James was a bright, popular ten year old boy in the 1950's. If you'd asked him, he'd have told you how happy he was. He had a loving mother and a dad who played football with him on Sundays after church which helped him practice the skills he needed for the school football team which played its matched every Saturday during the season with practice every Thursday after school. James enjoyed most lessons, but he lived for his football. It was the big match of the season – a real grudge match between James' school and the next primary school which between them always won the football trophy. This year it was all on this, the last match of the season. If James' school won, then they'd be the champions, but if the other school won, they'd steal the championship and James and the rest of the team weren't about to let that happen.

It was a vicious match with the referee having to show several yellow cards. James was just about to score when he was barged hard in the chest by a defender from the other team who also hooked his legs from under him. As James fell backwards, he instinctively put both hands behind him to break his fall. He fell across his wrists and both heard and felt both wrists snap as his weight bore down on them. As he fell, he heard the referee whistling for a foul. The game was stopped while a teacher ran into the school to phone for an ambulance. James' mum and dad ran over to him as he laid there desperately trying not to cry in front of the other team. The referee came over to see how he was and knelt down beside him. "You're a brave lad. That was an evil foul. I'm awarding a penalty and then I'll blow up for the end of the match. That'll leave your school two goals up if your mate can score, but you've won anyway." James gave a small smile at this wonderful news. It wasn't so bad: he'd not let his team down and they'd won the cup again. He laid there, covered by a blanket brought by the school secretary as they waited for the ambulance. His wrists really hurt and he was desperate not to show how much pain he really was in.

The ambulance arrived and James was given the black rubber mask connected to a cylinder of Entonox. The ambulance man held it over his nose and mouth and told him to take lots of deep breaths. He could hear the hiss and click from the demand valve as the mixture of nitrous oxide and oxygen entered his lungs. In a short time, his head felt like it would fly away and he felt as if he was floating. He was lifted onto a stretcher and carried into the ambulance. There his mother was asked to hold the mask over James' mouth and nose while the ambulance men fastened splints to each arm to support the fractures while they took him to hospital. He was taken to the Children's Hospital, although he couldn't remember much about the journey as the Entonox mask held to his face ensured that he stayed pain free on the gas. At the hospital, he was X-rayed and the doctor announced that James' arms were too swollen to set that day and that he'd be admitted to the orthopaedic ward for his arms to be set the next day and for a couple of days afterwards to give him chance to recover from the surgical procedure. His mother and father went with him on the trolley up to the ward where the accompanying nurse handed over the documentation and reported to sister about James and his admission. Sister directed them to an empty bed and then instructed two nurses to attend to James. The nurses came back with a trolley loaded with various items including a large rubber sheet and a bowl of steaming water. The rubber sheet was laid on top of the bedding and then covered with two thick towels. James was gently lifted from the trolley onto the towels and then his parents were politely, but firmly, requested to leave. They trolley on which James had been brought upstairs was removed and the curtains pulled around his bed. One nurse, the one with the kind smile, spoke to James, "I'm Mary and this is Gill. We're going to wash all the mud off you and get you into bed. I'm going to be your 'special' nurse and Gill is helping me clean you up a bit. All right, James?"

With that, the two nurse stripped James naked, being very careful not to hurt him. His genital area was covered with a dry wash cloth to cover his modesty while they washed him literally from head to foot, removing all the mud and rinsing him clean and spotless. "Good boy, James, that can't have been comfortable, " Mary said to him. "Gill, would you leave us for a moment, please?" Gill left the curtained area around James' bed and Mary sat down beside James. "James, I need to explain something to you. I know you're not a baby, but I'm going to have to put you in nappies and rubber pants. Every patient on this ward is wearing nappies and rubber pants because most of our patients have to stay in bed and that's the way the hospital deals with toileting from them. For some children, being in hospital makes them wet the bed at night so everyone wears nappies as the way we look after them." "I don't want to wear nappies 'cos I'm not a baby. I'm a big boy now. I don't wet the bed!" James wailed. "Yes, James, I know you're not a baby, but this is a hospital and this is the way all the children on this ward are nursed. Let me tell you a secret. Nappies feel really comfortable – you'll see! Please don't fight me, James, I really must put you in nappies. I'd get in trouble if I didn't." James had been taught to be obedient to those in authority so he agreed to do as he was told, though under protest! Mary whispered to him, "It's up to you how you use them. If you want to keep control for when you get home, hold it until you really need to go, then let it out a little at a time. If you just let go, your nappy may not soak it up fast enough and you'd leak into the bed. That way you'll still be dry at night and in control when we send you home. If you don't do that, you may find that you start wetting yourself at night so you may need nappies when you go home. As you're only planned to be in three days, that shouldn't matter, but I always warn new patients of your age."

