July 25, 2000

BOOKS ON HEALTH

Two Fine Minds, Tested by Failing Bodies

In her 1961 poem "Grace," Maxine Kumin described hens pecking on gravel and the invincible armor one might gain by similarly ingesting small stones. "I find it good to line my gut," she wrote, "with tidy octagons of grit."

Nearly four decades later, as she lay immobilized in the hospital with a nearly fatal spinal cord injury, Ms. Kumin's kernels of redemption were the words she managed to connect to her thoughts and ultimately commit to paper, at first dictating them when her own hands were incapable of typing. Although "Grace" didn't specifically come to mind as she kept her journal, Ms. Kumin said in a telephone interview, she has no doubt that writing (and her daughter Judith, who helped her to write) was her salvation.

"I guess it's what saved me, really. But words have always been what saved me," she said from her New Hampshire farm.

The resulting book, "Inside the Halo and Beyond: The Anatomy of a Recovery" (W. W. Norton & Company), offers a clear description, in accessible terms, of spinal cord injuries and the harrowing methods used to help patients regain the use of their bodies. Though Ms. Kumin is an avowed atheist, this memoir is nonetheless a testament to self-discipline and the power of creative expression. And for those interested in the life of one of the country's pre-eminent poets, "Inside the Halo and Beyond" is filled with insights into her childhood, her marriage, her relationships with her children and the deep connection she feels to nature.

The title of her memoir comes from the metal bird-cagelike contraption that was literally pinned into her skull to keep her head and neck from moving and give her spinal cord a chance to heal. An avid equestrian, Ms. Kumin regained consciousness inside the device after her beloved horse Deuter bolted on July 21, 1998, throwing her from the carriage she was driving and fracturing the top two vertebrae of her spine.

"Imagine a human head inside the cage fastened by four titanium pins that dig into the skull," she writes. "The pins are as sharp as ice picks. I wake up in this cage, disoriented, desperate, sicker than I have ever been. No feeling in my arms or legs, but a vague sense that my head is entrapped forever. No movement left or right, up or down. I am a stationary parrot inside my strict cage. . . . Some orthopedic wag dubbed this form of axial traction a halo."

The Pulitzer Prize-winning poet remained in the halo for three excruciating months, until X-rays and other tests showed the vertebrae had fused back together on their own. She was spared the life-threatening surgery that the actor Christopher Reeve, for one, was forced to undergo after his own 1995 horseback riding accident. In Ms. Kumin's case, her mystified would-be surgeon pronounced her condition a miracle; most people who suffer her type of injury either die or, like Mr. Reeve, become paralyzed. Today, she is hiking again, driving, carefully riding Deuter, cooking and trying to wean herself from painkillers.

During her recovery the fiercely independent Ms. Kumin, who was 73 at the time of her accident endured constant pain, grueling therapy, the fear that she might always be impaired and the indignities of being catheterized. Exposing herself in a memoir seemed easy by comparison, she said.

"Everything becomes so public when your body is almost destroyed," she said. "You have no autonomy. You're full of tubes, your bodily functions are not within your control. You're completely infantilized, you just become a piece of flesh. By writing about it, it was a way of regaining some small piece of autonomy."

Ms. Kumin also forced herself to read, sometimes only a paragraph at a time because of the awkward position of her head, and she drew upon her memory bank of poems. Inside the claustrophobic tube of an M.R.I., for example, she recites A. E. Housman's "A Shropshire Lad" to the medical machine's thumping beat. And she was fearless, almost masochistic, in her choice of reading materials, which included medical articles and Mr. Reeve's own heartbreaking 1998 memoir, "Still Me" (Random House).

Like Ms. Kumin, Mr. Reeve was supported through his injury by a loving and resourceful family. While Ms. Kumin's kin sustained her with baskets of fresh vegetables from her garden, Mr. Reeve's relatives faithfully served up fan mail to nourish his spirit through the worst of his depression. With his spinal cord completely severed (Ms. Kumin's was merely "dinged") it was immediately clear he faced life without the use of his arms and legs and would need a ventilator to help him breathe.

In his book, the actor best known as Superman candidly chronicles his suicidal thoughts and the constant dread that he would suffocate. "A large part of the fear was because I couldn't take a single breath on my own," he writes. "And the connections of the hoses on these ventilators are tenuous at best. The nurses put tape over the joints, but they don't always hold very well, and you lie there at three in the morning in fear of a pop-off, when the hose just comes off the ventilator. I had several. After you've missed two breaths, an alarm sounds. You just have to hope that someone will come very quickly. . . ."

Eventually, Mr. Reeve's fine mind and education kick in when his body fails him and, like Ms. Kumin, he finds salvation in his work. His book culminates with his directing, from his wheelchair, the HBO movie, "In the Gloaming." He concludes that "a hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles."

Neither of these authors is ordinary of course but, as their books attest, their use of their talents in response to their cruel accidents make them all the more remarkable.


By LESLIE BERGER

Copyright 2000 The New York Times Company

"http://www.nytimes.com/library/national/science/health/072500hth-book-spine.html"

janet paterson
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