The “Sickest Town In America” Short on Facts, Large on Stereotypes

“What we see depends mainly on what we look for.” Sir John Lubbock

On January 22, 2015, The Atlantic published a feature by Olga Khazan – Life in the Sickest Town in America. Ms. Khazan, who lives in Washington, D.C., subtitles her piece with this sentence: “I drove from one of the healthiest counties in the country to the least healthy, both in the same state.” The town she bills as the sickest town in the country is my hometown – Grundy, Virginia.

When I am asked the question: Where are you from? I give the same answer every time. I am from Grundy, Virginia. Although I now live out-of-state, when I think of my hometown I think of the most beautiful, kind, and loyal place. And when I return to Grundy, as I do frequently, I find exactly that. When we go to Grundy, Ms. Khazan and I, we look for different things, and we both find what we are looking for. I find a place to be proud of and she finds a backward, sad, desperate community that time forgot.

Ms. Khazan attempts to illuminate some important issues that many towns in Appalachia struggle with – health and well-being, health care access, the disability system, and the decline of the coal mining industry. Sadly, though, any positive intent and material she may have had or presented were overwhelmed by her exaggerated, inaccurate, and stereotypical portrayal of Grundy as a poor, sick, and backward Appalachian town.

Ms. Khazan, a staff writer covering health for The Atlantic, isn’t the first reporter who has come to our little town from the big city with her own vision of what is in Appalachia. Perhaps colored by visions from old black and white photographs, it appears these reporters come to town to search for old women in aprons standing by outhouses, long lines of coal miners leaving the mine with picks and shovels over their shoulders, or dirt roads populated by nothing but camp houses and trailers. Some of those things still exist in Appalachia, but those visions and pictures are not the predominant way of life in the region or in Grundy. However, as Ms. Khazan has demonstrated, if you look for it, you will find it. This approach to journalism is a disappointment and a disservice to the people of Grundy and the readers of The Atlantic.

Ms. Khazan, in addition to various statistics on unemployment, receipt of disability checks, and some health statistics, supports her claim that Grundy is the sickest town in America with a visit to the Buchanan County Remote Area Medical (RAM) event. RAM is an annual event where hundreds of people are provided free health care, including general medicine, dental, women’s health, and vision services. The event in Grundy draws people from beyond the local area. You can find people from Eastern Kentucky, Southern West Virginia and other counties in Southwest Virginia at the event. The article does not mention that the patients at the RAM event come from a large area; rather it would have you believe that this event is only for local citizens and the immediate surrounding area. This is a misstatement. But let’s give the benefit of the doubt here and assume that Ms. Khazan simply failed to ask the right questions to elicit this information or to perform a basic Google search on RAM.

But that doesn’t explain the bigger misstatements in her article. Ms. Khazan takes the typical Appalachian stereotype one step further. She states “But if this place has the scenery of the Belgian Ardennes, it has the health statistics of Bangladesh.” With little evidence, she pronounces Grundy to be the equivalent of a third world country. She offers no analysis, only a link to the Buchanan County health statistics. It is a sensational line, but it is a shallow and unfair comparison. Health care access is a universal problem, it is in small towns and big cities and everywhere in between.

The RAM event in Buchanan County is held at a large, modern elementary/middle school that serves around 1000 students from kindergarten to eighth grade. The article describes the building as one of the “few buildings, really” in Grundy. In truth, there are new and old buildings within the town limits, including the three-building Appalachian School of Law campus, a brand new Baptist church, a Masonic temple, two new two-story retail and commercial buildings, a two-story parking garage with a Wal-Mart atop it, a movie theatre, a bank building, a historic courthouse, and numerous other buildings.

In order to reach Riverview Elementary Ms. Khazan had to drive past all these buildings.[1] Additionally, outside the town limits, but within the county and on her route into Grundy, she had to drive past the two-building Appalachian College of Pharmacy campus, a 50,000+ SF Food City grocery store, various restaurants, retail stores, and churches. So, for Ms. Khazan’s article to state that the school is one of the few buildings in town is completely and totally inaccurate. However, it does support her vision of an Appalachia that is a desolate, sad, and empty place.

