Hill Women

by Cassie Chambers

  I had gotten used to saying goodbye to places. My life since I left for UWC had been transient: I was always planning my next step to somewhere new. A decade of constant transition had left me tired. I was physically tired from moving, and I was emotionally tired from always saying goodbye. I was ready to go somewhere to stay.

  But, as I hopped into my car to begin the fifteen-hour drive to Kentucky, I was also aware of what I was giving up in exchange for this stability—the way I was intentionally turning my back on many of the glitzy possibilities I had once thought I wanted. I intended to put down deep roots in Kentucky, roots so strong and winding that it would make it near impossible for me ever to leave again. Up until then, my adult life had been characterized by adventure, uncertainty, a lack of constraint. There was both good and bad in that. But now I was trading adventure for connection; uncertainty for reliability; a lack of constraint for meaningful relationships. I began to drive, knowing that the closer I got to Kentucky, the farther I would be from the person I was in Boston.

  It felt surreal, going back home. In some ways I wasn’t sure that Kentucky was my home anymore. And several of my friends thought I was crazy for going back. “Cassie, you love to travel,” they reminded me. “You’re going to be so bored, stuck there in middle America.”

  I reminded them that Kentucky did, as a matter of fact, have airports. “Some even with direct flights,” I teased. “Don’t worry, I’ll come visit you in your fancy New York apartment,” I promised. I hoped it was a promise I could keep.

  Some of my friends had also come from rural communities. We had talked at length about the problem of “brain drain”—of promising young people leaving their hometowns—and justified our own role in it. Most of them now believed that they could be happier, maybe even do more good, away from their home communities. “National-level policy is made in D.C.,” more than one person reminded me.

  I was nervous during that drive down the coast and across the mountains of West Virginia. I sang along to “Take Me Home, Country Roads” at the top of my lungs as my overloaded car huffed and puffed through the Appalachian hills. I wasn’t sure what my life was going to be like in Kentucky, but I was mostly sure I was looking forward to finding out.

  * * *

  —

  There was one very important tangible difference between Boston and Kentucky: I could get a table at a coffee shop. I love working at coffee shops; I can concentrate better when there’s a background of noise and movement. In Boston, it was next to impossible to secure a spot. I often got to the Starbucks near campus ten minutes before its 5:30 A.M. opening time just to make sure I had a place to study with an outlet nearby. But here in Covington, the city I had moved to, tables were abundant. The same was true with street parking. And reasonably priced apartments. Everything seemed just a touch easier.

  I spent that first year back clerking for a federal judge in the Eastern District of Kentucky, the district that covers the whole eastern part of the state. Clerking is to law a bit like residency is to medicine: It’s a chance for recent graduates to learn a lot of information in a compressed time period by working under leaders in the field. Clerks spend a year or two working with one judge, gaining a deep understanding of how the law plays out in real cases.

  Many judges are based in a single courthouse. Particularly in urban centers, there are more than enough cases in the surrounding area to keep a judge busy. But in rural states where the population is more spread out, instead of the parties always coming to the judge, sometimes the judge goes to them.

  Judges in the Eastern District of Kentucky have to travel, so their clerks do too. Although we were based in Kentucky’s northernmost tip, every few weeks we would head east into the Appalachian Mountains. Mostly we traveled to preside over sentencings in criminal cases. Trials are increasingly rare; in criminal cases, well over 90 percent of defendants accept plea bargains.

  I remember the first time I watched the court sentence someone for a drug crime. The bailiffs brought a middle-aged white man into the courtroom. His face was lined, and I could tell he was younger than he looked. The orange jumpsuit highlighted the sallow tones of his skin. His eyes were heavy with acceptance. He had been selling heroin to support his own habit. He had carried a firearm during one of his drug deals, and that act—as well as the amount of drugs he was distributing—had triggered a mandatory minimum sentence. He was going to jail for fifteen years. In the federal system, unlike in the state system, there is no parole. He would serve the majority of that time.

  What struck me was how calm he looked, how resigned. He didn’t fight, or kick, or scream as the guards led him away. He didn’t even seem angry. In that moment, our judicial system seemed both very strong and very frail, as if the authority of the judiciary were based in large part upon people believing that it has authority.

  I would see the same story play out time and time again during my clerkship year. The court had sentencings at least once a month, sometimes more, and sentenced two to ten people each time. A majority of these defendants were going to jail because they’d sold drugs, usually to support their own addiction. Many were also facing mandatory minimum sentences. Watching people file through the courtroom day after day, I came to know the face of Eastern Kentucky’s drug epidemic.

  * * *

  —

  I met Susie one Wednesday afternoon at a Starbucks near her home in Lexington, Kentucky. I was surprised that she wanted to meet there. It somehow seemed a little posh considering that we were getting together to talk about our Owsley County roots.

  Susie, Aunt Ruth’s step-granddaughter and Sonny’s granddaughter, is about ten years younger than me. She and her father lived next door to Ruth and Sonny for several years. Susie and I joke that we were the children Aunt Ruth took it upon herself to help raise. Even though Aunt Ruth has always loved children, she never had any of her own. Susie and I laugh over the fact that she calls each of us by the other’s name. I hadn’t seen Susie since she was a child, but she had recently moved to a city close to me, and I was excited to catch up with her.

