The Ezra Klein Show: Barbara Kingsolver Thinks Urban Liberals Have It All Wrong on Appalachia

From New York Times Opinion, this is the Ezra Klein Show.

So in 2023, the Pulitzer Prize for Fiction was won by two novels, Trust by Hernan Diaz

and Demon Copperhead by Barbara Kingsolver.

And Kingsolver, I think, is a literary legend in her own time.

I mean, she wrote The Bean Trees, she wrote The Poisonwood Bible, she has won all kinds

of prizes, but I think it's fair to say Demon Copperhead is a kind of masterpiece.

And it's a kind of masterpiece she was trying to create.

She set out to write, as she tells me in this conversation, she was setting out to write

the great novel of Appalachia, and I think she did.

And this is a novel that is following loosely in the structure of David Copperfield by Dickens.

It's a novel set a little bit back in time, I think, that so much of our thinking now

about this is political and places that go for Trump and places that don't go for Trump.

But the novel set in the 90s and in the 2000s, so a little bit before some of the current

economic and political cleavages attain, at least the form we know them in.

And it's a beautiful book.

It's a wrenching book.

It's a book that I routinely had to stop reading because I was so fused with a character and

so fused with a story that when I could see something bad coming, I just couldn't handle

it before bed.

I just couldn't go through that with the main character.

So I mean, that I think is about as much as you can say for fiction when it almost feels

more real than the life you're living.

So I was grateful she was willing to come on the show and talk a bit about her life, how

she came to writing the novel, the sort of experiences she brought to it and the kind

of argument she's trying to have through it.

As always, my email as her client show at nytimes.com.

Barbara Kingsolver, welcome to the show.

Thank you for having me.

So you've said that you're Appalachian through and through.

What does that mean to you?

I'm Appalachian and it's a funny thing.

It's a marker.

Appalachian means you say, I live in Appalachia.

It's a region that's a little hard to pin down on a map because it includes parts of

a lot of states starting from North Georgia, Eastern Tennessee, Western North Carolina

and Virginia up into the cold country of Kentucky and West Virginia and then up into sort of

the ridge country of Pennsylvania.

So that sounds complicated, but to us, it is a whole place.

We're more connected with each other culturally and geographically than we are with the far

ends of our own states.

It's a place and it's a mindset.

We are connected by our mountains, our economies and the fact that for a couple of centuries,

we have been treated almost like an internal colony of the US.

We have suffered the exploitation of extractive industries managed by and profited from outside

companies that come in and take what they can and leave a mess.

So it started out with the timber industry, then it was coal and then it was tobacco.

And now the latest car and this coal train of exploitations has been the opioid epidemic,

which was, again, quite deliberately perpetrated on us as a vulnerable population.

We're going to come back very much to the opioid epidemic, but before we do, I want

to talk a bit about just your geographic history because you grew up in Kentucky, but then

moved to the Congo.

Tell me a bit about the various places you've lived and why and what it was like coming

back then later in life.

Okay, I grew up in the eastern part of Kentucky, sort of the foothills of Appalachia.

And that was really my home for my whole sort of schooling years up until I was 18 and left.

Because of a sort of a very unusual history, my dad was a physician who was dedicated to

serving.

Well, he was from poverty.

He was the first person in his family to go to get higher education.

And he was determined after he became a doctor to serve people who really needed a doctor.

And so for most of that time, that meant the rural parts of Kentucky where he'd grown

up, one of the more economically sort of depressed parts of the U.S.

But from time to time, he would get invitations from his colleagues to go to places where

people needed a physician even more.

And so that took us to the Congo, to rural Congo for about a year of my life.

I call it the what I did instead of second grade.

And a few other places once stint in the Caribbean.

So those were kind of adventures in my childhood, but we always came back to Kentucky.

So I still consider myself a Kentuckian, but I was the one among my classmates who had

lived on another continent.

I mean, most of my classmates, you know, never left the county.

So it did sort of distinguish me.

I was a person who had seen the world.

And maybe because of that, I had a sense of the world, and then I wanted to see it on

my own terms.

So when I was 18, I went to college in the exotic far away land of Indiana.

And I was lucky to do it.

Very few of us in Nicholas County High School ever went to college.

That was a really rare thing.

University in my school was telling me you need to take these things called SATs.

Nobody was advising me.

I just kind of clawed my way into a scholarship, and I got to Indiana, DePaul University, and

to my amazement there, I discovered I was a hillbilly.

I never thought of myself as a backward, coming from a backward place, but oh my goodness,

I needed only to cross the river into Indiana to discover, you know, what ignorant backward

folk we were from Kentucky.

And people laughed at my accent.

People actually, I was a curiosity on campus.

People I didn't know would come over to me in the dining hall and say, say this.

You know, say this.

Well, what's this?

Like they wanted to hear me say syrup and mayonnaise and these other words that they

thought were, you know, hilariously charming.

And so I said about slowly, not even that intentionally, altering my persona in the world,

erasing my Kentucky in affect, just so that people would hear my words instead of making

fun of them.

And so now I've tried to become this imaginary cosmopolitan person.

I mean, I always wrote.

I just didn't think that I could be a writer.

