink at the moment without being sick. We don't want you to accidentally pull the needle out as that would hurt. That's why your arm was tied up. We won't tie it up during the day, but we'll have to tie it up at night, I'm afraid. The reason you're in nappies and you've wet them is that you're very poorly and we expected that you'd be wet. That's why you were put in the nappies last night, or don't you remember much about arriving here?" "Not really," said Tim.
First, the cot sides were lowered after Tim's arm had been untied The nurses took Tim's gown off him, feeding it through the drip tubing and bottle. He was lifted up and a towel placed under him. The nurses then proceeded to wash him from face and ears to feet, leaving his nappy on. His rubber pants were pulled down to his ankles and the soaking wet nappies removed. His nappy area was washed and dried and a thick layer of zinc and castor oil cream was applied to prevent nappy rash. Tim was rolled onto his side and 'dark' took a thermometer, stuck it in a pot of Vaseline and inserted into Tim's bottom. She held it there whilst she watched the second hand of the clock in the room. 'Fair' took Tim's wrist and took his pulse at the same time, also checking his respirations while she held his wrist. 'Dark' removed the thermometer, wiped it and put it back in the container on the bedside cabinet. The nurses then rolled Tim onto his back and put another thick layer of nappies on him, finally pulling up the rubber pants and tucking all of the nappies inside the rubber cuffs at legs and waist. Tim didn't like the rubbers as they were tight at the legs and waist and dug into him. He also wasn't happy about wearing nappies as he was a 'big boy' of eight years now. 'Fair' said to him, "If you need to go to the toilet, you must use your nappies. We'll be in to check on you from time to time and we'll change you if you need it." 'Fair' wasn't a children's nurse – she was used to nursing adults, but had been loaned to the Isolation Hospital from the main hospital for three weeks to cover for a nurse who was off sick. 'Dark' could see the distress which Tim was suffering because of his nappies and said, "You're not a baby, Tim, and we don't think you are one. It's just that you are very poorly and it's easier for us for you to be in nappies and, probably, easier for you. Don't worry about it, pet. You'll soon be well!" She mentally added a "we hope!" to that last comment.
Tim had been in the hospital for four days, although he'd completely lost track of time as he'd spent so much of his time asleep. The doctor came to see him and palpitated his abdomen again. "His liver is still very swollen," he said to 'fair'. Tim really didn't like her. Of all the nurses, she was the roughest and seemed to object to looking after him. "I don't think we should start him drinking for another couple of days, but he needs mouth care and I notice he's not passed any stool since he's been here. With hepatitis, his liver doesn't need the strain of an oral laxative, so I'd like you to gibe him a soap and water enema this morning," the doctor continued. Tim saw 'fair' make a face when the doctor's back was turned as he left the room. He wished that it had been any other nurse except her. He also didn't like the sound of a 'soap and water enema'. He didn't know what it was and he thought he didn't really want to find out. However, he was sufficiently aware to know that he'd have very little say in the matter.
'Fair' left the room too, but came back a few minutes later with 'ginger'. Tim liked her. She had a sense of humour and was kind and gentle with him. They were carrying some equipment on a tray. Both nurses put on their rubber aprons. 'Ginger' lowered the cot side on one side of Tim and pulled back the sheet which had been covering Tim off him. He'd not had anything else over him as his temperature was still too high and they didn't want to overheat him. She then removed his gown to avoid it getting wet or messy. Gently, with Tim's co-operation, she worked a large red hospital rubber sheet under him and a couple of large bath towels so that he was lying on the towels rather than the rubber sheet. 'Ginger' said to him, "Roll onto your left side, Tim, and draw your knees up." Tim did as he was told. 'Ginger' turned to 'fair', "I'll do this with your assistance. He needs treating gently and it's not his fault you're here." Tim didn't know what that was about, but he was grateful to 'ginger' for thinking about him like that. She poured soapy water from a jug into an enema can and gave the can to 'fair' to hold. She held the nozzle over the towel and opened the tap to let a little of the soap out of the tubing, thus expelling all of the air. She pulled Tim's rubbers done at the back and worked his nappy down a bit, exposing his bottom. She dipped a finger in the Vaseline pot and lubricated the nozzle. "Tim, let me tell you what we're going to do. I'm going to put my finger into your bottom to put a little bit of lubricant there so I can put this nozzle in without hurting you. Then I'm going to run some soapy water into your bottom. Tell me if you feel any cramps and we'll stop for a bit. When all the water is inside you, I'll remove the nozzle and pull your nappies and rubbers back up. The soapy water will make you want to go to the toilet really badly, but I'd like you to try to hold it for as long as possible before you let it out into your nappy. Can you do that for me?" "Yes, nurse," Tim affirmed. She was nice and he'd do anything she said.
