where wheelchair users and BIID/transabled unite!

I had Idiopathic Scoliosis

Today, teenagers who suffer from curvature of the spine – scoliosis – are treated with a brace, and if the curve continues to develop, they usually undergo surgery to fit metal rods into their spine, to stabilise and reverse the curve. Once these rods are in place, the patient can live a normal life. Immediately after surgery nowadays, the patient is usually nursed on a Stryker frame, which immobilises him and gently applies traction through a halo attached to his head, and to his femurs (thigh bones) through pins in his legs. The whole process takes two or three weeks, before the patient is allowed up and about. However, this treatment is fairly recent.

When I was treated for scoliosis in the late 1950s, things were rather different. The spine was straightened by traction and then locked into the correct position with bone grafts. One had to be completely immobilised until the bone grafts had fully healed, because there were no rods to take the strain whilst fusion took place. The chips of bone in the grafts were held in with wires. The patient, or perhaps “victim” therefore had to be totally immobilised for months, with the result that rehabilitation after so long an immobilisation took a very long time.

I am probably amongst the last generation to be treated for scoliosis in a plaster body cast. It was an experience I shall never forget.

I don’t remember having any problems with my back until I had a medical examination at school when I was about 11. The doctor told my mother that I had a slight hump in my back and it should be checked out. We got a hospital appointment and I was taken to see a paediatric orthopaedic surgeon. I remember sitting around for what seemed like hours, wearing only my underpants. In between the waiting times, I was measured with a kind of giant set square across my shoulders and hips, photographed against a wall marked out in squares, made to bend over and touch my toes and finally X-rayed. At the end of the day, the doctor told us that I had a double curve in my spine and that it would have to be carefully watched as I grew up. We had to come back for follow-ups every 3 months. My mother asked a lot of questions that, at that time, I did not really care about. But I do remember the doctor saying that, if the curves progressed then I might have to have an operation, which would be a serious matter. At that time he thought that surgery was unlikely, but he did say that the double curve I had was unusually high and if it affected my lung function, then surgery would become inevitable.

About 6 months later, I had another check up. All the same tests and measurements. Bad news! The curves had progressed and were becoming serious. They decided I would have to wear a brace.

It took a whole day at the hospital to have a pattern made. First they stripped me naked. They wrapped a canvass sling around my head and under my chin and put a rubbery skirt around my hips to protect my lower body from the plaster. The sling was then hoisted up to a pulley in the ceiling and I was held perfectly upright by my own weight. The pattern for the brace was then formed by wrapping me in plaster bandages from hips to chin. I do remember the heat of the plaster pattern as it dried and the feeling of being gripped by it as it set. After an hour or so, they cut the plaster shell off up each side with huge shears, and so they had a mould to make my brace fit exactly.

I went back again for the brace to be fitted about two weeks later. It had a steel frame with leather-covered pads moulded closely round my hips and buttocks, front and back. More leather-covered moulded pads supported the small of my back and there was a pair of pads at each side of my chest from waist to armpits. At the top of the brace there were closely-fitted mouldings that supported my neck. At the front, my chin rested on a shaped platform that held my jaw all the way back to my throat. At the back, another mould covered the back of my neck and went up behind my head finishing just above the level of my ears. I was held very stiffly upright, hardly able to move my head or twist my body at all. The whole contraption was adjusted to fit my body very closely and they showed my Mother exactly how to put in on and take it off me – which had to be done while I was standing up. Then I had a session with the physiotherapist who taught me exercises that I was to do every day during the one hour while I could have the brace off. As it turned out I was much more interested in having a bath than doing the exercises!

I hated that brace! It took me a long time to get used enough to it to sleep reasonably well, and I was only comfortable in bed either on my back or my front – and even then I needed pillows in strategic places to take up the hard protuberances of my scaffolding. During the day I was convinced that everyone was staring at me. Perhaps I was right – although a casual observer would only see the top of the brace enclosing my neck and supporting my chin and head – I moved so stiffly and was clearly so handicapped that stares were probably inevitable.

It was hard to move – my body was held rigidly from buttocks to chin. I especially remember having to learn to turn my whole body to look around me because my head was held so stiffly. Reading and writing on an ordinary desk was very difficult because I could not look down. In the end I raised my books on my school satchel so that they were more in view – but the effort to look down was very tiring.

My mother had to alter all my clothes to make it easier to dress and undress. She bought me voluminous new knickers that would go over the hip and buttock mouldings, and bigger shirts and trousers to hide the strange shape of the brace. She altered my trousers (I wore shorts then) to undo at the sides, so I could be toileted and cleaned more easily, and they had to be held up with braces as I no longer had much of a waist that you could get at. I was so encumbered by the bracing that I always had to have help with any dressing and undressing below the waist.

We went to the hospital every month for check ups – more measurements, photographs and X-rays each time. The doctors checked my reflexes with little hammers, and stuck pins into me to see if I could feel them. Then the physiotherapist watched me do my exercises and made sure they were done right. The technician also tightened all the adjustments on the brace so that it was always correctly fitted.

I was not allowed to do games or PT at school; in any case I was so handicapped and clumsy that vigorous exercise was impossible. I had to report to the school nurse at break times for help with toileting because I couldn’t handle my trousers and underpants, couldn’t see what I was doing and couldn’t reach to clean myself properly. Though the nurse was very nice about it and tried to be gentle and tactful, I really hated that loss of freedom – but it was only a taste of what was to come. The thing that sticks in my mind is that I found it very difficult to pee accurately because I could not look down. My aim was so poor that the school nurse or my mother had to hold my penis and direct it for me. It was especially embarrassing having them wipe me intimately.

In the summer I remember especially how the whole contraption became unbearably hot and sticky. On hot days, when I was at home I would just wear knickers and shorts – but it still was hot. I was aware, I think for the first time that summer, of my body odour and I could never get enough baths!

I wore that brace for 18 months. During that time the curves kept on becoming larger. I was also growing quite fast, and the brace had to be adjusted several times.

Two days before my 13th birthday, disaster struck. When my mother came in to wake me up that morning, I found my legs and arms were all pins and needles and would not do what I wanted them to do. To my utter humiliation I had wet the bed as well. The more I tried to feel and move my limbs, the more impossible it became. I was absolutely terrified. So, I think, was my mother. She called the doctor and held me close to comfort me until he came. He took one look at me and called an ambulance.

In hospital we went through all the usual checks, only this time I was lying on a trolley, helpless and scared stiff. Finally, I was given several injections, which made me very dopey, and put to bed.

At long last, they took my hated brace off! But then they put me in spinal traction. I wore a canvas sling around my head and under my chin. This was attached to a cord that went over a pulley at the head of my bed and was then tied to a weight. The bed was sloped so my feet were lower than my head, and around my hips I wore another canvas sling belt arrangement, which was tied to the foot of the bed. I was, literally, on the rack. But it worked! By the next morning the pins and needles had much reduced and I was dimly aware of limbs again. What a relief! But I still could not move my legs myself and my body felt curiously distant and numb. I was very frightened.