But that was an important and really dark phase of my own writing.

I tried to write from that place of this imaginary cosmopolitan Barbara.

And it was just the most ridiculous, fakey nonsense you've ever read.

And then to fast forward a little bit here, you lived as an adult in Arizona for quite

some time and then moved back in the 2000s, I believe to Virginia, to where you live now.

And I always thought of you, I think because I read you in that period as a writer in Arizona,

but now I sort of understand more of the complexity of it.

So tell me about the decision to move from Arizona back to Virginia.

It was all a part of the sort of my, my exodus from Kentucky was driven by what I think drives

most small town kids, you know, we want to kick the little town dust from our shoes and

go see the world.

If we're lucky enough or fierce enough or resourceful, we do that.

And after college, I actually backpacked around Europe for several years, doing the low paying

jobs that you can do as an ex-pat, living out of a backpack.

And I really wasn't sure I wanted to come home, whatever home was.

But I had to because of visa problems in the late 70s.

I lost my work visa.

So I had to come back to the US and just decided to try out Tucson, Arizona, because I wanted

to see the West.

It seemed the next step in my exploration of the big world.

And I didn't really plan to stay in Tucson, but things happened.

You know, when you're at that stage in your mid twenties, you get a job and then you get

a little better job and then you meet somebody and then you have a house and then you have

a kid.

I went to grad school.

The next thing I knew I was really pretty settled in Tucson.

It didn't feel like home, not really.

No place I'd ever lived outside of Kentucky felt like home.

There were things I really loved about Paris and Athens and rural northern France.

And there were things I really loved about Tucson, but it never felt to me like the desert

wanted me there.

I missed towering green trees and mossy creeks and the sound of crickets at night and birds

in the morning.

It just was, it never felt right.

And I ached to come home, whatever home was.

Then after grad school, I began working as a freelance writer and I was working as a

journalist.

And so I learned a lot about the territory and I was trying to write a Southwestern novel

and then I had this epiphany.

Someone actually gave me Bobbi Ann Mason's short story collection, Shiloh and Other Stories,

which was a very big book that year in the world.

She's from Kentucky.

That book broke out that year with a lot of praise from the American Literati and I read

it and I was amazed because it was people who talked like me and who worked at Walmart.

There were cashiers and they did shift work and they were working class Kentuckians and

the scales fell from my eyes.

I understood that I had been holding my light under a bushel, that my own voice could be

something that people might want to hear.

And so then I did a deep dive back into these Kentucky writers I had known, but needed to

reread with new respect, Wendell Berry, Robert Penn Warren, poets, James Still, Harriet Arnault.

And it's not exactly a recovery.

It's more like a reacquaintance with an embracing of my own Kentucky voice.

And I found this voice and I named her Taylor Greer and I put her in charge of telling this

Arizona novel.

She was a character who came from Kentucky, moved to Arizona.

She did not have my life.

It's not autobiographical, but I knew her voice and her story and her mannerisms and

everything and I put her in Tucson, Arizona and she told the story and that was the Bean

Trees.

It was the first fiction I wrote that was successful because I had decided to own myself, my Appalachian

background.

This book has a lot of that dynamic to it and one thing that is threaded through it is

Demon, the narrator, balancing the pride he feels in the place he comes from and the

shame he feels or the shame he has been told to feel in the place he comes from.

And you've talked in interviews about having internalized the shame of your upbringing,

of where you come from.

What is that shame?

Well, this place where I live, just over the mountains from Kentucky in southwestern Virginia,

is a perfect home.

We live on a farm and it's just exactly where I want to be, among people I want to be to

be with and to claim as my own and as my neighbors.

So here I am as an Appalachian writer and it was finally with Demon Copperhead that

I could tell the most Appalachian story I've ever told.

I really, I know this probably sounds ridiculous, but I wanted to write the great Appalachian

novel.

I wanted this novel to hold the entire story, the whole background of why, why it is we

are who we are, all of the things that people look down on, sort of how they are not our

fault, how they were perpetrated against us as sort of an economic program exploiting

us and also all of the good stuff that we are people made of community, that we are

the most resourceful Americans you're probably going to find anywhere.

So what is that shame that I had internalized?

Well, look, it wasn't just in college, it was everywhere.

Just about every time you speak with someone who is from outside of your region, they make

some remark like, you seem really educated for a Kentuckian or more crudely, you're wearing

shoes.

I'm not kidding.

Or more subtly, are there any people there you want to be friends with in MAGA country?

How many people, well-meaning people have asked me, how can I live there in the middle

of nowhere?

People, this is my everywhere.

This is my everything.

I live on a farm that grows food where water comes out of the mountain among trees that

make oxygen.

City folks are depending on us for a lot of things that they routinely discount or make

fun of.

It's been a very long program in the development of the world that economies and governments

have urged people into the cities away from the countryside, try to get land-based people

into the cities because there are a lot of reasons, but it boils down to this.

People in the money economy can be taxed.

People in a land economy produce a lot of what they consume on the spot.

So if you're growing your own food and eating it, there's no way to pull taxes out of that.

So I know this sounds really simplified, but it is the bottom line.

I can point you to points in history where this has become overtly an issue.