Mary went out to fetch Gill back. "Let's get him sorted and into bed now," Mary said to Gill. Mary took two thick nappies off the trolley and Gill grasped James' ankles and lifted them off the bed so Mary could slide the nappies under James' bottom. Mary pulled the nappies tightly between James' legs and across his abdomen while Gill pinned them in place with four large nappy pins, being careful to put her fingers between the nappies and James to be sure she didn't accidentally stick a pin in him. Gill took a pair of semi-transparent rubbers off the trolley. These were a yellow-brown colour, but see through. Between them the nurses worked the rubber pants over James' ankles and legs and up over the nappies making sure that all the terry towelling was tucked inside the rubber pants. The pants cut into James' thighs and waist but the terry towelling between his legs, around his bottom and across his abdomen did, as Mary had promised, feel warm and strangely comforting.

"Now then, James, when you need to 'go', let it out slowly if you can. Sister gets cross if the bed gets wet because you've leaked and we get the blame for not putting enough nappies on you! The system is this: you'll be changed after tea and just before bed into a really thick set of night time nappies. You get a wash after breakfast and your nappies changed then and again after lunch for your afternoon nap which all our patients must have. Even if you don't want to sleep, you must be quiet so that others can have a rest. But I should warn you, you won't be having breakfast tomorrow as you're going to theatre for the doctors to reset your arms while you're asleep so it won't hurt you. You're not allowed to eat or drink before your anaesthetic. Have you been in hospital before, James?" "No, nurse, this is my first time." "well," said Gill, "I'm sure you'll be all right. It'll all seem a bit strange at first but you're a smart lad – you'll soon get used to it! Any questions at the moment, James?" "Well, um, err, what do I do if I want to do 'number twos' – you know," James said, blushing as he did so. "Well now, James, Gill said with a laugh, "You've got nappies on and we expect you to use them for everything! You'll be more comfortable, though, if you use them just before we come to change you. You'll find that a wet nappy isn't bad at all, but a dirty one can be a bit uncomfortable." "Can't I use a toilet or something?" James asked in anguish. "Sorry, James," said Mary, "but it has to be the nappies, I'm afraid, and if you don't 'go' as often as sister thinks you should, she' has ways of making you 'go', some of which aren't much fun for you." With that, the nurses got James into a hospital gown and put him in bed, clearing away all the wet towels and rubber sheet. Mary turned to him, "I know you can't drink, so you're down for regular drinks which we'll bring you. But if you're extra thirsty, just ask one of us and we'll get you one. OK?" James nodded, mortified by the thought that he not only had to wet his nappies but soil them as well. He discovered that there was a rubber sheet between the mattress and the bottom sheet, a rubber draw sheet under a cotton one and rubber covers on the pillows: they meant to keep things dry, he thought to himself.

Gill went to report to sister that James was washed, in his nappies and in bed while Mary went to dispose of the towels and things in the appropriate places. "How did he take it, nurse," asked sister. "I'm afraid he is very, very unhappy about being back in nappies," reported Gill. "Well, yes, I can understand that," sister replied, but he'll have to learn to put up with it. It'll only be three days in his case. He can think himself lucky he's not got a fractured femur and would be here in nappies for three months! I'm going to suggest to the night staff that they give him a strong purgative with his night drink: he'll need clearing out before theatre so we'll kill two birds with the same stone, nurse. He's down for chloral hydrate tonight to help him to sleep so that should do the trick nicely!"