To Ms. Khazan’s credit, the article fairly addresses some of the economic and social issues in the area related to health and the decline of the coal industry. However, the article completely misses an opportunity to explore local efforts to improve this economic situation. For example, the article never mentions the local government efforts to revitalize the economy through higher education, which has produced both a fully accredited pharmacy school and law school, or other efforts, which are numerous. If Ms. Khazan had approached this article, and Grundy, with an open mind, she may have gotten a better story – one that showcased ideas that are innovative, progressive, and that showed the enterprising spirit of an unexpected area of the country. The truth is, Grundy is a place that is trying to improve, to change, to survive, in spite of the economic and social issues that Ms. Khazan mentions. But that truth doesn’t fit within the Appalachian stereotype of ignorance and helplessness that she was looking for.

Ms. Khazan is nothing if not committed to impressing her stereotypical beliefs upon The Atlantic readers, even if that proves a difficult task. Relying on Martin Wegbreit, the director of a legal aid society in Richmond, VA (350 miles away), she states, “there are only a few paved roads in the county.” When I contacted the Buchanan County Highway Engineer he reported that 93% (421 miles out of approximately 450 total miles) of the state maintained primary and secondary roads in the county are paved. Ms. Khazan’s route to Riverview Elementary/Middle School for RAM, and assuming she actually went to the law school and social services to conduct her interviews, would have taken her on Routes 83 and 460. Both roads are state maintained paved roads. I confirmed with the county engineer that there are no dirt roads that intersect with Route 460 or Route 83. It is hard to imagine that Ms. Khazan encountered a dirt road while in Grundy, and if she did it was one that she went looking for because they are very hard to find. Instead of relying upon local sources or her own experience she choose to report as fact the remarks of someone sitting behind a desk 350 miles away.

What’s not hard to find in Grundy? Grocery stores. Ms. Khazan relied again on Martin Wegbreit, when he told her that Grundy did not have a grocery store until recently. This is laughable. The chain of Food City grocery stores, which includes 96 locations through Kentucky, Virginia and Tennessee, is owned by a family from Grundy who opened their first store in Grundy in 1955. Grundy currently has three large grocery stores, including Wal-Mart. Ms. Khazan drove by all three of these grocery stores during her visit to Grundy. Yet, she reported totally inaccurate information.

I was not present at the interview with Martin Wegbreit so I am not sure what he said but if he indeed said what he is quoted as saying, I will simply state that Martin Wegbreit lives in Richmond, and is not a journalist purporting to report fact.

In this feature, Ms. Khazan picked few named sources, but instead relies upon generalizations like “the majority of the people I talked to were missing some of their teeth.” She picked her subjects at a free clinic that provides dental services. So, I imagine that was true. But she doesn’t explain that; she would rather imply that Grundy is full of people with no teeth. That is the image she wants to sell.

The bottom line is that the picture Ms. Khazan attempted to paint is not true. It is not true that most people do not have teeth. It is not true that most homes are trailers. It is not true that the only restaurants are Dairy Queen, Long John Silvers, and Pizza Hut. It is not true that everyone has an immediate family member injured in the mines. It is not true that all the women are obese. It is not true that the county started in farming; it was logging. It is not true that the county is devoid of highly educated professionals. It not true that all the people are sad, poor, and trapped. So much of what she said and implied is not true.

I have only mentioned a few of the gross inaccuracies reported by Ms. Khazan, but the unmentioned are no less offensive and untrue.

These misrepresentations are hurtful. It hurts her credibility; what little good she may have been trying to do is overcome by her need to prop up the stereotypes of Appalachia. But Ms. Khazan will move on, she will write more and better pieces, and her career will continue to advance. She will be fine. So, the real pain inflicted by this kind of journalism is inflicted, once again, on the good people of Appalachia, the good people from Grundy.

Yes, the area has problems; it struggles in some ways, like many cities and towns in the U.S. But it is a unique, beautiful, and good place filled with good people. It is a place driven by honor (read Malcolm Gladwell’s book Outliers, chapter six) and family. It is a place that for many is inescapable, not because they are trapped there, but because the love and connection to place and family is too strong to leave or stay gone. The pain is that we cannot make people look at Appalachia and see beyond the negative image and antiquated stereotypes. We cannot make people see what they refuse to look for to find what we know is there.