The Whiskey Rebellion, George Washington marched the whole army into Appalachia because people

were making whiskey and the government wanted to tax it.

Well, there's no money changing hands, so you can't, and that was the reason for a war.

It feels like an impossibly simple thing, but if you look at all the ways that rural

people are stigmatized, it comes down to their self-sufficiency that's being mocked.

If you look at the cartoon Hillbilly, he's got a fishing pole, that's food self-sufficiency.

He's got the jug with the XXX on it that is alcohol self-sufficiency, and he's got a straw

hat on because he's a farmer.

It's all about what he's making and consuming himself.

It's so insidious people don't realize it, but this long, long-term brainwashing has

resulted in a widespread notion that city people have got it.

City people are sort of the advanced form of humans, and rural people are this sort

of having this provisional existence.

They just haven't made it yet into the real life, and so everybody looks down on the country

people and the country people sort of absorb that.

You can't help but absorb it.

When I set out to write my great Appalachian novel, I was paralyzed with self-doubt because

my starting point was that I wanted to write about the opioid epidemic, which has become

a huge assault on our culture, our families, our communities.

It's devastated so many of the good things about this region that we value and that we

love.

And so I wanted to write about these kids who've been damaged and this place that's

been damaged, and it seemed like a really hopelessly sad story, plus it's about people

that I didn't feel the outer world cared about.

And so I just really, I spent a couple of years walking around and around this story

trying to figure out how to break into that house because I really felt sure nobody wants

to read it.

I think there's so much power in that and it's something I was thinking about a lot

during the book.

And let me try to see if I can hold two things in tension here because everything you say

is true and I think your point about the ways in which people from rulers are visually

stereotyped, having a lot due to self-sufficiency is true.

And this is something that I'll be honest, sometimes I think greats on us city dwellers.

So I come from a people who over and over again were driven out of land.

I come from Jews driven by pogroms again and again off of land where they could have been

self-sufficient and into cities, into one city and then into another city and then into

another city.

Part of my family comes to America by way of Brazil.

Another family comes by way of Eastern Europe.

And there has always been this tension, I think broadly, it particularly afflicts Jews,

the sort of rootless cosmopolitan stereotype.

But then there's also this side thread in America.

I won't speak for it in other countries of, oh, the city dwellers aren't real Americans.

They're not on the land.

What they do isn't real work.

You know, I remember George W. Bush winning the election in 2004, oh, Democrats have lost

the heartland.

There's a part of this country that is its real heart.

And the other parts, they're not real.

You're not a real American, you're something else.

I think all the contempt you talk about is real.

And yet it also does in this strange way go the other way.

And maybe that is a kind of cliché, a kind of pat on the back where your economy is

destroyed.

But oh, you're a real American.

But there is something I always think about when I hear this, that it has never felt to

me that the contempt actually only goes one way.

As a Jewish urbanite, I have definitely often felt that it is very easy for people in all

parts of American politics, but I've mostly heard it on the right, to talk about cities

and talk about people like me and with my history as if they are completely alien to

this place.

You're absolutely right.

It's a dialectic.

It's an antagonism.

It's like there's no point in asking who started this because it's a really, really old antagonism.

And you know, I was just kind of talking about a larger framework of development that has

really tried to get people off of the land.

But here we are in the middle of it with a lot of rock throwing in both directions.

And it's become devastating for American politics because, you know, rural people who are less

frequently called heartland as called flyover country, it's a sort of a self-defense saying,

well, we, they hate us, we hate them back.

And let's talk about kind of who gets seen and who gets to tell the story in the US.

I think that's probably what's most critical right now is that all of our entertainment,

our news media, it's all made in cities.

And I think this has left rural people feeling so unseen and their problems so trivialized

or ignored that they've gotten vulnerable to a damaged extent so that they're ready to

vote for the person who comes along and says, look, I see you and I'm going to blow up the

system.

Okay, not the right answer, not the right guy.

But I understand why so many people for the first time felt like for the first time in

many election cycles, somebody was paying attention.

And now we've got a mess because that sort of validated this urban notion that those

people are, they're voting against their own interests, they're not well educated, so they

can't make good choices, so we don't really need to listen to them, so we just hate them.

So it's worse than it's ever been in my life, this urban rural antipathy to the point where

conversations are really difficult to have, because we will only take information from

people we trust, that's just human, that's the animal we are.

We only listen to people that we feel like are on our side and going to look out for

us.

If you open a conversation with you bonehead, then that conversation is over.

And those are the only conversations that are happening now in a political arena and

it's scary.

So this is something I feel like I can do in my small way as an Appalachian who has

also been lucky enough to have a higher education and I can read a lot of stuff and I've lived

in a lot of parts of the world and I can come back to my home and see what's good about

it and what's challenging about it and I can try to talk across this divide, I mean demon

copperhead is my attempt to speak to people, well it's doing two things, I mean I want

it to be a window and a mirror as they say books can be, I wanted it to be a mirror for

my people to feel seen and that's been an amazing experience to hear from kids in the

foster care system, from teachers, from so many people in demons walk of life saying

I never knew that anybody else could see how hard this is.