Later that afternoon James' parents came to see him. In those days it was an hour on Saturday and Sunday afternoons and an hour each weekday evening from 6 until 7 o'clock as it was felt then that parents visits upset both the children and the ward routine. When visiting was over, Mary came, wearing a white rubber apron, to give James a drink. She helped him to sit up as she tied a green rubber bib, with a 'catch-all' pocket for crumbs and dribbles, around his neck. "I don't need a bib. I'm not a baby who dribbles everywhere," James said, crossly. "No James, but you can't use your arms and we have to help you." With that, she sat on the bed and laid James upper body across her lap. Before he could protest, she stuck the teat of a baby bottle between his lips as he opened his mouth and told him firmly, "Suck!" James drank his orange juice that way as she explained that sister wanted children who couldn't feed themselves to drink from a bottle as it didn't spill if dropped. "Sorry, James, but we all have to do what the sisters say and the general agreement is bottles for those who can't drink for themselves."

At tea-time, James was propped up in bed, still wearing his bib, by Mary and Gill who then went to prop up a girl who couldn't use her hands because they were covered in bandages. Gill went to feed the girl while Mary fed James. James hated being fed. It just didn't square with him being old enough to go to secondary school in the September of the following year when he was eleven. After tea, all the curtains were drawn around every bed and a trolley heaped high with nappies, rubber pants, towels, nappy cream and bowls of water for washing was brought into the ward. When James saw the trolley and the curtains being closed, he guessed that he'd been told the truth and that everyone was indeed in nappies. That didn't make it so bad, he felt. Mary came in and asked him if he had wet his nappy yet. James was bursting to go, but really didn't want to give in to the inevitable. "Not yet, nurse," he said. "Well James, I'll give you a few more minutes while I go to change someone else. When I come back, I want a wet nappy to change. You must be bursting by now!"

James lay there and tried to overcome his conditioning. Not only was he going to break the "thou shalt not wet thyself" part of his toilet training, but the "thou shalt not wet thy bed" one as well. He knew he was wetting his nappy, but it felt like he would be wetting the bed if he 'let go'. He struggled and eventually a hot stream of urine started to flood out into his nappy. He remembered Mary's instructions and kept slowing down the flow to allow time for the terry toweling to soak it up. To his surprise, he found the warm wet feeling wasn't anything like as bad as he thought. He struggled with this a bit, but sort of admitted to himself that it felt quite nice. Mary cam back and put her hands between his legs on the rubber pants. She could fell the warmth of the urine soaked terry toweling through the rubber. "Good boy, James. I'll change you now and be back again in a few minutes to give you a drink." James found that he liked his nappy being changed. Mary washed him, dried him and rubbed cream all over his bottom as James rolled over to allow her to do this. She managed to get James into the nappies by herself, but called for help, which was soon forthcoming, to get his rubbers up over his legs and around his bottom.

After all the children had been changed, the curtains were drawn back and one of the nurses sat in the middle of the room to read to them all. While she was doing this, other nurses went to children who couldn't use their hands to give them a bottle of water to drink from. James also had another bottle of water to drink. James thought, as he sucked at the bottle, that this would shortly be reappearing into a very wet nappy!