  Susie grew up around drugs. She doesn’t remember a time her parents weren’t using them. Once, when she was seven or so, her mother left her in a stranger’s house all night while she went out to get high. Her father used to give Susie drugs to hide in her socks when they were in the car in case they got pulled over. When she was in elementary school, she found her father unconscious from a drug overdose and had to call an ambulance. That was the first of many overdoses over the years.

  When Susie was around eleven, her mother went to prison for several years on drug-related charges. Susie lived with her dad after that, and she says that he did his best to take care of her. But he was often high, and—even when he wasn’t—he didn’t know much about raising a preteen girl. Susie used to spend hours trying to figure out how to put her hair up into a ponytail. Although it seems simple, it’s a lot harder when nobody shows you how.

  Susie’s peers had parents addicted to drugs too. But, even though they all knew about their parents’ struggles, it wasn’t something they talked about. They brought it up only when they were fighting, when one child would scream at another, “Well, your daddy ain’t nothin’ but a drug addict!” Families felt shame about drug use despite knowing that they weren’t alone.

  Aunt Ruth did the best she could to shield Susie from her parents’ addiction. Once, when Susie was a child, Aunt Ruth noticed a bunch of disheveled, red-eyed men hanging around the house with Susie’s father. Aunt Ruth, convinced that they were there doing drugs, asked the men to leave. “We ain’t a-leavin’,” they told her. “What are you goin’ to do about it?”

  Aunt Ruth walked back to her house a few yards away and grabbed an old board with rusty nails sticking out of it. She marched into Susie’s yard and yelled, “I said git.” She held the board up so they could see. “Don’t make me kill you.”

&n
bsp; The men noticed the steely look in her eye and decided she just might follow through on her threat. “You’re plumb crazy!” one of the men hollered as they began to disperse from the yard.

  “That’s right, I am,” she yelled back, still standing firmly. “Git on to my house, Susie.”

  When she was in high school, Susie decided she was going to college. She had seen how rough life was for her father and mother, and she didn’t want to stay in Owsley County and risk turning out like her parents. Plus, Aunt Ruth had been pestering her to get an education for as long as she could remember. Susie used to go over to Aunt Ruth’s house after school, and Aunt Ruth would make her do her homework. No one else ever made her do that.

  Even in the 2010s, going to college wasn’t the norm in Owsley County. Susie estimates that less than a third of her high school class went on to higher education. She started taking dual college classes her senior year, and she eventually earned a scholarship to study nursing.

  Susie’s father promised her he would attend her high school graduation. He had wanted to go to college himself, but he’d gotten caught up in drugs as a teenager and hadn’t finished high school. He beamed with pride each time he told someone that his daughter was graduating from high school and going to college.

  The day of Susie’s graduation, she didn’t see her father in the audience. She spent a good portion of the ceremony hoping he would show up, but he never did. Later, she learned that he had overdosed that morning, and an ambulance had transported him to the University of Kentucky hospital—the hospital associated with the college that she would attend in the fall.

  A few years later, her father gave her a plaque that said A DAUGHTER IS A BEST FRIEND FOR LIFE. Susie checked the sticker on the back and realized her father had purchased the plaque while he was in the hospital that time. He had wanted to give his daughter something special to commemorate her graduation, but he’d been ashamed, lying there in his hospital bed.

  That fall, Susie started school in Lexington, which is Kentucky’s second-largest city. She couldn’t believe how many people and cars there were. During her first few months of driving in Lexington, she would pull over to the side of the road and cry. She had never driven in traffic before, and it was all too overwhelming. She felt like she stood out among the other students; she was usually in jeans and T-shirts, while they wore fancier clothes. She wasn’t sure how, exactly, they were fancier. She just knew that they were. She ended up transferring to a smaller school in a smaller town that she felt she could navigate.

  But Susie was determined, and eventually she graduated with her degree in nursing. She moved back to Lexington and started a job at a hospital there. She got married and, when I met her at that Starbucks, she had her beautiful six-month-old baby boy with her. He had big blue eyes and smiled every time his mother talked to him.

  She reminded me of my mother, this young woman from Owsley County who had set off to a strange place. The exact reason she had left was different, but the driving force was the same. She wanted something better for herself than the life she had seen in the mountains. Now that she was a mother, she wanted to provide every opportunity for her child.

  Susie’s parents still struggle with drug addiction. Her mother was clean for a while, just after she got out of prison, but Susie suspects she has relapsed. Susie’s father now lives just up the holler from Ruth and Sonny, in a brand-new house that Sonny built for him. Sonny is getting older, and construction work is harder for him than it used to be. But Susie’s father had just gotten out of yet another stint in rehab, and Sonny wanted him to have the best opportunity he could to start a new life.