So I had my 13th birthday flat on my back in traction. I don’t remember very much about it because they kept me sedated, so I was very sleepy. I was like that for several days before they decided what they were going to do next. Bad news – I was to have bone grafts in my spine to prevent it collapsing further and to hold the correct straight line. I would be in hospital for at least four or five months and off school for the whole year – although once I was convalescent I would be able to have tutoring in schoolwork.

At this point they told me what they proposed to do. I had two superimposed curves, the top one in my neck and upper chest, the lower one through my chest. The reverse curve in the middle had been progressively growing more acute and had finally pinched the spinal cord – hence the pins and needles and making me an emergency. If nothing were done I could be paralysed for life. The traction had reversed the pinching of the cord, and they hoped that more traction would straighten my spine enough to make it worthwhile stabilising it with a bone graft. This procedure was called spinal fusion and would be a major operation. The idea was to take chips of bone from my legs and wire them into place in the curves in my spine to lock the vertebrae into the right position. This would be done in three places – my neck (cervical vertebrae), my upper thoracic (chest) vertebrae and the lower thoracic and upper dorsal vertebrae (my middle). Once the new bone had healed up with the vertebrae I would be able to lead a perfectly normal life again.

I was introduced to two other patients about my age on the ward. There was a girl (called Clare) opposite me, who had just had her fusion and was encased in plaster from just under her chin down to her knees. She was being nursed on a turning frame and wore a blue pinafore dress with most incongruous pink woolly socks on her feet. A boy, a little younger than I, was in the next side ward, with Perthes disease of the hip and he was in plaster from his mid-chest to his toes. They were both quite philosophical about their problems and said that one “got used to it in the end”.

The ward Sister sat beside me that evening, holding my hand and talking quietly to me. She had a wonderfully calming way about her. She explained to me that I was very ill, that there really was no alternative now but the spinal fusion operation, and that I had to get used to the idea of being in bed, helpless, for at least 12 weeks. And even then it would take a lot of hard work afterwards to get fit and active again.

It was she who first told me what to expect. They would be putting me in stronger traction the next morning. I would still wear the halter around my head with the weight over the head of the bed, but they would put the traction onto my legs instead of my hips. To do that I would have both my feet put into plaster boots up to my knees. The weights would be attached to the leg casts instead of my hips. I would be in that traction until they were satisfied that my spine was as straight as they could get it, and that could take a couple of weeks or so.

The next stage would be to hold the correction ready for surgery. For that, I would be put into a plaster jacket like Clare – but because my curve was very high I would probably have the whole of my head held in the plaster cast too. Once that had settled down, they would cut an opening in the back of the cast and do the actual spinal fusion operation through that. After my operation I would be nursed on a turning frame, like Clare, until X-rays showed healing was complete – and that would take 8 to 10 weeks. It would take another month or so to get me back on my feet, and I would continue to wear support until they were satisfied that all was well.

At the time, I really did not take it all in. I was quite ill, and in something of a daze from shock and from the sedative medications I had been given. The bits I did grasp terrified me, and there were so many unknowns. I remember asking the Sister how I would eat and how I would go to the toilet. I had already discovered the answer to the former – I had to be fed and could only drink through a straw. In answer to the latter, Sister took my hand and guided it to my crotch. It was bulky, cold and slick. I suddenly realised that I was wearing a nappy and waterproof pants! I cried myself to sleep that night, and was still tearful as I was fed breakfast, washed and changed the next morning.

Sure enough, mid-morning my bed was wheeled down to the plaster room. It took no time to be given the plaster leg casts that Sister had told me about. I was expecting a pair of boots up to my knees, but I ended up with my right leg encased from hip to toe and my left in an equally beautifully finished knee-high boot. They wrapped both my feet in soft thick padding and then put plaster slabs up the back of my calves. Then they attached a metal “U” to each leg and bandaged it into place with plaster so that the loops of the “U” hung under my feet. They wheeled me back to the ward. The plaster got quite hot as it dried, and a nurse came every so often and tickled my toes to make sure I could move them and that the casts were not too tight.

Next morning, after I had been changed and washed and fed my breakfast, the doctor came and carefully examined me all over. With help from a couple of nurses, he attached cords to each hoop on my boots and tied them to the end of the bed. At that point, they took my canvas belt away, and immediately, although the pull on my head was stronger, I felt much more comfortable.

The doctor carefully examined the halter I was wearing around my head and asked me if it was comfortable. I told him it was tight and irritated my chin. “Well, I think we can put that right,” he said. A nurse sat at the head of my bed and held my head, one hand under my chin and the other gripping the back of my head so it was absolutely still, while the doctor removed the canvas sling and replaced it with a moulded collar. This was rather like the collar arrangement had been on my brace, with a moulded chin rest at the front and a fitted head support from my shoulders to the crown of my head at the rear. It also had loops for the traction cord at each side just above my ears. The doctor carefully adjusted my head into the collar, put some gauze padding around my ears, and attached the traction cord again. Then the nurse shifted her grip to my shoulders and held me up while the doctor wrapped my head up in several rolls of bandage round my chin and my forehead so that the traction could not move. I felt the softness of the bandages enclose my head, and sounds become dimmer as my ears became buried inside their new padding. The new arrangements did not irritate my chin and I later discovered it was much easier to talk and eat. On the other hand, with most of my head enclosed in thick bandages it was quite hot, the world felt remote and not really a part of me.

Once all that had been sorted out, two nurses appeared with a long cotton gown for me that opened flat and tied down the front with tapes. One of them gently lifted me a little, while the other slid the gown underneath me and then brought the gown around me and did up the tapes. Then they drew a sheet over me so I was neatly covered from my shoulders down to my ankles – with just my elephantine plaster feet poking out of the cover at the bottom and my heavily swathed head at the top.

My Mum and Dad came in to see me after lunch that day. I was feeling a bit sorry for myself by then, and was rather tired. When my mother came in she just said, “what have you done to your poor head?” and started to cry. I joined in too!

That evening, when the nurse was changing and washing me ready to sleep, I asked if I could see myself in a mirror. She had to ask Sister – who, herself, came back to talk to me.

I told Sister that my Mum had been upset at the sight of me and I wanted to see too. She just said “that’s quite alright. Of course you can have a look.” She drew the curtains round my bed, took my sheet off, undid the tapes on my cotton gown and held the hand mirror above my face and angled it so I could see. “Go on,” she said, “it’s quite alright to touch.”

No wonder Mum had been upset; my whole head was wrapped in crepe bandages. The traction collar enclosed my neck right down to my shoulders, so my face just peeped out of an enormous complete helmet of bandaging. My plastered legs were tied to a bar between the metal hoops beneath my feet, that was in turn tied to the end of the bed. But there was no disguising my nappy! No way could it be passed off as an ordinary pair of pants. It was a giant version of a baby’s towelling nappy folded to be thick and absorbent between my legs and fastened with four large safety pins – two at each hip. It was tightly covered with translucent plastic pants with wide elastic waist and leg bands. The plastic waterproof pants had a row of popper fasteners at each side, so they could be taken off without having to go over my plaster-encased legs.