The night shift swapped with the afternoon shift and one nurse disappeared to refill the nappy change trolley while the others went round pulling curtains. Two nurses came through the curtains to change James. This time James was put in really thick nappies so that he couldn't bring his heels together as the bulk of the warm nappy between his legs was so thick that it pushed his legs apart. One nurse went out to the trolley and came back with two pairs of rubber pants. She held them up to her colleague. "Should we put him in pop on pants or pull- ons?" James realised that the children who had their legs in traction must have the popper pants as he'd wondered how the nurses changed their nappies with their legs up in the air like they were. He'd also realised that it was probably much easier for the nurses just to change nappies on those patients than to deal with their toilet needs another way. It made sense, he supposed, for all the patients to be treated the same. "Oh we can put pull-ups on him – he'd leak otherwise as he can probably turn on his side even with the splints." James wished that they'd talk to him rather than each other as the afternoon staff had spoken to him. When they finished, they left him, pulling the curtains open. When all the children were in their thick night time nappies, the nurses came round with bedtime drinks. There was a choice of Ovaltine or milk. When the nurses came to James, he was asked which he wanted. He chose the plain milk. One nurse picked up a baby bottle and filled it with milk. She then took a second bottle and poured in some liquid from a blue glass bottle which contained chloral hydrate. She added some orange juice and some crystals from a carton using a teaspoon to measure three spoonfuls. She put the large hole teat on the bottle and, squeezing the teat shut, she shook the bottle hard until all the crystals dissolved. She put the bottles on James' bedside cabinet and then put on a white rubber apron. James was still wearing the green rubber bib and he was helped to sit up so that the nurse could lie him back across her legs as she gave him the bottles. "James, the first bottle is some medicine to help you sleep. It tastes a bit funny so I've added some juice to make it taste better. I suggest you drink it down as fast as you can, then I'll give you your milk." She held the bottle between his lips and James obeyed her by sucking as hard as he could. He quickly emptied the bottle, grimacing at the salty taste. She then offered the second bottle which he drank more slowly. She then helped him to lie back and tucked him in for the night, wishing him a good night's sleep.

She went around with the other two nurses until all the children had had their drinks and been bedded down for the night. They went to the nurses' station which was a desk in the middle of the ward. While two of them got out their knitting, he other turned on the light on the desk and turned out the ward lights. "Good night, children," she said to them all. James was already feeling very drowsy from the effects of the chloral hydrate. One of the nurses who'd dealt with James whispered to the third, "I don't know what he'd done to annoy sister, but the amount of Epsom Salts she'd written up for him to have tonight will certainly make a very messy nappy for him before morning. I wonder whether he'll wake up when he soils himself?" "Oh yes, I think he will. He's going to be filling that nappy for some time tonight. I suspect he's objected to filling his nappy and sister decided to clean him out tonight rather than in the morning." The third said, "That's cruel!" "Yes, but he's got to get used to using his nappy sometime – it may as well be now!"

James woke in the early hours of the morning because his insides were churning from the Epsom Salts he'd been given. As he woke, he realised that he'd not only wet his nappy but soiled it as well. He started crying quietly, aware that he might be in trouble if he woke the other children in the ward. As he did so, another wave of contractions forced him to release yet more liquid stool into his nappy. He could hear it gurgling as he released it totally out of his control. As he did so, he also felt himself releasing more urine into his soaking nappy. What was happening to him? The night sister was on her rounds of her wards and came in to hear James' quiet sobs. She went over and whispered quietly to him to ask him what the matter was. He told her and she went to check with the nurses. She came back to him and told him that he'd not only been given a sleeping draught, but a strong dose of laxatives as well and that she wasn't surprised that he'd 'had an accident' as he had put it to her. "Try to empty yourself as much as you can," she said to him. "I'll ask the nurses to change you and give you some juice to drink to help you to settle down. You can also have a bottle of water if you want as you can't have any more to drink after that until you've been to theatre. Don't worry. There's nothing wrong with you! That's part of the reason you're all in nappies on the ward. Sleeping draughts do tend to cause you to wet your nappy in your sleep as it makes you so sleepy you don't realise it's happening," she told him kindly. "You may still have some more to come, but I suspect it won't be a lot now." With that, she went to the nurses and gave her instructions that he was to be changed and give a drink.

A few minutes later, after he'd forced out all he could and could feel the warm wet mess between his legs, two nurses came to him and pulled the curtains around him. They put the light over his bed on low and placed a rubber sheet and towel under him while he was washed to clean him up and changed into another thick dry nappy. The light was turned off and the curtains opened. One of the nurses came back with a bottle of juice, another of water and the blue bottle of the chloral hydrate. She carefully measured out a dose of the sleeping draught and told James that she'd been allowed to give him one more dose that night.