  The last time I stayed with Ruth and Sonny, we sat on the porch and watched the sun sink over the mountains. As we sat there, we could see cars pulling in and out of Susie’s father’s driveway. Each time, a passenger would get out and look around furtively as he went inside, then return to his car a few minutes later. We tried to ignore what I think we all suspected was happening inside.

  Susie lives with the constant fear of getting a call that one of her parents has overdosed and died. She has to take medication for her anxiety, which she attributes to the ever-present worries she had when she was growing up. She learned at an early age that there is a lot to be nervous about in the world.

  Despite all of this, Susie doesn’t complain about her parents. She is particularly close to her father, who she describes as being “all heart.” He once took the shoes off of his own feet to give to a woman who didn’t have any. She maintains that he did the best he could to care for her, even when he wasn’t able to do it very well. She is sure to tell anyone who asks that her father and the others she knows with addiction issues are fundamentally good people.

  Susie wants to move back to Owsley County someday. She thinks there is a lot of value in going to a small school like she did, and she says there’s something special about living in a community where people know one another. I agree with her. One of Susie’s friends recently ran out of gas in Owsley County, and three separate people stopped to see if the friend was okay. She had gas and was back on the road within minutes. “That would never happen in Lexington,” Susie told me. “Even if you ran out of gas right in the middle of town you’d be lucky to get one person to stop.”

  She likes how the people in the community take care of one another. She was especially excited to tell me about a program that just started to provide every child in Owsley County with lunch during the summer.

  But right now, there are no jobs for Susie in Owsley County. There isn’t a hospital in town, and the one in Jackson—currently the closest, about an hour away—may close soon. Her friends who stayed in Owsley County struggle to find jobs. Those with a college degree do things like teach. Those without a college degree work at the Dollar Store or one of the two restaurants in town. A lot of those who haven’t been able to find jobs have fallen into a life of drug use.

  That day in Starbucks, I asked Susie what sorts of things she and her friends had done when she was a child. I wanted to see if her experience was the same as mine. It wasn’t. Whereas I had the farm to play on, most of the farms were gone by the time Susie was growing up. A skating rink opened up when she was in third grade, but it closed down a year later. Susie thinks the lack of opportunities in Owsley County leads to at least some of the drug use. “What else are you supposed to do other than look at each other?” she asked me. “There are no jobs for adults and nothin’ fun for the kids.” And yet something makes her want to go back.

  * * *

  —

  I had seen the beginnings of the opioid crisis when I was a child. When my cousin Melissa wasn’t allowed to spend the night with her friends because her family was afraid of the drug use in the area. When the boys in my middle school class would raid their grandparents’ medicine cabinets and trade pain pills. When young people started dying, and their obituaries in the paper did not list a cause of death.

  When I was a high school student in Berea, we heard most often about meth, about homemade labs nearby being shut down. Sometimes they would explode and people would die. A recent study showed that dry counties, like Owsley, had the most meth labs per capita. It reasoned that an existing black market for alcohol made it easier to develop a black market to sell drugs.

  But, over the next several years, I began to hear more about the pill epidemic. A wave of opioids entered the mountains in the 1980s and 1990s, as doctors began to focus on pain management as an important part of patient care. This trend wasn’t limited just to Appalachia—rates of pain pill use in America went up almost tenfold from 1997 to 2002.

  The pill epidemic hit the eastern part of Kentucky so hard in part because there was so much physical pain there. In Owsley County, more than 22 percent of adults under the age of sixty-five have a physical or mental disability. In Clay County, which shares a border with Owsley County, four out of every ten residen
ts rate their health as being poor or fair, a rate that is twice that of the state as a whole. Plain and simple, Eastern Kentucky is unhealthy. It has higher rates of all prescriptions—not just pain pill prescriptions—than the national average. Many people began using pain pills to treat legitimate physical pain; from there they became addicted.

  For others, the social environment likely played a role. A famous study in the 1970s, called the Rat Park study, examined the effect of social environment on rats’ opiate usage. The experiment involved two sets of rats. One set was kept in a plain, boring cage, socially isolated from one another. A second set lived in Rat Park, an exciting and stimulating environment with plenty of toys and peer interaction. Both groups were given unrestricted access to morphine water.

  The results showed that rats in the plain, boring environment drank more opiate-laced water than those in Rat Park. Even more interesting, when the rats in the boring environment were moved to Rat Park, they drank less of the morphine water. Although some have criticized the study for overemphasizing the importance of environment in addiction, the authors argued that their results proved that a stimulating, enriching environment impacts one’s level of drug use.

  People are social animals, creative creatures. If we aren’t getting the necessary stimulation from our environment, we may try to get it from other sources, like drugs. And some parts of Eastern Kentucky don’t always provide enough stimulation.

  The steady supply of opioids into Eastern Kentucky helps fuel the crisis. In 2018, the attorney general of Kentucky filed a lawsuit against McKesson, a pharmaceutical distributor, alleging that that company alone sent 56.3 million doses of opioids into Floyd County—in Eastern Kentucky—between 2010 and 2016. That translates to more than 1,400 doses for every man, woman, and child in the county. The lawsuit claims that the company either knew or should have known that residents would use some of these drugs illegally.