'Ginger' gently worked her lubricate finger into Tim's bottom, eventually reaching the end of her finger. She was trying to get as much lubrication there as possible and to dilate Tim's anus a little as it had tightened from disuse to stop it hurting too much as the hardened stool came out if he didn't hold it long enough for the soapy water to soften it for him. She then put the nozzle into him and opened the tap. She held the nozzle in place with one hand while 'fair' held the can up. "Not so high," said 'ginger', "he's only a young boy and we don't want to hurt him, do we?" She gave 'fair' a 'hard stare'. Tim reported cramping, so the tap was turned off to allow 'ginger' to rub Tim's tummy for him. The tap was turned back on and the process repeated until Tim had taken all of the soapy water. 'Ginger' removed the nozzle, pulled up the nappies and rubber pants and said to Tim, "Good boy. You've done well! I suggest that you roll on your back and bring your knees up. It'll be easier when you need to 'go', but please hold it as long as you can for me, won't you?" With that, both nurses left the room, taking the equipment to wash and sterilise. Tim laid there, feeling very bloated from the soap water. His tummy was already swollen from the hepatitis and was now even more swollen from all the soapy water inside him. He felt the urge to have a bowel movement, but fought it with all his might, so much so that sweat covered his head as he tried his best for 'ginger'. About five minutes later, 'fair' came in. She reckoned he'd held the enema long enough to do its required task so she thought she'd have some fun with him. She really hated nursing children and wished that she could be back on her male surgical ward in the main hospital. She came over to Tim, "Still holding it, Timmy?" He hated being called that. She was the only one who insulted him by using that diminutive of his name. "Yes, nurse," he replied, "I was told to hold it as long as possible, so I'm trying to do that." She reached over to him and started to tickle him. "That's not fair!" Tim exclaimed as he fought to do what 'ginger' had asked him. Suddenly he couldn't' hold on any more. The tickling had made him loose control and the enema did its worst, flooding his nappy with the light brown soapy water and stool (Hepatitis means that the bile from the liver is excreted via the blood into the urine, making the urine dark and the stools light in colour) The soapy water just poured out of him uncontrollably and could be seen staining the nappies through the rubber pants. 'Fair' kept teasing him, "Who's been a naughty big baby then and messed his nappies?" She laughed and put her rubber gloved hand between Tim's legs and pushed, making the wet mess up around his genitals and over his abdomen. She laughed at him as he blushed bright red at loosing control of his bowels in front of her and being mocked in this way.
The door flew open. "Nurse, to my office right now!" It was Sister in her navy blue uniform, belt with silver buckle from her nursing school, white starched apron and cuffs around the short sleeves of her dress and stiff starched white hat. She'd not even bothered to put a gown on when she opened the door. She held the door open while 'fair' hung up her rubber apron and left the room. Tim laid there wet, messy and miserable. She'd confirmed it: he was a big baby wetting and soiling his nappy like that. As he thought that, a fresh spasm overcame him as he emptied his bowels some more.