Every two hours or so, day and night, two nurses would come and check me over. They would check my nappy, tickle my toes, wipe my face, then gently turn me so that I lay alternately on my back and on my tummy – the latter with pillows under my chest and my knees so that I could read if I wanted to. Every morning, a nurse would cradle my head to keep it perfectly still as another unwrapped it, she would wash me very gently and then bandage me up in my padded helmet again.

The best bit of being nursed was the over all body wash twice a day, that left me cool and comfortable. I hated being fed – everything came in slightly lumpy mush that tasted of nothing, although ice cream (which happened very occasionally) was OK. I drank through a straw, but it made me dribble and so my mouth was carefully wiped each time.

I suppose it was because I was at a critical age, but the memory of being nursed in nappies remains very clear. Although many of the other children on that ward were also being cared for in nappies, I was probably one of the oldest and extremely embarrassed at needing to wear the things at all. In those days, disposables were unknown; we were all protected in bulky terry towelling squares and plastic or rubber waterproof pants. There was absolutely no disguising them because of their necessary bulk. In any case, apart from the bulk of my nappied bottom, my immobilised legs made wearing conventional underpants or pyjama trousers impractical. I was very conscious of the size of my pants and the conspicuous heavy plastic waterproof cover that I thought I could hear crackling every time they moved me.

Of course the nursing staff had to know I was in nappies, they were caring for me, but I was usually handled essentially naked for the X-ray staff, and so the porters also saw my intimate protection during my various journeys round the hospital. It did not matter to me that many other patients were in the same state: it was my dignity!

At first I had only a strange tingling feeling below my chest for most of the time, and I was completely unaware of needing to pee or defecate. It was a day or two, indeed, before I realised at all that I was incontinent and quite a lot longer before I was really aware of the consequent practicalities of nursing me. I usually had no idea, at that time, when I needed changing. After a bit, when they took my plastic pants off, the smell often revealed if I was messy, but I was unable to feel at all whether I was wet or dirty. But I well remember the characteristic smell of used nappy once the protective plastic cover had been removed.

At that time, I had no bladder control at all. Urine just dribbled continually, so I was always wet when they came to change me. My bowels were a little more predictable but very often I was in a mess as well. Again, it was not until I had been in that state for some time that I came to realise what was going on. As I spent about half the time lying on my front, the proceeds of my bowel evacuations often became plastered all over my genitals. Sister told the nurses that I should be on my back in the mornings to try and avoid that problem, but I remember it happened several times while I was nappied because I was just so unpredictable.

Despite my complete incontinence, most of the nurses were careful always to ask me if I wanted to be changed. However, not all were that thoughtful. One nurse in particular embarrassed me by patting my padded crotch with her open hand, rather than just looking at it, to see if I needed changing, and another always unpoppered my plastic pants and felt me intimately through the towelling before deciding whether to change me.

They always turned me onto my back and put a rubber sheet under me for changing, and I often had to be turned over again onto my tummy, so they could clean my buttocks properly too. When I was soiled, clean-up got quite complicated because of the restrictive traction on my legs – little children normally have their legs lifted up and held apart to clean up when their nappies are changed – but my legs were almost completely immobilised in their plaster casts and traction arrangements. I remember I always knew when I was dirty because the nurse changing me would put on rubber gloves to handle the swabs, my soiled nappies and plastic pants.

I do remember the feeling when they unwrapped my protection and wiped my genitals, crotch and buttocks with the rough towelling – was almost pleasurable. And I also liked the cool clean feel of the barrier cream with which they covered my pant area at each change.

I had visitors nearly every day. My family (parents and two sisters) came of course and several friends from school. Everyone signed the casts on my feet. I remember being very concerned that they too might see I was in nappies – but I was always carefully covered with the gown and a sheet, and I don’t think any of my visitors, even my mother, ever knew.

During my third week in traction, things improved considerably. I woke up one morning very aware, for the first time, of the heavy bulk of nappy between my legs and the clammy feel of my wet bottom. I was able, a couple of days later, to actually feel myself filling my nappy. The first time this happened, I called the nurse to come and change me because I was soiled; she called me a “good lad”. Within a day or two this progressed to me being aware of needing to go, so within the fourth week, I was well enough not to need the protection any more, much to my joy. The nurses were a little suspicious of my reliability at first, so I had a draw sheet and a rubber sheet under me for a few days, but I don’t think I needed them. I did not then wear any pants of any kind, and the freedom and coolness of the new arrangements were a great contrast to the bulky, hot, damp enclosure of the nappy and plastic pants. However, it was not perfect. It was nearly as embarrassing having a nurse hold my penis into a bottle for me, and help me use a bedpan! I was always very carefully washed and barrier-creamed after each nursing and I looked forward to the cool fresh feeling of that care.

I was X-rayed several times during this process. This involved being taken up to the X-ray suite, bed and all, and being turned gently this way and that to get all the views they wanted. The problem with the X-ray suite was that there was always a queue consisting of patients in various states waiting for pictures or waiting for results or waiting to be taken away again. At this point I was acutely aware of people staring at me, my thickly swathed head especially drawing comment. On one occasion I was left waiting without my sheet on. To my mortification a lady passing by noticed my heavy incontinence protection and remarked that I was “a rather big girl to need nappies still!” It was bad enough being criticised as a baby – it was far worse having my sex mistaken!

Finally, after just over four weeks in traction, the surgeon arrived to tell me they were ready to start the process of spinal fusion. They had decided to put me in a body jacket with hip inclusion – which, he told me, meant I would be in plaster from just above the knee on my left side and from my toes on my right, up to and including my whole head. While I was in the plaster I would be attached to a special frame which would make it easy to nurse and turn me. The plaster cast would be fitted the next day – it would take most of the morning to do the job – and allowed to dry for 3 days. Then they would cut openings in the back and in the right leg ready for the surgery. Once healing was well under way, he said, it might be possible to split the cast to make a plaster bed. That would allow me just to lie in it for support, either on my front or on my back – but that would depend on a number of factors and he would make no promises.

The next morning I had a drink, but nothing to eat, for breakfast and then was given pills to make me relax. Even with them, I was very apprehensive. I was toileted and, after the usual careful washing, the nurse dressed me in a pair of special, very tight, close-fitting, towelling pants that opened out flat and tied at each hip with tapes. I discovered immediately that the pants were lined with a thick pad in the crotch – panic: was I going back into nappies again?

Everyone wished me good luck as I was wheeled away down to the plaster room.

There were five people in the room – two technicians, two nurses and my doctor. First, they gently lifted me off my bed and put me, face down, onto a high table. Immediately I felt the pull on my head relax as they undid the weights. There was an X-ray machine beside me and they took a picture. After a bit of time and some discussion, the traction cords were reattached to my head and feet, and I felt the pull under my ears again. They fiddled around with my legs for some time, and eventually I felt them being set much more widely apart than they had been before and held in position with a bar strapped between my ankles. Then they took another X-ray to be sure my spine was still where they wanted it. More waiting, and more discussion, irritatingly just outside my earshot!