"It'll settle you to sleep again, but don't be surprised if you wake up with a wet nappy." The nurses cuddled him and gave him the bottle of juice and chloral hydrate and, as he was still thirsty, the bottle of water. They then settled him back down to sleep.

In the morning, he was gently shaken awake to find that all the other children had had breakfast. The nurse who had woken him said, "We let you sleep until they'd had their breakfast as we thought you'd rather not see them all eating." James thanked her as he felt really hungry, perhaps made worse by knowing he couldn't eat with the rest. "You're going to theatre soon, so I'm going to get you ready. The curtains were pulled around him as the nurse was joined by another. His rubber bib which had been tied round his neck and his waist was removed together with his gown. They proceeded to wash his face, then arms, working down to his feet. His nappy was then removed and his nappy area thoroughly washed and creamed. He hadn't released any more stool into his nappy, but he'd decided he liked having a wet nappy so, despite needing to 'go' somewhat, he held on to it while he was being washed and changed. This time four nappies were pinned around him making his legs spread even further. A pair of larger rubber pants was pulled over his legs, but still with the same tight waist and leg bands to seal the wetness in. "As the doctors need to get to your arms, we won't be putting a gown on you. I'll just give you an injection into your leg which will make your mouth dry and may make you drowsy. They'll be coming for you soon, but don't worry. You'll be back here very soon with your arms in plaster." with that, she gave him the injection in his leg and the nurses left him still with the curtains drawn around his bed. Once they were gone, and with a sigh of relief, he let his bladder empty into his new nappies, enjoying the way the warmth spread across his tummy and down between his legs and round his bottom. "Mary was right," he thought to himself, "wearing nappies can be nice."

A few minutes later, his mouth felt very dry but he didn't feel at all drowsy. The curtains were pulled back a little and a porter with a trolley came into the curtained area around his bed. "Hallo, James," he said, "I've come to take you to have your arms set in plaster." A nurse was with him and they gently lifted James onto the trolley. The nurse covered him with a draw sheet lengthways and a blanket to keep him warm as they set off to the lift. On the ground floor he was wheeled to the theatre where they stopped with him just outside the theatre doors. A nurse dressed in green gown, cap and white cotton mask opened the door of the theatre. She received the notes from the ward nurse and took them inside. She came back with another nurse and carried James into the theatre between them. They laid him on the cold black rubber surface of the operating table. A lady in white at his head said, "James, I'm the doctor who's going to put you to sleep for the other doctors to set your arms in plaster. In a moment, I'm going to put this rubber mask over your face." She held up the black rubber mask with the corrugated black rubber tubing snaking from it to the anaesthetic machine which had glass bottles, dials, gauges and a big rubber bag hanging from it. "I'll put a strap round your head to hold it in place and you'll hear some hissing noises. That's just oxygen for you to breathe. When you're comfortable, I'll turn on the gas and you'll drift off to sleep. When you wake up, your arms will be in plaster and it'll all be over. You're a big sensible boy so you know I'm trying to help you get better so you can score more goals!" James was about to speak when she laughed and said that they knew all about his footballing skills. "James, when you can smell the gas, I'd like you to try to take deep breaths so you'll go to sleep more quickly. I can assure you that you'll find it better that way!" With that, she took a pillow in the shape of a roll and put it under James' neck so his head tilted back with his chin upwards to keep his airway clear. She placed a lack rubber 'thing' under his head and bent over the anaesthetic machine and turned a control. James heard a hissing sound and she reached over his face with the rubber mask. She placed it over his nose and mouth and, holding it in place, a nurse came and pulled the straps from the 'thing' under his head to hook on the mask to hold it tightly to his face. James could smell the anaesthetic in the tubing and mask and tuned his head sideways to look at the machine. As he breathed in and out, the rubber bag inflated and deflated. "Are you comfortable, James?" she asked. James turned to look upwards at her seated behind him, and nodded. "Are you ready now?" she asked the doctor who nodded. "Good lad, I'm going to turn the gas on now and you'll start to smell it. Remember to take the deep breaths. Shut your eyes now and you'll soon be asleep."