[1] Grundy is indeed a small town. Three state roads serve as the primary routes in and out of the county (Routes 460, 80 and 83). Routes 460 and 83 are the primary routes into the town of Grundy. The route Ms. Khazan could have taken to reach her Grundy destination is therefore limited and obvious.

I no longer live in Grundy, VA. However, I lived in Appalachia for 30 years and 25 of those years were in Grundy. While I left most recently in 2011 for a career opportunity in the Midwest I return at least 5 times a year to visit my immediate family. The mountains of Southwest Virginia are part of my identity. The love, loyalty, respect, and hard work that those mountains taught my parents and grandparents lives on in me. In the words of Hazel Dickens “can’t you feel those hills around you, can’t you feel that touch of home, don’t you wish you’d never gone, there are some things memories can’t bring home.” I miss Southwest Virginia everyday. There’s nowhere else like it.

Whitney Caudill

What I’ve Learned from the Sun

I have always loved a sunset, but since moving to the Midwest I have fallen in love with the movements of the sky. I have try to watch as many sunsets and sunrises as possible; in four years I have seen hundreds. I make a special effort to watch them on certain days ­– my birthday, the new year, or when I need a reminder of just what a little speck that I am in this universe or how I am part of a large, unknowable plan.

The first thing I did on the first day of this year was get in my car and drive to my spot, a church parking lot at the edge of my subdivision, to watch the sun come up. In the silence I watched the light glow above the horizon and tree line. Then the sun slowly inched across the sky. As I did I made a list of the things I want to do and do better this year (no resolutions, just observations and promises to myself).

New Years Sunrise

When my list was long enough I stopped and put my phone down. I thought about how long I’ve been walking or driving to this spot to observe the sun. What have I learned from it? Is there anything to be taken from watching the two most physically beautiful parts of the day? It did not take long to realize the lessons and reminders that I can take from observing the sun.

The earth, the divine, speaks lessons and reminders, if we will listen. As I sat in the car, window down and seat heater on, a list of these lessons and reminders came quickly to mind.

Always look behind you.

RainbowsThe sun rises in the east and it does amazing things. But, that is not where all the action is. Look west. There is often something just as beautiful behind me. During a sunrise it is a pale pink glow on a clear day, other times the reflection of the sun’s glow on clouds, and if I am lucky, it’s a rainbow inspired by the morning dew. At sunset it’s the ombre of blue to purple to black layered from west to east. In the morning and night I look to the north and south and see more of that pink glow, carbon trails drawing pictures in sky reflecting the light in different ways, or long flat clouds that seem to go on forever.

I spend so much time looking in one direction – what I want, need, or where I am going down the road. If I’m not careful my laser focus causes me to miss things just as lovely, and important, that are happening in and around me. It is never just about what is in front of me. Situations look different depending on the point of view; sometimes I have to change my perspective to get to where I’m going.

Be patient.

Stalking sunsets and sunrises takes effort. It also takes practice. I can’t just show up at the exact time the weather channel says that the sun will set. I’ll miss it. This is especially true of ocean sunsets, if I look away for a second or stop watching for a moment to mess with my camera I’ll miss it. I have to find my spot and get there early. This might mean getting up early or staying late. It makes me work for it.

Pacific

Don’t all things worth having, seeing, or keeping take a little (or a lot) of work? The sun might be free, but it isn’t easy.

Embrace silence.

I like to talk. Frankly, I need to talk (my poor mother used to pray for 5 minutes of silence when I was a child).  If I am not talking I am playing music or running the television in the background. The sun, though, does all its work silently. Most of the year it does its work when the world is quiet – no traffic, little work, and before or after most people have gone inside.

The sun in some ways demands silence. I have watched sunsets with people and 100% of the time everyone becomes quiet as we watch. No one says, be quiet or shhhh. Your spirit just knows to quiet itself – to embrace the peace of it, to stand in awe and reverence of the divine.

It is a lovely time – a new day or the end of one – to think, pray, reflect, or whatever I need to do. A time to be quiet and still. A time to listen to that still small voice.

Summer Sunset

I can’t always see what is next, but I trust it will be good.