Then someone adjusted my head again. One of the nurses cradled my head in her hands while another unwrapped the bandages and replaced the leather collar round my neck with a canvas sling, like the one I had started with. The sling was very tight under my chin and I could only mumble that I felt dizzy and couldn’t breathe. Someone adjusted bars under my shoulders and hips, which took some of the weight, and someone else gave me some bitter-tasting liquid. I felt better after a few minutes. From then on, it was a strange sensation as I was steadily enclosed in plaster. Lying face down, I could not see much of what they were doing; I just heard footsteps around me. Everyone was wearing short wellington boots and there were splashes of plaster everywhere. Then all I could hear was the occasional remark and the steady “slap slap” of wet bandages being layered down onto me.

They started by wrapping me up in some soft cloth. It covered my whole body except my arms, and was thin enough for me to see through because they brought it up over my head. Then they wrapped sheets of thicker cloth over my hips, around my shoulders and neck and around my left knee. Then they started with the plaster. First, I remember, they worked up my back with wide strips from my thighs, up over my shoulders and crossed over the top of my chest. Then more plaster strips from my buttocks up the back of my neck and over my head. Bits of plaster splashed over the gauze across my eyes. It felt like layer upon layer and made a “slap smack” noise as they laid the slabs of plaster on each other.

At first it felt cold and clammy, but, as they rubbed the slabs down against my body, they became hotter and hotter. Then they applied rolls of wet bandages wrapping my body in plaster bandage from low down over my hips up to my armpits. This was energetically rubbed – there were two plaster technicians and two nurses working on me. Hotter and hotter it got, and gradually I felt my body being gripped tightly and evenly in its new cocoon.

Then they did my head. The plaster round my neck and chin and at the back of my head was built up layer by layer and moulded to be a tight fit. At that point I felt very dizzy and tired. “OK old chap”, said one of the technicians, “we’re just about to turn you over now”.

Now I was face up, and this time the plaster slabs were laid from my shoulders, down each side of my chest and tummy and then all the way down my legs. I remember vaguely wondering why my left leg was being plastered up to my hip, when I was sure that only the right leg (where the bone was coming from) should have been done – but I was exhausted by then and could only mutter a mumbled protest. One of the nurses cut a slit in the gauze over my face and gave me some more of the bitter drink through a straw. Both technicians were still busy, bandaging me firmly from my waist and down my thighs.

I felt quite dizzy and sick. I remember my doctor bending down over me and saying, “well done lad, we’ll just finish off the odds and ends and do a check X-ray and then you can go back to the ward”. The “odds and ends” turned out to be more plaster bandages up both legs – I was quite sure now that both my legs down to the toes were plastered – and a lot of bandages around my hips and waist.

Just as I was sure they had finished, the technician cut away the traction sling around my head and gently pulled it out from under my chin. He then cut away the gauze over my face. I felt him push a soft gauze pad underneath my chin and place fresh soft padding over my ears. Then he wrapped my head up in more thick, soft padding. Then more plaster bandage, layer after layer, cocooning my head into a rigid helmet. Like all the rest, my plastered head was vigorously rubbed down and polished.

I was aware of a nurse holding my hand and talking to me, but I was not sure what she was saying. I still felt faint and dizzy, a bit sick, and very tired. I heard the noise of what I later discovered was an electric plaster saw and felt someone massaging my tummy. Then I felt a hand deep between my legs as someone removed my tie pants. A bit more fiddling between my legs and suddenly my crotch was open again to the world, cool and fresh, and not enclosed in a nappy!

The technicians then put two large metal rings around me and bolted these to the crossbars that they had bandaged into my cast at my shoulders and hips. Everyone then lifted me off the table and, face down again, onto my bed. There were more clanks and tinkles as they bolted the metal rings to the bed in some way, and I was “done”.

The whole process had taken over 5 hours. I was asleep before we got back to the ward.

It was evening when I woke to find myself face up now. The curtains were drawn around my bed and a nurse was attending to me. She was putting circles of sticking plaster over the edge of the cast around my face. I asked what she was doing.

“It’s called petalling”, she replied, “and it makes sure that all the edges of your cast are soft and will not irritate you or fall apart”. She finished the bit she was working on and took my hand. “How do you feel now?” she asked.

“Headache”, was the one thing of which I was aware.

“Are you thirsty or hungry?” she asked. I thought I was. Another nurse appeared with a beaker and straw. Nice cold water.

“Steady”, she said, “just sips for the moment”.

She wiped my face with a cool soft cloth. Then once again she was doing something to the plaster round my face – I felt a clean, dry, soft pad under my chin again.

The other nurse tickled my toes – a routine I was well used to. I wriggled them in return. It was true; they had put both my legs in plaster all the way down! I raised my other hand to my face – that was OK. I felt my head and neck – solid plaster from my chest to my forehead. Then I felt down my chest – more plaster until my tummy, which was open again.

The other nurse gently stroked my bare tummy; “can you feel that?” she asked.

“Yes,” I replied. Then, “why are both my legs casted? I thought it would only be my right leg.”

“At the moment we need to get a good straight pull on your back. We might be able to take your left leg out of plaster once your back is straight enough.”

There was one other question in my mind, but I found I could not quite reach my crotch because the thickness of the plaster round my chest prevented my arm from reaching so far. I could just feel the upper rim of the opening in the plaster – it was soft and had obviously been petalled too. The nurse saw my effort and said very gently, “It’s alright my dear. You will get used to managing while you are in plaster. I am sure you can feel quite normally.” She gently placed her hand over my genitals, which she squeezed lightly, then she felt down my crotch and finally caressed me very firmly underneath across my lower buttocks. “You see, there is a hole here in the plaster. You will be able to use a bottle and a bedpan just as you did when you were in traction. Ask when you need them – just as before.”

I was dimly aware, during the night, of being checked, tickled, toileted and turned periodically.

Next morning, in bright sunlight, Sister came and asked me how I felt. “Hungry”, was the simple answer. Now I discovered one advantage of the new nursing arrangements. The metal suspension rings allowed them to turn me in any direction they wished. For eating, I could lie slightly tilted to one side, which made eating and drinking not only easier, but I could actually see what I was being offered, rather than having a spoonful dumped into my mouth from above. After each drink or meal, my face would be gently wiped with a soft cool cloth, and the gauze pad under my chin changed for a dry one.

I rapidly discovered, however, that toileting was more complicated than it had been when my body was free. If I just wanted to pee, as I had done during the night, they would rotate me until I was face down, then the nurse would firmly hold my genitals and guide my penis – which of course pointed straight downwards – into a bottle. While I was in traction, the bottle was just wide enough to place my penis into its neck, but now they used a much bigger-necked bottle pressed over my genitals so they were completely covered by its opening. Managing a bowel movement was harder. The textbook clearly said that idea was to perform flat on my back. So that first morning, a bedpan was put on a stand under my buttocks and the nurse carefully tucked a sheet of plastic under the rim of the crotch opening in my plaster cast, to drain into the bedpan. With that in place, she took my penis between finger and thumb and tried to guide it from above into a narrow-necked bottle, held between my legs. Although this had worked when I was in traction, now my legs were stretched much more widely apart – the bulky plaster enveloping my thighs got in the way of operations and I could not perform. Worse, the moment she let go, urine sprayed her as my penis stood up vertically again. She took it in good part with a simple “Oh dear!” turned me face down, fetched a bigger urine bottle and finished the job. Even if I only used the urine bottle, the nurse would always finish by carefully washing and drying my genitals for me. But that first morning I could not move my bowels – and this was duly reported.