But at the same time to let people from elsewhere understand the complexity of our lives here,

the nuance of Appalachian culture, the value of our communities, the whole ecosystems of

characters that we are, the bad and the good and how the ways that we take care of ourselves.

I wanted this book to be a conversation about that divide and it is being read mostly by

people who are not from here.

I'm sitting here in the epicenter of urban journalism at the New York Times.

Yeah, exactly, exactly.

Which has gotten much worse over time, I mean it used to be that you had much more geographic

dispersion of the papers people read, not so much the TV they consumed but local radio

stations were stronger, newspapers were more regional or more local and that is not gone

but is even weakened from when I was a kid.

Oh, it's so nearly gone, it's really scary to me.

Even in a place like California where you still have the LA Times and the Chronicle

and others, I mean the New York Times is the biggest paper in California.

It's based in New York and I was thinking about this for a bunch of different reasons

but one of the things that even if you think, and I do think this, that then some of the

quality of journalism people get is better, you can get amazing national and international

journals and which was much harder to get when I was growing up but what even a great

international paper can't do is create a sense of local identity and pride.

When you are growing up somewhere that is not New York and you read the New York Times

there is a function that regional media, that local media play that is not being played

for you, that I would be very different if I hadn't had when I was growing up.

Well and identity aside, just the information.

Yes, just the information of course.

Even about maybe 2% of what we see and read about is about us.

So it's a void that's, you know, how do we address that?

It's really profoundly debilitating not to see yourself anywhere and we're aware of

this in other, in terms of other, we've made huge strides just, you know, in the last decade

in terms of identity politics.

Yes, we understand people with disabilities need to see themselves in ads and in shows

and film.

We understand that people of color need to see themselves to feel validated.

Okay, rural people need to see ourselves too, farmers need to see ourselves too and we're

not and so I hope it's understandable that we're really mad, that we're really tired

of being overlooked.

And the economic aid that goes to farmers really goes to factories, you know, industrial

farms that are producing soybeans and corn that are going into fast food and that's not

helping people.

Another unique quality of Appalachia is that we're one of the last strongholds of small

family farms because of our topography.

Because in the mountains there's no flat land.

A farm might have like a half of acre of one acre that's flat and all the rest is too

steep to plow.

So we don't have the giant combines.

We don't have the giant wheat fields and tractors that look like they came out of Star Wars.

If we ever see farming on TV, it's that and that's not real people.

To us, that's not farming.

I want to move us into the universe of the book and there's a particular character who

I think bridges a bunch of the conversations we're having here, which is Tommy.

So can you tell me a bit about Tommy?

The ghost in the room here is Charles Dickens because I owe him everything with respect

to this book.

Charles Dickens is the key I finally found to the door of that house of this novel.

When I decided to write this as a modern day David Copperfield, he gave me, I guess the

chutzpah to tell the story because people really liked his version of it and I thought

that could surely help.

He gave me a crackerjack plot and all these amazing characters and he gave me Tommy who

was called Tommy in David Copperfield.

I will say here, as the disclaimer I always make, you do not have to read David Copperfield

before or after you read Demon Copperhead.

It's not necessary at all.

There's not a test?

There's no test.

No, but I took David Copperfield as my template and I just laid my book right over it because

it worked so well and then of course I had to use some of the characters in other ways

and Tommy, he was called Tommy Trattles in David Copperfield.

In my version he's called Tommy Waddles.

Everybody has a nickname here.

So Tommy, his demon's best friend in his first foster home, which is a horrible foster

home.

It's this farmer who uses foster kids as enslaved labor on his farm basically.

He uses the money that he gets for feeding, being a foster home to pay off his farm taxes

and he uses the kids for free labor and he's really pretty horrible and he doesn't feed

them enough and that's really sad.

But these boys bond and Tommy's a sweet, sad character who makes the best of everything

but he knows he's never, ever going to have a real foster home.

Nobody wants, he says nobody wants the fat kids.

He's really big for his age, but he's a reader.

Demon is fascinated by the fact that Tommy brings home arm loads of books from his school

library and he stashes them under the bed and at night he tells Demon the plots of

all the magic tree houses he's ever read and all the, you know, he reads the boxcar kids.

So even though Demon is not himself a reader, he's introduced to, I guess, Tommy is the

first intellectual he's ever known and as they grow up in their own hard scrabble ways,

they reconnect, that's a Dickensian thing, the great Dickensian coincidences.

They run into each other a few years later in the pharmacy where Demon's picking up

his illicit drugs.

He runs into Tommy who's now working at a newspaper, he's a janitor but he's found

a job and he works his way actually into the newspaper business and he puts his education

into good use, being a copywriter for ads in the local little newspaper, which was,

you know, it's sad because those local little newspapers hardly exist anymore, but I worked

on one when I was in high school.

So I know how that all works, how you lay stuff out on the table with wax.

You cut them out and you lay the columns out and that was really fun to write about.

The whole place smells like hot wax and they form a partnership actually, Demon and Tommy,

it becomes Demon's extraordinary way out of his situation or a part of it.

One thing he used Tommy to do really effectively I thought is talk about how even what might

seem like sympathetic coverage of Appalachia reads within, so he gets very upset for instance

over a headline that just says, rural dropout rates on the rise, which seems like a pretty

neutral headline.