Half an hour later, 'ginger' came in with 'fair bun'/ She had fair hair too, but her hair was done in a bun at the back, so Tim called her that to himself so he could identify each nurse individually. 'Fair bu' was nice, too. "We've come to clean you up and put you in clean nappies. Have you passed everything, do you think? If you haven't, we can come back in a few minutes rather than your having to go again and being uncomfortable in messy nappies." "No, nurse, I'm sure I've finished, than you." was Tim's reply. The two nurses quietly and carefully removed the wet messy nappies and rubbers, washed and dried him, creamed him and then put a clean gown on him. 'Ginger' then washed his face for him. This was done in silence by the two nurses and Tim wondered what he'd done wrong that they wouldn't speak to him. 'Fair bun' left and 'ginger' sat on the chair beside the bed. "Tim, I'm not sure I should really be saying this to you, but Sister has sent that nurse who was nasty to you back to the main hospital and asked for a nurse from the children's ward there to take her place. She'd in an awful lot of trouble both for they way she treated you and two other children in this ward. You're not a big baby – just a very sick boy who needs looking after. Just look at you face," she said with a laugh. "Don't fret, poppet, you've done nothing wrong. It's not your fault." With that, she lifted him from the bed and placed him in her lap. The cold rubber apron felt strange against his face and the smell of the rubber was strong. She rocked him gently, murmuring reassurance to him. Sister came in, "Nurse, doctor has decided that we should try Tim on a drink today. I've put it in a bottle so he can't gulp it. Would you give it to him?" "Of course, Sister, it'll be a pleasure." Sister held out the bottle with a rubber teat on it. The nurse took it and gently put it between Tim's lips. "Don't suck too hard. Let it wet the inside of your mouth and wash away any nasty taste. Just relax now. Don't worry. Everything is fine." She continued to rock him as Tim fell into an exhausted sleep from the exertion of having the enema. He continued to suck at the bottle as the nurse intended. She smiled to herself. Yes, she was treating Tim like a baby, but the other nurse didn't understand that people can't help regressing when they're very ill and she enjoyed being able to care for them. She liked working with children and babies and, if Tim 's needs were to be babied a little, well, so be it. Assuming he survived the hepatitis and, fortunately, that was looking more likely every day, he'd have plenty of time later to go back to his chronological age.
Tim unfortunately had been very ill. Although he'd been allowed to drink a little, his liver took several weeks before the swelling went down. Meantime, Tim had turned a deep yellow-brown colour from the bile which was in his bloodstream. He Was too poorly to be allowed to eat as it would only have made him sick again. He continued to receive nourishment through his drip and became very thin. His mother would come to visit him and, unbeknown to Tim, leave in tears because of his condition. The doctor and nurses assured her that Tim was getting better, but looking at him wasting away day after day, getting weaker and thinner, didn't reassure her.
One day Tim complained that he felt like he needed to do his 'number twos' and couldn't. The nurse spoke with the doctor who suggested that it could be a build-up of mucus from where Tim's colon was out of use. "Give him another enema, nurse. That should sort it for him." 'Ginger' and 'black' came to give Tim his enema. "Tim," 'ginger explained, "we're going to ask you to use your nappy again when you release the enema. If you were a grown-up, one of us would have to stay with you and help you on the bedpan. We'd probably have to support you, too, as you know yourself you're very weak at the moment." "It's all right, nurse. I don't mind 'cos you look after me so well." 'Ginger smiled and said, "Thank you, Tim. That's nice to know!" Between them they lifted the boy who was now so light with his wasted muscles and not an ounce of spare flesh on him. You could count all his ribs and he looked more like a child from a famine. 'Ginger' gently pulled back his nappy, lubricated his anus with her greased finger, and inserted the nozzle. This time the enema was only warm water as it was felt that a full soapy enema would be too much for him in his weakened state. When they'd finished, 'ginger' pulled his nappies and rubber pants back up, but left him lying on his side. "We'll be back soon to change you into dry nappies in a while." Time decided that he enjoyed the warm, wet feeling as he found it strangely comforting. When 'black' called round the door, to save having to mask and gown up, to ask if he was ready for a nappy change, Tim blushed a little as he lied to her, "Can I have a few minutes more. I don't think I'm finished yet." "OK," came the answer, "We'll be back in a bit." About half an hour later, 'black' and 'ginger' came in to wash and change Tim into clean, dry nappies."The enema was a success as a load of hardened mucus came out and Tim said he felt much more comfortable.
Came the day when the doctor decided that he could start to try to eat. 'Ginger' held him cuddled close into her rubber apron on her lap whilst 'black' spoon fed him jelly. It was divine! The next day ice cream was added to the jelly and Tim was pleased, as were the staff, when it stayed down without problems. Soon Tim progressed to a light diet and the needle was able to come out of his arm. He was still skin and bones with his arm and leg muscles wasted to little knots along the bones. With his inactivity, no-one was surprised when Tim became constipated. The doctor ordered a glycerine suppository, followed by a soap and water enema if the suppository proved ineffective. 'Ginger', his favourite nurse, came in to give him his suppository and explained what she was going to do and the consequences of the treatment failing. She asked Tim to roll over onto his left side and then pulled his rubbers and nappies down far enough so that she could slip the suppository into his bottom. She noted that he was slightly damp, but decided to change him after the suppository had done its work. She dipped the glycerine suppository in warm water to soften and lubricate it. Picking it up, she pressed it against his anus and pushed with a finger from her other hand to slide it up inside Tim as far as she could reach. She pulled his nappies and rubbers back up, asking Tim to try to hold it for about twenty minutes if he could. She washed her rubber gloves at the sink and, after drying her hands, went over to ruffle Tim's hair. "You're a good boy," she said to him.