James could smell the anaesthetic which made him want to cough at first. He struggled to take deep breaths as he was told and a blackness descended over him. As it did so, he felt his bladder let go again into his already wet nappy and he smiled to himself. He could still hear the theatre staff talking among themselves, but gradually he could both hear and feel a buzzing as the anaesthetic rendered him unconscious rapidly. He woke up back on the ward where he noticed several things. The anaesthetic had made him feel rather nauseous, his arms were in plaster and feeling sore and his nappy was wet and felt nice between his legs. Mary came over to him. "Do your arms hurt, James?" He nodded as he was still a little drowsy from the anaesthetic. "Would you like an injection to help with the pain?" James mumbled a definite 'yes' to her. She left him and came back with Gill to give him an injection of morphine which sent him back to sleep again. When he woke, he felt much better although his mouth was dry. Mary came over and asked if he was ready for a drink. James said with his dry mouth, "Yes please!" She went away and came back with a bottle. "Small sips at first to see if you feel sick at all. If you try to drink too much at once you may be sick and we don't want that to happen!" Slowly James drank the whole bottle. A little while later, some of that drink ended up in his nappy followed a little later by the rest of it. He really did like the fell of the wet nappy, he decided. His parents were allowed a quick visit just to reassure them that he was all right. Over the next few hours, he was given several bottles of water and his nappies changed. Eventually, he was given some milk after he'd been changed for night time with really thick nappies again. He settled down to sleep and later, as the night nurse did her rounds, she smiled to herself to see that his thumb had crept into his mouth. The next morning, James felt fine.

He was expecting to go home that day. How he would manage for his toileting needs was another matter, but he was sure that he would manage somehow, perhaps with his dad's or mum's help. Sister came over to see him. "James, I've got some bad news for you. I'm afraid you'll be staying here until your plaster casts come off and you can look after yourself. That'll be about six weeks, I would expect." James was about to say something, but sister continued. "Your mother was admitted to the General Hospital last evening with appendicitis which turned into peritonitis. She was operated on immediately and is recovering well. Unfortunately she will be in hospital for some time and won't be able to look after you. Your little sister is with your grandmother, but she feels that she can't look after you as well, so I'm afraid it's here you'll stay." "I won't have to stay in nappies, will I?" James asked. "Yes, James. It's ward policy and I make no exceptions. You'll be in nappies and rubber pants until you leave to go home. I'd get used to it now, if I were you. But don't worry, your mother really is making a good recovery and will be home before you, although she will be looking after herself for a while until she's fully healed and won't be able to look after you until your casts are off." With this, she left a very glum James. He did want to get home, although the answer about nappies and the rubber pants was one which pleased him greatly. He'd decided that, as all the children wore them, he'd make the most of it!

During the course of his stay, he became constipated on several occasions, but he found he was actually enjoying the feeling of a wet and dirty nappy tightly between his legs. Just like many of the children who were long stay on that orthopaedic ward, he soon forgot Mary's advice about 'holding back' and soon he was wetting and soiling without even being aware of it, both at night and during the day as well. He enjoyed being spoon-fed and drinking from a bottle, cuddled up to a nurse, as well as being washed and cared for by them. James was quite disappointed when his plasters were cut from his arms and the X- ray showed that the bones had set. The next day he went home, still in nappies and rubber pants, along with a supply of both rubbers and nappies as well as a rubber sheet for his mattress, which the hospital had loaned out until James was dry again. Strangely enough, he was wet at night for some considerable time. His father bought some nappies and rubber pants so they could return the supplies sent by the hospital. James stayed in rubbers and nappies at night, by choice, 'just in case' even though he didn't have any 'accidents'. When he was poorly with influenza or the like, he would be put back in nappies while he was in bed during the daytime as well and would have 'little accidents' which the doctor said was understandable.

Now James is grown up, married and lives away from his parents. He married a nurse who loves to 'baby' her husband in rubber pants and nappies, feeding him and cuddling him to give him a bottle to drink from. They have a baby of their own so James' nappies don't look strange on the washing line. Don't you just envy James?