So what does he hate about it?

What he hates about it is that's all anybody ever hears about us is the bad stuff.

And yeah, this is Tommy's education like me and like all of the kids in this book have

no idea how we are seen by outsiders, we're just people.

These kids have never thought about being Appalachian.

And now that Tommy's working in a newspaper and he's seeing the headlines that come in

over the AP thing and he's working for this little town newspaper in Pennington Gap, they're

looking desperately for some syndicated stories that have relevance to the local area.

He's attending to this and he's seeing what's coming through.

He's dismayed that the only thing that outsiders ever seem interested in noticing is how poor

the place is, the dropout rates, the poverty rates, the unemployment rates.

What about the good stuff?

They're living all the good stuff too, you know, all the memos that look after every kid

in the neighborhood, the fact that you know who your neighbors are all the time and they're

always going to be there for you unless they're not, but that's important too.

Demon tries to explain this in Demon Psychology.

This is what he knows.

Look, everybody needs somebody to punch when they get mad because this is, you know, all

he's ever known.

So the stepdad punches his wife or his, you know, or the girlfriend.

The girlfriend punches the kid.

The kid has to go kick the dog.

Everybody needs somebody to look down on.

When Demon explains all this to Tommy about how everybody has to look down on somebody

and then has these conversations with Tommy about how much condescension, how they're

seen by the rest of the world, he says, well, we're the dog of America.

Now that Tommy's become aware of this, he sees it everywhere.

He sees the TV has a festival of stupid hillbilly movies, you know, deliverance, whatever, hillbilly

chainsaw massacre or whatever it is.

Now that his eyes are open, he's seeing it everywhere and he gets really upset about

it because he's got this email girlfriend from Eastern Pennsylvania and he's afraid

to meet her because he says she's going to think I'm a stupid hillbilly and her whole

family is going to think we're stupid hillbillies.

So this becomes Tommy's quest to figure out how this happened and why.

And so that becomes, you know, this is a way for the reader to follow Tommy on this quest

to understand how this happened.

And so Tommy, as the nearest thing we have in this book to an intellectual, he reads

some social history and he figures it out.

And so it allows the reader of this novel, and this is just a tiny part of the book,

but there is a moment where the reader gets to learn about land-based economies and money-based

economies and demon in his short stints of living in cities, visiting or living when

he's in rehab, he lives in Knoxville and he lives this and he gives you the story in

Demon's Peak.

You know, so he says, there's country poor and there's city poor.

When you're in the country, at least you have food.

He says in the city, where are people even going to raise their tomatoes in Knoxville?

He feels the desperation of people who have no access to the fundamental needs like apples

and tomatoes.

He has a job in the produce section of Walmart.

When the artificial rain comes on every 15 minutes to keep the produce wet, he says this

is the closest thing people are ever going to see to rain on a real vegetable and he

feels sad for them.

As you mentioned, Demon and Tommy meet in foster care and foster care makes up a lot

of the first half-ish of the book.

And it's really, I mean, as somebody with young kids and it's hard to read.

Something you're focusing on there is the way in which the opioid epidemic hasn't just

harmed those who have been killed or have ended up in rehab or struggling with addiction.

But how many children have simply lost parents?

Can you talk a bit about what you found when you were researching that or seeing it around

you and how you began to think about the scale of what it has done to children now?

Yeah.

That was my point of entry into this novel.

That's what I really wanted to write about the orphans.

It's a whole generation of kids.

The counties around where I live have enormous, I can't give you exact statistics, I've heard

anything from 15 to 35% of kids in some of these counties who are being raised by someone

other than their parents because their parents are addicted or incarcerated or dead.

We have a generation of orphans coming up through our schools.

Some of them have gone into foster care, but the system is so incredibly overloaded, which

you learn about in the novel.

There's so many more kids in need than there are social networks to catch them.

But the caseworkers are so overloaded and so pathetically underpaid, they make less than

school teachers.

They don't make enough really to live.

These caseworkers, the turnover is really rapid, the files get lost, these kids are

just lost.

I didn't even know until I did more research into this, that's where we are.

This is something that I think the world needs to know about.

This country, voters need to know about.

We need to know how this epidemic has left a generation of innocence that nobody's taking

decent care of.

The story of the big players in the opioid epidemic, Purdue Pharma, the attorneys and

the DEA and all of that big story has broken and it's been told beautifully by a handful

of journalists have done a great job of cracking and telling us that story.

Beth Macy among them with her fantastic book, Dope Sick.

So that was my point of entry in this novel.

The story I wanted to tell was not about the big guys, but about the little people.

These kids have been left behind.

Our burdened public school systems are being asked to raise these kids.

Our public schools are the point of delivery for pretty much all the social services that

these kids may get.

They get most of their food from free school lunches, a lot of them are not getting fed

at home.

They get their mental health care through the school system.

It's not the public school that delivers it, but county mental health agencies deliver

the care the counseling they do is in the schools because they can't expect families

to take kids to counseling.

So this is a burden on our public school system and on our libraries and on everything that

we have here that nobody outside of this region is even aware of.