Tim decided that he wanted to have the enema and decided to try to hold on to the suppository if he could. After about an hour, 'black' opened the door and called to him, "Has it worked, Tim? Have you had a bowel movement?" "No, nurse," he called back, "nothings happened yet." "OK, Tim. We'll be in to give you an enema then." They came back a few minutes later, but not with the equipment he'd been expecting. The enema can was there, but a rubber syringe was connected to it. It was red rubber with a bulb in the middle. 'Black' explained that the black rubber nozzle would be put in his bottom as before, but that one of them would squeeze the bulb gently to pump the ho soapy water into him. The enema can was placed on the bedside locker and Tim was lifted by the nurses onto a rubber sheet and a layer of towels. His rubber pants and nappies were pulled down enough to expose his anus and 'black' inserted a greased finger into his back passage before inserting the nozzle. 'Ginger' started squeezing the bulb to squirt the soapy water into Tim's rectum. She did it slowly and gently, but Tim could feel the pulsations as the soapy water was pumped into him. When the can was empty, Tim's abdomen was bulging as he'd taken quite a lot of soapy water with that enema. The nurses had decided to do the job properly. The nozzle was removed and his nappies pulled back up and his rubber pants over the nappies. They left him to hold it as long as possible. When they'd gone and after a reasonable time, he left the water out a little at a time until he was thoroughly soaked. His nappy was damp already so he leaked spectacularly. When the nurses came back, he needed washing all over again. He loved that!
Tim began to enjoy her enemas. He liked the warm wet feeling in his nappies as he found it strangely comforting. He loved the attention which the nurses gave him and he enjoyed being cuddled by then as they all encouraged him to drink from 'his' bottle. He'd go to sleep in the nurse's arms and wake up later in bed. He didn't mind as he'd had the cuddle first. He wet his nappy during the daytime without thinking about it anymore. The feel of the wet nappy against his skin and the tight rubber pants became the norm for him. He would often go to sleep with his thumb in his mouth and his other hand caressing the smooth rubber of his pants.
All too soon, to Tim's mind, he was well enough to be discharged. Staff no longer needed to wear masks and gowns when they came into his room. He really didn't want to go home as he loved being in nappies and having enemas regularly. The doctor came to see him. "Tim, I'm pleased to tell you that you're well enough to be discharged from here. However, you need a great deal of physiotherapy before you can go home, so I've arranged to transfer you to a convalescent hospital near here. They don't usually take children, but, because of your weakened state, they've agreed to look after you." 'Ginger' was with him. "I'm being transferred to the convalescent hospital until you've well enough to go home. I hope that's all right with you?" "That'll be lovely, nurse!" Tim exclaimed with enthusiasm.
He was transferred by ambulance the two miles to the convalescent hospital with her. She had brown paper packages with her. Tim was staring at them , wondering what they were. 'Ginger' saw his interest and told him, "As the hospital doesn't normally have children, I've brought a pile of nappies and rubber pants for you to wear, as well as hospital gowns for night-time. Did the doctor tell you that you're been so poorly and have been using nappies for so long that your bladder has shrunk so you may have to wear nappies for the rest of your life." "Really?" Tim asked, then realised that perhaps he shouldn't sound so enthusiastic. "Oh dear!" "that;'s all right, Tim, I know you like your nappies and enemas and you'll still be getting those while they get you back on your feet again."
She was right: Tim's bladder didn't stretch back again and efforts from the doctors to encourage it to do so were undermined by Tim not co-operating with them. In later life, he was offered a surgical procedure to stretch his bladder, but he turned it down, preferring to stay in his nappies and rubber pants. He even refused to switch to disposable nappies when they were made in adult sizes. He still needs regular enemas to help with his constipation, but, then, he wouldn't have it any other way.
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