After each meal they cleaned my teeth and washed my mouth out. This again required careful organisation to keep my plaster dry. Again, I was put face down with a plastic sheet tucked under my chin and round the sides of my face. A bowl was placed under me on the bed. Then the nurse would give me a drink of water through the straw, which I sloshed round my mouth and tried to spit into the bowl. Then she would work the toothpaste round with the toothbrush. However, as she was working from underneath me and as my chin was surrounded by plaster, we actually spread a good deal of the toothpaste around the rest of my face. Another rinse, which I dribbled out rather than effectively spat in any kind of coherent direction, and she would then wash my face with a damp flannel and gently dry everything in sight, including me, with a small towel. A clean chin pad carefully tucked into the plaster around my face, and I was decent again.

Sister appeared early on with the mirror again.

“Did I want to have a look at myself?”

“Yes, I did”.

At that stage, I did not have a stitch on, so I could admire the plaster technicians’ handiwork in full. My head looked odd, because the top had been left open and my hair stood up through the gap like it had seen a ghost. I ran my fingers through it, and Sister produced a comb – it felt very strange. The cast enclosed the rest of my head – even my ears – and was moulded closely over my chin and neck, down to my chest. My face peeped out of an even smaller opening than when my head had been all bandaged up for the traction. The cast came down to my eyebrows at the top, over my chin to my lower lip at the bottom, and within an inch of my eyes on each cheek. My arms were free from the ends of my shoulders, and the nurse had petalled the shoulder openings as beautifully as she had done my face. As I knew, there was an opening over my navel (also petalled) showing my tummy from the base of my chest down to a broad cross piece of plaster covering from below my navel to just above my genital area. More petalling surrounded the vital opening round there. The gap in the cast continued between my legs and evidently finished low down over my buttocks the other side. After the toileting experience I had just been through, I noticed – I think for the first time in my life – not only that my penis stuck straight out in front of me then, but it was no longer than the plaster cast was thick at that point. No wonder there was difficulty in getting me to drain neatly into a bottle!

As I had realised, both my hips and legs were fully enclosed in the cast. Clearly, they had not removed my original plaster boots, they had just added them into the whole caboodle. The original metal hoops were still there and some of the signatures had not been bandaged over. There was a bar bandaged between my legs just above my ankles to keep them wide apart, and my toes peeped out of neat new petalling too.

No wonder people stared! Only my face, shoulders and arms, tummy, crotch and toes were visible now.

“Now then”, said Sister, “you need to be dressed a little to be decent. Your Mum has been busy. Would you like to wear some clothes?”

All I could say was “How?”

The first thing was the, now familiar, open-flat tie pants – in a giant size this time to fit over my much-augmented hips. With the help of one of the nurses, Sister put them on me and then produced an outsize pair of pink woolly socks, just like Clare’s but about four sizes bigger, that duly covered my plastered feet. Next came a T-shirt that had been slit down the sides and fitted with pop fasteners. It looked huge when she held it up, but it fitted quite well over my bulky body cast and came a third of the way down my thighs, so it covered my pants. Finally, she produced a scarf, which she tied in a knot round my neck like an outsize tie. She held the mirror up for me to admire. I felt very depressed, but they had tried. I mumbled a “thank you” and Sister squeezed my hand.

“It won’t be too long, you’ll see,” she comforted me.

My mother came to visit that afternoon. I had eaten my lunch as I had felt hungry, but now I was very tired and complained of a tummy ache. Mum sat beside me and held my hand. I remember she offered to read me a story, but I did not feel up to it. She caressed my face gently and kissed the tip of my nose as she left. I think she was crying again.

The care routine went on every two hours or so day and night. I did not really care very much at that point. I felt unwell with a gut ache and a headache. The plaster felt tight and uncompromising. And it was very frightening being completely unable to touch more of my body than my face, a bit of my tummy and my arms. Having my toes tickled, my face and mouth washed and my genital and crotch area cared for regularly helped to keep me in touch with my body, but I really missed being held and cuddled. Mum even seemed scared to kiss the bits of me she could reach!

There continued to be a problem with my bowel care. I was not able to have a bowel movement for another four days. Each failure was duly reported to Sister and the doctor prescribed nasty concoctions to get me working. They would not be able to start any surgery until my digestion had settled down. They even tried massaging my tummy through the hole in the cast, which was very soothing, but produced no results.

However, on the fifth day I had stomach cramps after breakfast, so asked for a bedpan. This time, they organised me face down with the plastic sheet in my crotch hanging forward into the bedpan and my penis draining neatly downwards – (as had become routine for my bladder care). Nothing happened, so they left me like that for a while to see if it would. Suddenly I felt a powerful urge and I literally heard my bowels explode. A tight cramp wrenched my belly and I felt my guts contract sharply. I was having a huge bowel movement and it was completely out of my control. I was aware that the plastic sheet tucked into the gap between my legs tightened and shifted as a wave of faeces hit it. With disgust, I felt my crotch, genitals and lower tummy becoming coated in hot faeces. Massive waves of nausea swept over me. I helplessly continued to noisily evacuate my overful bowels and bladder all over my crotch and into the bedpan, but as I tried to cry out for help my stomach tightened and heaved up my breakfast in wave after wave of retching.

Sickness and diarrhoea while encased in plaster is very uncomfortable. You want to double up, but cannot move. You need to hold your aching stomach, but cannot touch it. So violent was the retching that vomit poured out of my nose as well as my mouth and I felt my face becoming as soiled as my crotch was. I couldn’t get my breath as my nose was blocked and my throat was full. I panicked and choked. I heard running feet. Someone was giving instructions, and my frame was turned so I was on my side. Someone held a bag to my face. That just made matters worse as I continued to vomit copiously and the mess got in my eyes and under my chin. The other end was no better, I was still expelling faeces explosively, in wave after wave of cramps. I felt my buttocks becoming as heavily soiled as my genitals already were. Someone was holding my hand and talking to me – but I couldn’t tell what she said. I felt a tube sucking in my throat and then up my nose. I felt cold and clammy, then hot and faint, and cold again. Cramps shot up and down my body. I felt my gut stiffen and relax, stiffen and relax, as with each spasm another burst of hot faeces was pumped out of me and spread over my privates. More waves of vomiting wrenched my stomach. For the first time I was sure I was going to die.

A sharp prick in my arm heralded an injection.

After what seemed like forever, the waves of nausea, retching and gut cramps finally ceased. I was became powerfully aware of the smell of vomit and faeces and a group of worried-looking people standing around me.

I was absolutely exhausted and ached all over. They had turned me onto my back. Someone started to swab down the mess between my legs while Sister herself gently washed my face. Then she sponged my arms and hands. It finally occurred to me how totally, utterly, helpless I was, and how heavily dependent upon nurses for every detail of my existence. I dissolved into tears of pain and humiliation.