So we need resources not just for treating addiction, which is an immense need, but that's

only one part of the damage.

A bigger part of the damage is what we do for these kids.

And so that's the story I wanted to tell.

I wanted to tell the story of the orphans.

And that's why Dickens came calling and told me orphan stories can work.

Let me give you an idea.

You had a passage here that I found extraordinarily moving.

I mean, this is how demon becomes an orphan, but also how he has to think about and over

his life has to process his mother and her relationship to him and what her death meant

in terms of her care for him.

So do you mind reading the passage on page 109, beginning with I had roads to travel?

Sure.

And this is at his mother's funeral, his mother overdosed on his birthday.

And he couldn't help but feel pretty furious at his mom for this abandonment.

And now he's looking back because this narration, this first person narration is told from the,

is a retrospective from later in his life, the advanced age of maybe 25 or something.

So he says here, he kind of steps slightly outside of the funeral scene and says, I

had roads to travel before I would know it's not that simple.

The dope versus the person you love that a craving can ratchet itself up and up inside

a body and mind at the same time that body strength for tolerating its favorite drug

goes down and down, that the longer you've gone hurting between fixes, the higher the

odds that you'll reach too hard for the stars next time.

That big first rush of relief could be your last.

In the long run, that's how I've come to picture mom at the end, reaching as hard as her little

body would stretch, trying to touch the blue sky, reaching for some peace and getting it.

If the grown up version of me could have one chance at walking backward into this story.

Part of me wishes I could sit down on the back pew with that pissed off kid in his overly

tight church clothes and dark hawk attitude and tell him, you think you're giant, but

you are such a small speck in the screwed up world.

This is not about you.

You have a interesting way of putting his mother in context in this part of the book.

When you talk about her as the unknown soldier, you talk about the way in which nobody cries

over someone's bad personal decisions or not nobody, but society does not cry over one

person's weakness.

But then when they're a mountain of bodies, then a story is called for, then a narrative

takes hold, then it's not their fault.

It becomes a societal force pressing down on them, but the people who fall at the beginning,

they don't get that grace not publicly and even at that time, not in their own families

because it's in their own families where these narratives have to take hold.

I'd like to just hear you talk a bit more about that, about how you thought about the

respect we do or don't give to people who end up addicted to or dying from medications

that they were given and told by people with medical degrees or people who were there,

the nurse in the doctor's clinic, that this was safe and somebody had checked this out

for them.

Exactly.

That's the crime that this drug was so addicting and the doctors who prescribed it were told

otherwise.

This region was singled out as particularly vulnerable partly because healthcare delivery

in rural places is stretched so thin that there's very little opportunity for follow-up.

They often see people on the one sick day that that person has in a year from work,

so it's of necessity.

It's prescription-pad doctoring and Purdue saw this as an opportunity because there's

so many people here with work injuries, old mining injuries, disability, and so they just

thought, aha, we can make a killing here, and they literally did.

To research this book, I spent time, I sat down with a lot of people who had been through

this whole journey to learn about the inside of addiction and just the logistics, like

here's the pill, how does it get into your veins, a lot of the specifics that I fortunately

don't know from firsthand experience.

I listened to a lot of stories and I shed a lot of tears with people who told me their

stories of how they became addicted and most of them started with a legal prescription

from a doctor they trusted, a doctor who was going on the best advice, who said, you have

to stay ahead of the pain, you set your clock, you take this on whatever timetable you're

supposed to take it, don't miss a pill, take this painkiller, and by the end of their 30-day

script, they were addicted, and so this was done to them.

Nobody wants to be addicted, but what I found and what I thought so much about in the course

of writing this novel, I realized that was another of the prejudices I knew I was going

to be up against because people have such firm ideas of addiction as a moral failing,

as a failure of willpower, a failure of virtue, and that's been done to us.

That's a brainwashing that the so-called war on drugs, which I think hit its 50th anniversary

this year, has been a whole lot of brainwashing on how the answer to this problem is just

say no.

The answer to this problem is incarceration.

We have been trained, culturally trained, to think of addiction in this way as a personal

failing that needs to be punished.

Incarceration does not cure addiction any more than it cures cancer.

Depression is a disease.

It's a disease of the brain, of dopamine and neurons in the brain that have been damaged

and rewired so that if you don't keep getting this drug, you get so sick that you feel like

you're going to die, you wish you're going to die, and you might die.

It's impossible to describe how terrible this disease is, not just the dope sickness of it,

but the fact that your entire life has to become just a really difficult, hard-working

process of every morning, getting your means, getting your fix, getting through another

day that nobody wants to live like that.

One of my hopes with this novel is that by portraying this process of addiction from

the inside, people might have more compassion for it as a disease and think of people with

addiction as diseased.

Even in our own families, we see this.

Nobody would tell their daughter with cancer, okay, I'm going to kick you out, I'm going

to wait till you hit bottom, and then you can have chemo.

That's how we treat the disease of addiction.

It's incredibly inhumane.

Effective treatment will only happen after we switch over from putting this in the hands

of the police and the prisons to medical workers who can meet addicted people where they live

and offer them the first steps of clean needles and fentanyl test strips so that they won't

die in the weeks that it will take for them logistically, physically, emotionally to get

to the beginnings of treatment.

