In July 1998 the poet Maxine Kumin was thrown from her carriage when her horse bolted during a competition. The type of cervical (C1-C2) fracture that she sustained is fatal before reaching the hospital in 95% of cases, and if survived, usually results in quadriplegia. This book is a memoir written in the form of a journal that begins on the day of the accident. In fact, it was nearly a month after the accident that the poet's daughter brought writing materials to the rehab hospital, and Maxine began to dictate the journal, and the two of them filled in the temporal gaps.

The journal covers her experience in the acute care hospital, the rehab facility, and the following months of convalescence at home. It ends on April 23, 1999, when Maxine climbs a hill (unassisted) near her Vermont home, looks out over the early spring vista, and concludes, "I am letting myself believe I will heal."

The journal describes the poet's physical, emotional, and spiritual experiences as she struggles, first to survive, and then to live with the "halo vest" that for months she had to wear to stabilize her fractured neck bones, and finally to regain her function and equilibrium. Much of the story is about her family--husband, son, and daughters--who mobilize from various points around the world to support her. Comments about her doctors and the medical care she received constitute only a small, at times almost incidental, part of this narrative.


This book's title refers to the "halo," which is a type of cage into which the patient's head is inserted and then stabilized with "four titanium pins that dig into the skull." (p. 16) This cage is attached to a rigid plastic vest that the patient wears. The purpose of this restraint is to reduce cervical movement sufficiently so that the spinal cord will not be damaged while the vertebrae are in the process of healing.

The halo is also a metaphor for the devastating results of spinal cord injury, as well as for the emotional and spiritual cage that constrains each of us. Interestingly, through the magic of words, we are able to turn confinement into a source of spiritual significance by labeling it a "halo."

Unlike many pathographies, Inside the Halo and Beyond focuses very little on doctors and medical care, and their inadequacies. There are no medical villains here, nor medical heroes, either. The author appears to have received very fine medical care, even though her orthopedic surgeon could have been more interactive. However, Maxine Kumin doesn't concern herself with anger, blame, or outrage in this memoir. Rather, she strives to achieve understanding and hope, and, especially through the poems she includes, to infuse her traumatic experience with meaning and beauty.


W. W. Norton

Place Published

New York



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