Recently a friend died unexpectedly. I found out on a Friday. As it goes with these things, I spent much of the day trying to understand and thinking about my life and its fragility. Understanding did not come, nor did I expect it. That understanding will only come, as Dolly would sing, “farther along.” But the lack of understanding hung there reminding me that I am not in control and I don’t know what will happen tomorrow.

LorinThe next morning I woke up, threw on my slippers and a jacket over my night-clothes. I drove to my spot to watch the sunrise. It was late fall and the sun had shifted behind a cluster of trees. I would not be able to see the sun itself until it was up and clear of the woods, a quarter of the way up. I waited and watched the light start to glow through and then above the trees. I knew what was coming but I couldn’t see it yet. As I waited I was reminded that just because I can’t see what’s next doesn’t mean it isn’t going to be wonderful. It is so easy to feel like things are not moving fast enough or going where I want them to go. But no matter how I feel, I believe there is something good ahead, just beyond what I can see. I believe it because I’ve seen it before.

Sometimes a memory is all I get to take with me.

My sister is great fun. Once when I was a teenager and she was living at home we had a particularly fun weekend. The following week I told her that I’d like to do it again. She told me it was fun but “those times are like bubbles, they last for a little while and then they pop. You can’t repeat them.” She was right.

Sunset and sunrises are beautiful, sometimes so much so that I can’t capture them in a picture. Even when I try the picture is so disappointing that I just delete it. There is a level of pretty that just doesn’t translate (at least not with an iPhone camera).

There are some things that so are beautiful that I can’t capture with anything but my mind, my memories. I get frustrated with the limits of my equipment and ability to share what I have seen, but that reminds me that some things, people, and experiences are meant just for me, not to be shared. The things that I keep for myself are the most precious.

Pink

I try to find something beautiful in every day. On days when I can’t accept beauty in myself, in others, or in the events of the day, I can find it in the sky. Even on a cloudy day. So, as the sun demands, I will stop and listen to what it has to say in its beautiful silence.

App-uh-latch-uh

Appalachia is more than a place. The Appalachian Mountains are rich with customs, food and dialect that is not found anywhere else. Those mountains are at the core of the people who were raised there or have adopted it as home. The mountains become part of who we are, why we are, and how we go about what we do.

Great Smokey MountainsOne of the things that many Appalachia natives are particular about is how we say our name. This is also something that many people from elsewhere do not understand. In Central Appalachia, where I am from, it is app-uh-LATCH-uh, not app-uh-LAY-sha. I am told that there are people in Appalachia who were taught to use the latter pronunciation. Fair enough, I obviously get regional dialect. Please understand, when you say App-uh-LAY-sha in much of Appalachia people, in addition to knowing immediately that you are not a local, may think you are trying to be fancy or worse. How you say the word Appalachia matters.

As you can tell, I and many others feel strongly about this word. So, when stumbling around on the internet I found a company called Pronunciation Tees I was super excited. What do these people do? Well, they get me and my people. Pronunciation Tees produces t-shirts that proudly display the proper pronunciation of Appalachia – [app-uh-latch-uh].

App-uh-latch-uh

The moment I saw this shirt I had to have it. Oh, and it gets better, the mission statement of the company is to

Help raise awareness about the infection known as [app-a-lay-sha].

I encourage everyone to support these brave and creative folks. It’s cool, it’s fun, and it’s just plain right.

Why Asking for Help is So Hard

I just never know when the next ah-ha moment will happen.

Weed Eater

The man from the landscaping company came by to talk to me about some rocks.

We surveyed the backyard together. As we did, I apologized profusely for the condition of the grass along my fence line; as if the condition of the yard was some reflection on my character. I was embarrassed and explained that I had run out of weed eater string and was working on how to replace it. I assumed this would be the end of that conversation.

I do not know how to replace weed eater string. In fact, I did not even know that the string was designed to destroy itself. Yard work is not one of my gifts.

He smiled sweetly and said “I’ll do it for you.” I, of course, said something like “oh no, no I don’t want to bother you with that.” He insisted.

I stood and watched, uncomfortably, as he laced the string into the weed eater. I apologized for using his time to do this for me. I apologized for not knowing how to do it myself. Really, though, I was apologizing for needing help; I was worried that he would judge me because I could not do this myself. I explained, apologetically, that this is the first house I have lived in where I was responsible for the yard. In the past I hired someone to do it and growing up my Daddy always took care of the yard. As I gushed, needlessly, I wondered why I needed him to know why I did not know anything about weed eaters. Why would I?