It took two poor nurses ages to clean me up. They had to change all the petalling around the crotch and face openings of my cast and quite a lot of my plaster cocoon had to be cleaned up as well. My turning frame had collected a fair bit of fall-out too, and that had to be washed down. I was given only sips of water again for the rest of the day.

After that, they always arranged that I emptied my bowels while lying on my back with the sheet of plastic carefully wrapped over my penis. The nurse would then gently hold my penis to point forwards between my legs and not upright, so urine drained down the plastic into the bedpan. While I was on the frame there was always someone with me when I was toileted after that.

Because of the colic attack, I was not ready to be prepared for surgery until another full week had passed – for most of it I had a naso-gastric tube in place and took a lot of my nourishment through that. When I had recovered from the colic and was eating and drinking normally again, they got me ready for the operation. Back in the plaster room, they cut a panel in the back of my cast so that they could reach almost the whole length of my spine from waist to head. They also cut a window in each thigh, ready to take out the chips of bone for the fusion. The panels were bandaged back into place. I had nothing to eat and only water to drink from that evening before the operation.

First thing next morning I was trundled down to the theatre. The last thing I remember was having an injection into a tube on the back of my hand, and the next thing was waking up again on the ward. It was early evening and ten hours had passed.

For a couple of days, I hardly noticed anything. I was kept very sleepy and doped up with painkillers. I drifted in and out of drugged sleep, dimly aware of muffled voices and footsteps. I could not focus my eyes – everything then always seemed blurry and confused. Gradually they woke me up, and gradually I became aware of things again. Everything ached and my legs throbbed. I was dazed and dizzy. Time passed in a haze of drugged pain. Every few hours someone would tickle my toes, rinse my mouth and wash my face, toilet me and check the dressings on my back and thighs. I did not feel like eating very much but I got through quite a lot of ice cream over the first few days. I wore a naso-gastric tube again.

After about a week I was well enough to notice that I was not wearing the T-shirt, so I asked where it was. The nurse twinkled a smile at me and said, “You are obviously feeling better!” Shortly, she returned with the T-shirt and my pink woolly socks too, which she carefully put on me.

They had moved my bed so I was next to Clare. When we were arranged so that we were both, more or less, on our sides facing each other we could, and did, talk. It was harder to communicate when either of us was on our backs or fronts, and impossible when we faced away from each other. I was in the corner of the ward nearest the nurses’ office, so I only had Clare to talk to. She had about 6 weeks’ start on me and was due to come out of plaster quite soon – an event we talked about a great deal.

Meanwhile the days and nights passed slowly, marked by the regular routine intimate care and visits from family and, after those first few days, friends too. Clare used to tease me about my sisters who plainly wanted to ask me about life in a plaster cast but were too embarrassed or delicate to actually phrase the questions, so they would carefully talk about something else while eyeing me up from every conceivable angle. My school friends were, I remember, equally intrigued and equally reticent.

The main thing I remember about being in the cast then was the very mixed feelings I had about it. On the one hand it was my friend: it cocooned me safely and supported my, very tender and painful, back. It protected me. But it was also my enemy: it prevented me from moving. I was completely helpless in it. Though its firm support and pressure was re-assuring and safe, it also prevented me – or anyone else – from touching or seeing most of my body, with the result that I began to forget what I looked like. Being unable to move my head at all was often very frustrating. You had to ask people to stand or sit in exactly the right place to be able to see them. Partly because I could not see, and partly because of the thick plaster and padding around my head, sounds were distorted and it was often quite hard to make out what was being said. I am not quite sure why I had to be fed, because I know my arms were fine. I certainly was fed mush with a teaspoon and drank through a straw until the cocoon came off, and I suppose it was really because my neck and chin were encased and so swallowing was difficult and there was a risk of me soiling my cast. They were always very careful to warn you before rotating the frame – but even so, if they were a bit too quick you could get unpleasantly dizzy when they did that.

I discovered that the nurses, out of a sense of modesty no-doubt, usually pinned the front of the bottom hem of my T-shirt to the back between my legs and similarly pinned Clare’s pinafore dresses, so that no-one could see our pants or intimate care arrangements. Not that there was anything beyond a comprehensively occluding towelling-filled crotch to see! Clare had read “Orlando the Marmalade Cat” and referred to this arrangement as our “modesty awnings!” Clare could also imitate my older sister’s slight lisp to a “T” and I often had to ask her to desist because laughing hurt quite a lot still.

It was about then that I first became aware of my new sexuality. Remember that I could not see or touch my genitals, otherwise I am sure I would have tumbled to what was happening earlier. When I had first seen myself in the body cast, my penis was buried deep inside the crotch opening, but now there were several mornings when I woke up distinctly aware of the roughness of my towelling tie pants against its tip. Obviously I was having an erection, but I did not understand that at the time. I was also aware that my crotch felt full and warm. I very much wanted to explore myself, but try as I might, I could just barely touch the top of my crotch opening and even that was usually covered with the thick towelling of my tie pants and my T-shirt. Much to my frustration I simply could not reach my sexual equipment. But I was increasingly aware of the pleasure that my sanitary care gave me. Nurses had to handle me very intimately every few hours and I came to enjoy it.

One night I had my first wet dream. Again, at the time I did not realise what it was, although I could feel that my pants were wet – but the nurse who turned me early that morning changed my soiled tie-pants with the remark “You’re getting to be quite a young man now aren’t you?” A couple of days later, when toileting me, the nurse took my penis to guide it into the urine bottle as usual, but the sensation felt like an electric shock through my loins. Though I could not see it, that time I knew that I had an erection. I remember discovering for the first time how sensitive my penis was to touch and how heavy and full it felt. That was the first time I was really pleasurably aware of an erection. The nurse applied a cold damp flannel to my genitals, which quickly subsided enough to be guided back into the urine bottle.

The day came for Clare to get up, and she was duly wheeled down to the plaster room. She returned in triumph a couple of hours later, sitting in a wheelchair, wearing a new plaster jacket from hips to shoulders and sporting an enormous pair of pink knickers as well as the ubiquitous pink woolly socks. It was soon clear that getting out of plaster was only the first step. Clare went for physiotherapy every day, but it was days before she could sit up for more than a few minutes at a time. Very gradually they helped her stand, first just for a few moments and then gradually longer and longer. When she was able to walk with crutches from end to end of the ward, she finally went home. She had been in hospital for 18 weeks.

I missed Clare. A much younger boy, who had broken both his legs and his right arm falling out of a tree, soon occupied the bed next to mine. He was not good company, partly he was too young for me and partly he just whined about everything and anything. He was nursed in nappies as I had been, but he made a great production and objection to them, despite his evident need for their protection. I ignored him in the end.

Ten weeks after my operation, some 18 weeks after I had first been admitted to hospital, I went for an X-ray session that took all morning. Finally came some good news – I was healing up very satisfactorily and it was time to revise my plaster cast. The next day I went down again to the plaster room. This time I knew the technicians and was well enough to engage in some conversation.

“What does revise mean?” I wanted to know.

“You’re going to get your feet back”, one said.

“Could you undo my head?”

“Not yet. Be patient.”