There's still a lot of people who have a sort of, I guess, a moral objection to harm reduction

centers that just give people the basics of clean needles and fentanyl test strips

to keep them alive.

It's as if people feel that addicted people deserve to die.

Imagine if we looked at any other disease that way.

One thing that I think you described really well here is that the desire, the market,

the demand for OxyContin and for other kind of similar drugs in the period was also an

outcome of the kind of work we have people do in the kind of lives we have them live.

You describe OxyContin then as, quote, God's gift for the laid-off deep hole man with his

back and neck bones grinding like bags of gravel, for the bent-over lady pulling double

shifts at Dollar General, with her shot knees and ADHD grandkids to raise by herself.

There is something, I mean, all addictions are kind of horror, but there's a literalness

that is often a little bit obscured with other drugs.

I mean, this was a drug people got on to treat real pain and pain they often had to go through

because they were trying to make a living and being made to do repetitive tasks that

the human body is not built for.

There is just both a horror to that, but so much of this book, both in the foreground

of times, but in the background a lot of times, is about the economics of the area and one

of the economics of the area is the kind of work people have to do.

Exactly.

It was so predatory.

It was so intentional, and we know this now, that Purdue Pharma looked at metrics.

They looked all over the country to see where, you know, and identified, as I understand

at three regions, it was a combination of mining and a lot of physically taxing labor

that left a lot of people with disability and pain.

They're using people's pain for profit.

So that was part one, was to find these areas where a lot of people have live in pain and

have work injuries that they've carried for, in many cases, decades.

And the other thing is, as I mentioned before, this very stretched, thin healthcare delivery

system.

I think that one of many things that people in cities don't understand is how hard it

is for us to get to see doctors in the country.

The county where I live for many years did not have, it's a big county, too.

We did not have one physician here who could deliver a baby, not one.

We had to go to Tennessee.

One of the characters in this novel, Dory, ends up having to quit school when her father

is sick, her mother is dead, and her father is gravely ill, and she has to drive to get

him to heart-lung specialists and the different doctors he has to see, you know, almost every

week.

I have to go to another state.

That's the case.

I have driven with my kids to see specialists.

Many times I've driven to doctors who lived four or five hours away in the nearest city.

This is something that's just, that we live with here.

There are not enough physicians to meet our needs.

And so you have to wait a long time to get into one, and that doctor doesn't have the

chance to follow you up.

He's got one chance to help your, in this case, terrible pain, and he's got this drug.

I mean, they knew this was going to work.

They knew that they would be able to pump into these counties, in many cases, more than

one or two pills for every man, woman, and child in the county.

I mean, the flow of these drugs into these counties in the very short time, the relatively

few years that it was allowed, sort of before the whistle blew, is phenomenal.

And once that addiction has begun, it doesn't go away after the drug is reformulated.

The next step is heroin.

Something the book really emphasizes is both the protections, and I would also say the

predations of community.

Something that is there in Lee County, in the world of the book, I think also in many

ways in real life, is unknowingness.

Over and over again, a demon runs into people from his past, or finds that there is a connection

to somebody from his past.

And it's like, well, that's Lee County for you, everybody's connected to everybody.

And there's both these moments of incredible grace in that, in the story you tell about

him.

And then also, I feel like this interesting dark side of it, where he's preyed upon by

people in this community over and over again, or allowed to fall through the cracks over

and over again, that the community is not able to be that protective, and at times is

even the source of the danger.

So I'm curious how you thought about that, because it's clearly something that you love

about the place.

I mean, it comes through, but also something that you didn't allow that to be an easy answer.

And many of the worst things done to him are done to him, not by a faraway economic force,

but somebody living right down the street.

I think that's so much of the damage that happens, is because of the way that community

where he lives has become damaged and unraveled by the drug epidemic.

Just to back up and talk more generally about community, something sort of a mantra for

me and my teenage years growing up in a real little town, was the great thing about community

is everybody knows your business.

And the thing that sucks about community is everybody knows your business.

So if you're a teenager trying to do something that your parents don't know about, it's not

going to happen.

They're going to know.

You're going to have a flat tire and the guy that pulls up to help you is going to tell

your dad within minutes.

If you make an enemy, you're going to run into him again.

It's a funny thing.

And that's really Appalachian.

We are people made of community for better and for worse, but mostly I'm going to say

for better.

You are your people.

And when you meet somebody new for the first time and you sit down with them, the first

conversation is always the same.

I would title that conversation.

Who are your people?

You sit down and you talk about like who are you and what do you do?

And then you just keep talking until you find out that like your papa is related to their

second cousin or they worked together at one time or you find that point of connection

and then you relax and then you have whatever other conversation you're going to have.

But that's just how it is.

We don't even think about it.

We are just all aware of how we're related to each other.

And for the most part, that's a rare and beautiful thing.

I think especially in the United States of America, which has become since World War

II, so mobile that it's very common for people to live in communities where they're not related

to anybody.

We know everybody.

We live among our people and families function when a family member gets taken out.

There's a larger family to absorb up to a point.

It really works well.