He repeated sweetly and genuinely that he did not mind. He said that he was happy to do it and that “it makes us feel needed.”

It makes us feel needed – I thought about that comment for a couple of days. He did not care that I did not know anything about weed eaters; he did not expect me to and did not judge me for it. He enjoyed helping.

He liked being needed as much as I did not want to be needy. It’s clear to me now that when I refuse to ask for help when I need it I am depriving someone else of the opportunity to feel the joy of being needed.

Turns out, needing help is not a character flaw either. It is an opportunity to give someone else the gift of being needed.

Summer Sunsets

I can’t deny it any longer.

Last week I turned off the air conditioning and haven’t turned on the heat. I do my very best to delay turning on the heat. I am not yet sure whether that is stubbornness, denial or both. But today there is a chill in the air inside the house.

Suddenly, every Saturday morning I regret my choice to not have cable. It is that one time a year when I miss ESPN, or maybe it’s just Kirk Herbstreit.

My white shoes, linen blazer and seersucker suits are dry cleaned and packed away, sadly, for months.

As I type, it is 42 degrees in Fort Wayne. Today’s high is 46 degrees.

It is fall.

In an effort to further my stubbornness and/or denial, I want so share my best of the summer sunsets.

There is not much better than a warm/hot/sweltering walk in the glow of the setting sun in bare legs and short sleeves. I am afraid that there won’t be any more of those until spring.

Indiana Sunsets:

Alaska, Arizona and Washington Sunsets:

Eating Gluten-Free on Carnival Cruise Lines

Traveling with celiac disease is a never ending challenge. Spending a week or more in a domestic or international location is difficult. You have to locate grocery stores, pack your food for the plane and beyond and research restaurants that have gluten-free menus or are rumored to cater to the needs of the gluten free. It is a lot of work.

Instead of requesting a gluten-free meal on the plane, I bring my own.

So, when my sister informed me that the 2014 family vacation would be an Alaskan cruise I immediately started spinning all the potential food-related nightmare scenarios. This was my first cruise.

We sailed on the Carnival Miracle for seven days out of Seattle with stops in Skagway, Juneau and Victoria. I shared the least dramatic of my worries with my sister and she assured me that she had made the necessary arrangements for me. I was to meet with Guest Services and then the maitre d’ to discuss my requirements. The Carnival representative assured my sister that they could safely feed me. My sweet sister then researched gluten free eating on Carnival cruises and she found a blog post by the lovely G-Free Laura. I felt better. I knew I would be worried until I was on the boat and talking to someone but this information helped.

I arrived in Seattle and enjoyed lovely gluten-free meals at Tom Douglas’s Lola, Anthony’s and Elliot’sOddfellow’s in Capitol Hill (I also recommend Elliot Bay Book Company while you there), and Local 360, which is super awesome spot where everything on the menu is local. All these meals were lovely and gluten-free.

Then it was time to board the ship. The embarkation process took less time than I expected (considering there were over 2000 people aboard). We headed for Guest Services to request the partition between our rooms be opened and to talk about my dietary needs. Unfortunately, my record did not reflect that I needed a gluten-free accommodation, it only noted a special need. I took this as – they aren’t ready for me and I have to be perfectly honest, I was scared. Guest Services confidently advised me that all I needed to do was talk with the maitre d’ and it would be fine. I had packed enough food to each one or two meals a day out of my bag, but I knew I needed at least one good meal a day from the kitchen. So, scared doesn’t really describe it, I had a minor meltdown.

We made our way to the dining room for our first meal. I met the maitre d’, Ken, at the door and explained what I needed. He promptly dispatched the lovely Jana to my table. I explained to her that I have celiac disease and would need a gluten-free meal. I went on to explain that I am medically required to have a gluten-free meal and that I am extremely sensitive. She was unflappable. She assured me immediately that they could accommodate my needs. In fact, because of my concern she offered to personally order and deliver my food herself since my server would be responsible for multiple tables of people. I happily agreed. She got me. To ensure that the kitchen would have time to specially (separately) prepare my meals I would need to order my meals a day in advance. So, every night at dinner I ordered my meals for the next day. It seems like it might be inconvenient, but I did not mind and it gave my family a preview of the next day’s offerings.