It did not take very long. Both my boots and the spacer bar were cut off just above my knees. The plaster was finished off with new bandages just above my knees like the cast Clare had worn, and a new spreader bar was bandaged between my thighs. The last dressings on my legs and back were finally removed, the plaster windows replaced and bandaged up in fresh plaster wrappings again.

Back on the ward, one of the nurses carefully petalled me round my thighs. Then, bliss! She washed both my lower legs and feet. It felt very strange indeed having my legs free again. It felt cool and it was difficult to move my legs as I wanted, they felt floppy. Just as I had seen with Clare, they supported my legs on pillows. At last, we were making progress. My back no longer ached and I actually felt well for the first time for ages.

Every day after that, the physiotherapist came and made me exercise my legs and arms twice a day. She taught me exercises I could do myself. Having seen how hard Clare found it to get back on her feet, I worked as hard as I could at those exercises.

I had been in the shorter body cast for just over six weeks, a total time in the turning frame of just over four months after my operation, when the X-rays showed that I had healed enough to be let out. Wonderful! My doctor sat down beside me, told me they were very satisfied and ready to take the next step. The next morning, I would be taken down to the plaster room again, my cocoon would be removed and I would be taken off the frame. Then they would put me in a body jacket very similar to the one Clare wore, except I would still need heavy head support. Once that was dry I would have intensive physiotherapy and learn to sit up, and then stand again. But, he warned, it would take time, patience and some very hard work on my part to get fit and strong again. On the other hand, I would have to be very careful not to overdo it, as my back would be vulnerable for some months yet. I was to do exactly what the physiotherapist said. I could not wait and hardly slept a wink that night.

Again, they gave me medication with my breakfast to relax me; I certainly needed it as I regarded this step with a mixture of eager anticipation and slight worry. How long would it be before I could move normally again? When the washing, toileting and tooth-cleaning was done, Sister came to see me. The curtains were drawn around me because I was wearing nothing at all apart from my cast. She sat down beside me and held my hand.

“Well, my dear. The great day has come. I did say it would not be too long, didn’t I?” I grinned back at her.

“You have done very well,” she went on. “You probably did not know how very ill you were. You have stickability!” She concluded.

“Now I’ve got to learn to sit up and stand again,” I said.

“If you show the same determination and guts that you have so far, my lad,” she replied, “you will be running around again inside 3 months.”

“Is that the normal time?” I asked.

“Around that, yes.” She replied. Then she moved closer and caressed my cheek. “Look.” She said. “You had just about the most dangerous curve I have ever seen. You were in surgery for hours longer than most scoliosis fusion patients. You had 4 pints of blood. You were very poorly for a long time, and you are still ready to be mobilised well within the normal healing time. That’s good news. The sooner you come out of this cast, the sooner you will be able to walk again – and I promise you, the worst is over!”

At that point the porter arrived to fetch me down to the plaster room. I was acutely aware that I had no clothes on, not even my tie-pants this time. No one else seemed to notice.

The usual team was waiting for me in the plaster room. First I was lifted back, face up this time, on to the high table that had supported me all those weeks ago when I was first encased. Then the metal rings that had supported me were unbolted and removed.

“Right!” said the technician, “the noise is the plaster saw. You have heard it before. It can’t cut you. Just relax.”

And they started, one on each side of me. It seemed to take forever. They cut the whole cast in half at each side and finally up inside my thighs. Then they snipped the cast’s soft cloth lining all around with scissors.

“On three,” said someone; “one, two, three!”

They lifted the whole of the top of the cast away, leaving me lying in the shell of the bottom half. Suddenly I felt very cold. The four of them stood round me and, after another countdown, the five of them gently lifted me out of the plaster shell and placed me, naked, on another table.

Free! I hardly dared move. I explored my head and chest with a hand, then experimentally tried to move a leg. Very stiff, a most strange sensation of freedom, but feeling like I might fall to pieces. I shivered.

“How’s that feel?” asked a nurse.

“Wonderful”, I answered. Then I burst into tears.

The nurse bent over me and gently cradled my head and shoulders in her arms. “Alright, it’s alright,” she murmured. “Just keep still. We are going to give you a nice all over wash and then we will put your new jacket on.”

So that is what they did. The two nurses carefully washed me from head to toe. First my front, then, when everyone had helped to turn me over, my back. Then they washed my hair. It was utter bliss! I felt cool and clean and free. At one point I tried to lift my head to look. It felt massive and heavy. After a moment of unsuccessful trying, the nurse said quietly, “just lie still. Don’t try to move yet.”

“How do you feel about sitting up now?” asked the technician. I was game. My doctor came in and examined me carefully all over. After a few minutes he said to the technicians, “Alright! We will go for a suspension application.”

The next stage was familiar enough. My head was supported in the canvass sling again and my new-found freedom disappeared as my body was wrapped first in soft gauze from hips to chin, and then sheets of thick padding were fixed, once again, around my hips, my shoulders and my neck.

In a moment, they had tied my sling to a hook above the table. Then someone put a towel under my bottom. Suddenly, I was sitting up, suspended by my head sling from the hook.

“How’s that?” said my doctor.

“Bit dizzy”, I replied.

“Alright,” he went on, “you may feel groggy for a bit. That’s because you have been lying down for so long. We’ll keep an eye on you. This won’t take long.”

As before, they started with long strips of thick plaster slabs. This time the first set went from my hips at the front, crossed over my shoulders and then went down my back again to my bottom. Another one was moulded around my neck and a third set went from the top of my head, down my back to my waist. The familiar “Slap, smack” as they rubbed the plaster down, and the growing heat, brought back memories of that first session, now more than four long months ago. The next stage was wide rolls of plaster bandages. This time I could see a lot more of what they were doing. They worked in two teams, a technician and a nurse each. My doctor stood to one side carefully observing the whole process. One by one, each slab or bandage was selected from the correct pile on the side table. The nurse expertly popped the wrapping off the bandage and dunked it into a bucket of water. When all the bubbles stopped coming out, she took the roll out and squeezed it slightly, then undid the end and handed it to the technician. He applied it and used his rubber gloves to press it down into the growing cast and polish it as it dried. I was firmly bandaged up from hips to shoulders again.

At that point I fainted. When I came round, I was lying on my back. I was given a sip of cold water through a straw. “Nearly finished”, she said.

My head was hanging over the edge of the table as one of the technicians wrapped several more rolls of plaster bandage around my neck and chin. “Time to check that,” said my doctor. They took an X-ray. While we waited for the film to come back, he stuck pins into my legs and arms to make sure I could feel all over. Clearly he was satisfied because he just said, “finish off now. He’s fine!”

One of the technicians carefully trimmed the new cast round my hips and then cut off the sling under my chin, gently teasing it out from inside the plaster. Then he took a pair of shears and trimmed the plaster around my head so that I had a moulding rather like the arrangement of the brace I had worn; support under my chin, beneath my ears and up the back of my head. Suddenly I could hear everything much more clearly as I no longer had my ears buried in padding. My head felt cold and very heavy – I could move it very slightly from side to side!

