REVIEW: All the Difference by Patricia Horvath

Reviewed by Sarah Evans

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all the difference cover xray if curved spine in background with colors so it looks somewhat abstractPatricia Horvath is a bookish college professor much more at home in sedentary pursuits — sitting in her writing chair, tucking away in the library — than in active ones. She never learned to ride a bike, always struck out at bat, and failed her school fitness tests.

As she describes in her memoir, All the Difference (Etruscan Press, 2017), her rejection of physical activities is mainly due to her bones, her body inhibited early on by severe scoliosis. Horvath’s book is a beautiful chronicling of her adolescent struggles through disability and debilitating treatment that included spinal surgery, body casts, and braces limiting her mobility. But the book also is a reckoning with adolescence, physical and emotional development, and how her struggles with a body that failed her may have ultimately shaped her personality.

Through often poetic prose and lovingly rendered details, Horvath shows the physical impact of scoliosis on a growing, adolescent body. First she tried physical therapy, but after a growth spurt between seventh and eighth grades, her spine became more twisted. “My right sleeve hung lower than my left; I was always pushing it back,” she writes. “And in school, my right shoulder blade knocked against my chair, raw bone chafing metal. No matter how I shifted in my seat, I could not get comfortable.”

The discomfort only got worse when doctors ordered her to wear a pelvis-to-skull Milwaukee brace, a plastic and metal apparatus meant to keep her scoliosis from worsening as her bones developed, for 23 hours a day. Navigating the complicated high school social network is hard enough when you’re not wearing a highly visible device that keeps you from bending your back and neck. Horvath, already a lover of literature, retreated further into her books and the safe haven of her bedroom, away from the taunts of classmates and the stares and questions of curious adults.

Ultimately, Horvath underwent spinal surgery that left her lying in that bedroom 24-7 for three months. Confined in a chin-to-hip plaster cast, she was unable to sit up, raise her head, or roll over. She relied entirely on in-home teachers and caretakers, plus her saint of a mother who did everything she could to make her teenage daughter comfortable.

Throughout her book, Horvath waxes beautifully on her inner thoughts and memories, and how her disability changed both her physical body and her identity. At times, however, she moves too fast, glossing over potentially major plot points that could have added rich complexity to her story (we learn in an early chapter, for example, that her father “moved out, the private eye shacking up with his secretary,” but get nothing more about what happened leading up to and surrounding this life-changing moment in their family). Horvath’s book is only 181 pages, but it could easily have been twice that length with deeper dives into her day-to-day interactions with her family and their part in raising and living with an adolescent girl struggling with disability.

That said, Horvath does a remarkable job with the material she does have — namely, her own reflections and memories, plus several written documents and memories she gathered from her mother and brother. If anything, the fact that the reader may want more speaks to the compelling nature of Horvath’s story and her captivating prose.


Sarah EvansSarah Evans is an Oregon writer who has been published in Bluestem, Mom Egg Review, The Quotable, and on River Teeth Journal’s Beautiful Things blog and Brevity’s Nonfiction Blog. She earned an MFA in nonfiction writing from Pacific University. Read more about her at



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