Our server, Damir, was helpful and a pleasure to be around. He understood my need and worked hard with Jana and the kitchen to make sure my meals came out at the same time as the rest of the table. This was a struggle on some nights, but they were aware and working on it. The kitchen is stocked with gluten-free bread and flour. So, many traditional items (sandwiches, French toast, pancakes, etc.) are available. I avoid all grains but rice when I am traveling, so I was slightly more limited and declined to eat the bread and flour-based items. Despite my more restrictive diet Jana was able to work with the kitchen each day to find something for me to eat that was interesting. I did eat a lot of steamed vegetables and plain meat – salmon, mahi mahi, flank steak, filet mignon and ribs. But I was also to have the seafood Newberg revised to meet my needs. Instead of the Newberg sauce they made a lemon butter sauce and put it over rice.

They were willing to go the extra step to help me enjoy my meal. As for dessert, the cream brulee and chocolate melting cake were my go-to items. Although, they did have other gluten-free choices. While dining room service was very good and accommodating, the room service and buffet offerings were off limits. I was specifically instructed not to order room service and as a rule I do not eat off buffets (too many changes for cross-contamination). So, on the ship my meals were restricted to what I brought onboard and eating in the main dining room. Know this ahead of time – eating is not a whenever-you-want-it-option unless you have a large stash of food in your cabin.

Chocolate Melting Cake

I was pleased with the attention and consideration that I was given by the dining room staff. They were genuinely concerned for me and they went out of there way to try to make my meals fun and interesting. It was not a perfect situation but the service was great and the food was better than expected. Tip your servers, maitre d’ and Jana. They deserve it.

The Polar Vortex of 2014

I came to Fort Wayne for the first time in November 2010 for an interview. On the drive to town I became convinced that it was too far from home, too weirdly flat and not easily accessed. The weather was chilly but sunny. There was talk about what the weather would be like but in this two-day visit I fell in love with the academic community and small college campus I was going to join. I left Fort Wayne trying to decide how I was going to explain this move to my family and friends.

I returned in February 2011 to find a place to live. I flew this time and found myself in the midst of the Groundhog Day blizzard. It was cold, roads were snow-covered and at some point prior to my arrival there had been a travel warning prohibiting non-emergency travel. During that visit it all seemed manageable. My realtor drive me around in her minivan. I drove myself around in a rented Ford Explorer. It was an adventure and surely would not happen all the time.

My assessment of the Indiana winter weather was true for the first two winters I was here. The winter of 2011-2012 was barely existent. It kind of snowed once. The winter of 2012-2013 was a bit more serious, it snowed twice and I learned how to shovel (there are strategies and techniques for shoveling snow). That was manageable and I learned something.

Now we have the winter of 2013-2014. This one is not like the others.

Since December it has snowed over a 12 inches. In the last week we have lived in the snow globe that was early January 2014. Thanks, polar vortex. This has been an unwelcome introduction to the other extreme of Indiana winters. On day one of the storm I shoveled 5 times to keep up with the snowfall.

A state of emergency was declared, the National Guard was called out and a non-emergency travel was prohibited. On day two the temperature and windchill was frightening. The temperature was around -20 with windchills as low as -40 and wind speeds of 20 mph. I did not venture out that day.

IMG_6041On day three the temperature got up to 5 but the roads remained nasty with snow drifts and layers of ice. On day 7 we got a break, it reached nearly 40 but it rained (yes, that is nearly a 60 degree change in 3 days).

Now roads, yards and fields are slush-filled ponds. Yesterday on a dog walk I stepped into an area with shin-deep slush on the sidewalk.

I’ve never seen anything like it. It is only January.

I’m told that this kind of weather builds character and stamina. I appreciate that and while I’d prefer to do that voluntarily and in the sun it is rewarding to know that I can handle it – I can live in an extreme weather event by myself (I was in the house for 3 days without any face to face human contact). One day when I live or am vacationing somewhere very warm I’ll say something like “I remember the Blizzard/Polar Vortex of 2014 and it was a mess, but Scout and I had fun.”

Also, snow in large quantities is pretty.