I was determined to return to the ward in triumph, as Clare had done, and asked to go up sitting in a wheelchair. A wheelchair was produced, they wrapped a cotton gown around me and off we went! As I was wheeled back into the ward everyone cheered. I felt dizzy, but a million dollars better. To add to my triumph, I had been moved down to the other end of the ward by the window. Not only did this offer much more to watch and entertain me, but also it was a major badge of progress that I no longer needed to be so close to the nurses’ office.

Two nurses carefully lifted me onto my new bed and gently laid me down on my back. One of them produced some sticky tape.

“Petalling?” I asked.

“That’s the idea,” she said. Once more, she carefully stuck the circular pieces of tape around all the edges of my cast. She then slotted a gauze pad under my chin again too. When she had finished she said, “do you want to wear a gown or try some clothes on?”

“Clothes, please.” I answered.

She disappeared and came back five minutes later with an armful of the clothes I had been wearing when I was first admitted. The shirt, knickers and short trousers were still big enough to go over the cast, and I got a pair of real ordinary socks and sandals too. She showed me the result in the hand mirror. Apart from the plaster supporting my head and enclosing my neck, I looked ordinary again. I felt wonderful, but very tired.

I snoozed on and off until lunch, for which I was able to sit up – well propped on pillows – and eat all by myself for the first time for over five months. Food never tasted better. I could drink out of a proper cup again. After lunch, joy of joys, they took me in the wheelchair to the proper toilet and sat me on it. I performed in comfort and reasonable privacy – only needing help with getting on and off and with cleaning, as I had done while wearing my brace pre-operatively.

Mum came to see me in the afternoon. She seized me in a bear hug and kissed me until I thought she would explode. She was crying quite openly. I said something like, “don’t be silly Mummy” and she just cried a bit more. I told her what Sister had said to me that morning.

“That’s right,” she commented, “they said it was a dangerous curve. If it had moved any further the wrong way you would have been in a wheelchair for life. You probably don’t remember it, but when you came in you were pretty well paralysed. We were very concerned for you. You are very lucky. Now your job is to get fit and on your feet again. Promise me you will work hard and do what they tell you.”

I duly did.

Like Clare, twice a day from then on, I went down to the physiotherapy department. I remember I seemed to spend a long time lying on my back either pushing a weight up a slope with my feet or bicycling my legs in the air.

They still kept a very close eye on me, but now I could roll myself over in bed, and I could also sleep comfortably on my side if I was propped up with pillows. During the daytime I wore my “real” clothes from then on. I was able to sit up for increasing lengths of time although they always made me lie down for half an hour after meals to rest.

At night I was offered ordinary pyjamas to wear. I accepted them with alacrity. That first night of “freedom” I discovered that I could now get at my genitals reasonably easily as they were no longer buried deep inside the crotch opening of my hip cast. The new body cast was much slimmer over my chest and finished much more accessibly on the line of my hips. And there were no thick towelling pants in the way either! A few minutes of careful exploration made me wish I had the nerve to ask for the mirror – I wanted very much to see what I looked like. I could feel a line of soft new pubic hair on my lower belly, and my penis moved and swelled when I fondled it. It had also become much longer and thicker so it hung downwards instead of sticking out in front of me. During the following nights, I carefully explored and experimented with my new self and masturbated to my first orgasm and ejaculation a few days later. It was a bit scary but I was thrilled. Not only was I getting better, I was becoming a real man too. I could not wait for my voice to break, but that actually did not happen for another four months, just before my 14th birthday.

After a couple of weeks of intensive twice-daily physiotherapy, came one morning I shall always remember. I had just arrived in my wheelchair and was waiting at the door of the department. My favourite physiotherapist came up to me and smiled –

“Right,” she said, “time for you to do some real work!” She propelled me round to the parallel bars, on which I had watched many other patients perform with increasing jealousy over the last fortnight. Almost before I knew it, she and an assistant had hauled me out of the chair and had me standing between the bars. My legs felt like cotton wool and I grabbed for the bars. “Steady!” she said. “Just stand quite still for a bit until you get your balance.”

It was quite difficult to get my balance. My legs and hips felt very shaky and, of course, I couldn’t look down to see my feet. Someone had hold of my right ankle. “Slide this forward a bit. Stop! Rest.” She took my other ankle. “Now slide this one forward to meet it. Enough! Stop! Rest.”

I could feel myself sweating.

She repeated the manoeuvre twice more, then;

“Can you do that again yourself? We’re holding you, go on!”

It took a lot of concentration to make my foot slide forward – but it did. Making the other catch up with it was easier. I had taken my first step by myself for six months! I repeated the trick two or three times more. Then she said, “Well done! Rest now. Would you like to show your Mum that you can walk again this afternoon?”

Would I just?!

That afternoon, sweating with the effort, I walked the length of the parallel bars with only a little support from the therapist. As she guided me into the wheelchair my whole family – parents and both sisters – crowded round me, full of delight. The therapist said, “that’s a tremendous achievement. You have made it back on your feet in record time. Well done.”

Twenty three weeks after admission, almost to the day, I was well enough to go home. I could walk short distances unaided by then, but I still had to be dressed and undressed and have help using the toilet. By then, I got round the aiming problem by always sitting down to pee, so I directed my penis myself.

I went home just in time for Christmas – which was a tremendous celebration that year.

I wore the plaster jacket until the early spring – about another three months. The main thing I recall about the jacket was how hard it was to come downstairs in it. I had to feel every step. And I never really got used to people – if not actually staring – looking hard twice at me. Once I was dressed, only the plaster head and neck support actually showed, but I was still pretty obviously in a body jacket under my clothes because of their bulk and my stiffness. On a couple of occasions, solicitous old ladies (well, they looked old to me anyway!) would ask me what I had done to myself. That was horribly embarrassing.

In March I went back to the hospital to have my body cast taken off at long last. I remember that feeling of cold and vulnerability again when it was removed. My head felt terribly heavy and at first it was very tiring just holding it up. But it was great being able to look around me easily. Even better, I could look down. I saw my feet and my privates for the first time for months! They fitted a moulded collar round my neck which I wore, increasingly off rather than on, for another three months after that, but otherwise I was fine.

The best bit? Mum came in with me when my last plaster jacket was removed. They stood me up, naked, after it had come off, and washed me from head to foot for the last time. Then Mother produced new clothes that really fitted me, no longer having to accommodate an awkward brace or a bulky body cast. I wore a tie round my collar, which was the right size now, for the first time. My neck was very sensitive to the strange feeling of the shirt collar, and it felt cool and open under my chin. And, best of all, Mum had bought me my first pair of real man’s Y-front brief underpants. As I pulled them up in front of the mirror I could see, to my enormous pride and satisfaction, my sex filling out the pouch at the front with a very creditable bulge in exactly the right place. Three days before my fourteenth birthday, almost a year from the start of my spinal fusion treatment, I had grown up. I rejoiced that I would not wear little boy’s knickers ever again. To finish the effect off, Mum produced my first pair of grown-up long trousers too. Heaven!

That night I had my first real bath for nearly six months. I soaked and luxuriated in it for over an hour until Mother almost had to drag me out. And I admired my scars in the mirror. A most impressive one from the small of my back all the way up my now perfectly straight spine to the base of my skull, and two smaller scars on the outside of my thighs.

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