It's sort of our own another level of our self-sufficiency.

You know, when somebody dies, everybody brings food.

You know your neighbors.

You look everybody in the eye.

When you drive down the road, there's this way of waving that people put one finger up

from the steering wheel.

It's like everybody waves at everybody.

And this comes through in the novel when Demon goes to the city and he feels like an alien.

He feels invisible because nobody looks him in the eye.

Nobody waves to him.

Nobody looks at anybody.

And his friend there, who's a city guy, says, well, they're saving their juice.

You got to save your juice.

You can't just give it away to everybody because you have to save it for your own people.

And if you gave it away to everybody, you'd be done with your juice by nine o'clock in

the morning.

Demon haunders this and he realizes we in Appalachia are the juice economy.

I mean, we give ourselves to everybody.

We, you know, ladies get together on front porches and they make quilts to give to the

girls in high school that are pregnant.

That's a real thing.

You know, ladies get together and make sack dinners to give to the kids at school that

are going to go home for the weekend and not have any dinner.

It is how I think we have adapted to these centuries of exploitation from the outside,

just taking care of ourselves.

And that's Mrs. Paget in the novel who looks after demon and knows more than he realizes

about his situation, but it can only get you so far when you have something like, you know,

on the level of this addiction crisis, cutting through whole generations of families, taking

out so many people and also putting so many people in a position that they have to steal

to live.

It's the most tragic part of the whole story, I think, is what it has done to communities.

You talked about, and you mentioned earlier, feeling like a bit of an ambassador between

worlds here and this book in particular being a way of explaining where you come from and

where you live to people who are in a very different world, who are picking up the latest

Pulitzer Prize winner in fiction at the bookstore.

If you were doing the ambassadordom in the other way, in the other direction, trying

to communicate what's beautiful about cities, about some of these other parts of America

to the people you live with or to the people you're describing in this book, what would

you emphasize in the way that you emphasize community going in the current direction?

I would talk about the value of the richness and the privilege of living among many people

who are very, very different from you, who aren't related to you, who come from a different

country.

I mean, I just think about for years and years until she died.

When I ever came to New York City, I stayed with my agent, Francis Golden, in her apartment

on East 11th Street, and I just think about that part of New York City, the Lower East

Side, and how I would just walk down the street and hear people speaking different languages

and pass the Italian place and the Polish place.

All of the world is there, and how much you can absorb from people who are not like you,

who are white and not white, people of color, people of so many colors, people of so many

orientations, people who are gay and straight and trans, and acceptance and comfort with

difference comes with proximity, and that's something that's hard for us here because

just as a product of history, of the settlement of this region and the fact that there was

really no good reason after it was settled mainly by the Scots-Irish, there was no good

reason there were no employment opportunities or other reasons for people from outside,

from other countries, people who are not white, to come here.

So here we are, there's a whole lot more diversity in Appalachia than outsiders may think.

We aren't a dull monoculture, but it's also possible to go to school, and it's usual,

to go to school with people who are mostly like you, mostly your race and your class

and your cast.

And so one good thing about what kids get and well, and adults get from television is

exposure to people who are different, but that's not the same as having a friend who's

different from you, and so that's something that I wish we had more of here.

I think it's a lovely place to end, so always our final question on the show, what are three

books that have influenced you that you would recommend to the audience?

I would choose two books that are Appalachian about my place.

One of them is by Arwen Donahue.

The full title is Landings, A Crooked Creek Farm Year.

And it's, I love this book, it's a graphic memoir.

It's not like most books you're going to see.

She's an artist, so this book is a memoir of her year on her farm, which is in the county

where I grew up.

And every page is on the left hand side, a pen and ink watercolor drawing of a scene

of a day of a life in her farm, and it's paired with really lovely prose that just describes

their year on their small farm growing vegetables for a farmer's market.

And I said earlier that it's really rare to see descriptions of farming that are not

either condescending or romanticized.

This is neither.

It's just a real look at what life is like for a family that's very attached to a piece

of land and making their living from it.

I recommend Beth Macy's follow-up to Dope Sick, which is called Raising Lazarus.

It's a great piece of journalism on where we are now with this epidemic and what can

be done, what's being done and what we need to do more of.

And then the third is a novel I just read that knocked my socks off, and it's nothing

to do with where I live.

It's actually set entirely in the ocean.

It's called Pod by Leline Paul.

And it is set entirely in the ocean.

It's not science fiction.

It's realistic.

It's set in the here and now, and none of the characters are human.

I'll just tell you that.

And it's fascinating.

Barbara Kingsolver, thank you very much.

You're welcome.

Thanks for your interest.

This episode of the Ezra Clangio is produced by Annie Galvin.

Fact-checking by Michelle Harris, Kate Sinclair, and Mary Marge Locker.

Mixing by Sonya Herrero.

Our senior editor is Roger Karma.

The show's production team also includes Emma Fogau, Jeff Geld, Roland Hu, and Kristin

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Original music is by Isaac Jones, Audience Strategy by Christina Samilowski, and Shannon

Busta.

The executive producer of New York Times' opinion audio is Annie Rose Strasser.

Machine-generated transcript that may contain inaccuracies.