Illustration: Ansellia Kulikku.

And I saw the dead, great and small, standing before the throne, and books were opened.

— Revelation 20:12

I labored with my son Keats in an overcrowded hospital nestled at the base of West Virginia foothills. The room’s window view was green and lush and marred by a concrete, smoke-spewing, open-mouthed coal stack in the not-too-far-off distance. I stared out at the evening sky and hoped I’d beat the latest hours, a baby in my arms before midnight. When I’d arrived at the nurses’ desk in active labor, my hands atop my belly, waiting for another wave of pain as I signed myself in, I said a little prayer—though I’m an atheist—that I was far enough along to be admitted. There were few beds open. As a nurse walked me down the hall to an exam room, we passed a full-bellied woman who fought to stay. They sent her home and gave me her room.

Contractions with Keats were light, nothing more than a twitch in my belly, like the closing of a fist. Not the crushing kind I’d had laboring with my two girls. His labor was like the baby he is now: soft.

I asked for all the drugs anyway.

I pushed my son out in the late morning, into my husband’s hands. Keats was born limp and purple and quiet. I pulled him atop my chest, cord and all, rubbing him into his voice. We both cried out; him from the shock of life; me from the shock of that life colliding with something close to death. My husband passed our son to a mountain midwife and officially into Appalachia. Keats was born face up. The midwife had needed to twist his body to get him out of me; his collarbone broke from that turn. I wouldn’t know this until weeks later. By then we’d left West Virginia to see my husband’s family in California, a departure I hoped would also offer the time I needed to understand all that had happened with our baby and my body.

At Keats’s four-week check-up in California, the doctor felt a hard lump just between his chest and shoulder. “Of course, you know this is broken?” she asked.

I shook my head. But I’d suspected there was something wrong from the day we’d brought him home. Keats could wriggle his legs and curl his toes and punch the air with his left arm. His right arm flapped down at his side, immobile. I’d been assured by his doctors that his arm was fine. Keats was just figuring out how to live in his body, how to make it go.

The doctor placed her hand atop Keats’s clavicle where a bone callus had grown and drawn the fracture together. “Here.”

*

I was not born in West Virginia. My husband and I moved there three years ago with our then four-year-old daughter Josephine. We moved for my tenure-track job teaching creative nonfiction in an MFA program. I knew almost nothing about the place. If asked, I wouldn’t have been able to find the state on a map. I drove in at night the first time I went. It was deep winter, and though it was dark, the earth seemed lit silver from the inside with cold.

Our students come from all over the world. They arrive in Morgantown and are often worried about the wisdom of their choice. We’re the only state in the country with negative growth. More people are dying or leaving than are born and stay. Ours doesn’t have the usual charm of a college town. There are more churches than gas stations, and our poverty isn’t hidden. It’s a tired cliché, but many buildings are dilapidated. Some are coated black from ash and exhaust. Roads are steep and pothole-covered, chewed by coal and gravel trucks; driving is not driving as we know it in other parts of the country. Driving in West Virginia is like taking a roller coaster ride through a ghost town.

I reassure my students about their choice. I tell them they’ve arrived in a place worth writing about. It’s all here: coal, fracking, poison water, permit-less gun carry, white supremacy, Mylan pharmaceuticals, an opioid crisis that claims more people than anywhere else in the country. Good material is worth some discomfort, I say. It’s my mothering instinct to try to shield my students. If only mothers had that much power.

We came from Santa Monica, California, a thing that takes most by surprise. “California to West Virginia?” people ask, as if I’ve surely gotten this fact of my own life wrong, as if I were talking about a trip from Earth to Mars. But the path of my life, and my family’s, hasn’t been quite so straightforward. There’s a little white house on Orlando Avenue in Albany, NY. It’s 1,100 square feet and has two bedrooms. My mother grew up there, the last of five children, the unintended voyager of parents in their forties. Her father was a housepainter. Her mother was a house-cook. Her grandparents were immigrants. Nobody went to college. Mom waitressed most of my childhood. Sometimes we needed food stamps. More than once, we were homeless.

As soon as I was old enough to make my own choices, I left home.

I promised myself I’d never go back.

*

Since moving to West Virginia, I’ve learned that many people don’t even know it’s a state. They think we’re Virginia’s western arm. Just a place off Interstate 95 on the way to the beach. The official state motto of West Virginia is “Montani Semper Liberi” (Latin for “Mountaineers are Always Free”). “West, by God, Virginia!” is the unofficial state motto. Mountaineers yell it in bars and on streets and in churches, countering the assumption that they are invisibles, people from nowhere in a nothing place.

I’ve learned that when people from the coasts think of West Virginia at all, they think about banjo music, and Trump country, and sad miners and blown-apart mountains. What I observed as I settled in didn’t exactly match those stereotypes. There are progressive activists, and live-off-the-land farmers, and a vibrant community of artists. There are people living high off old money from coal, and people living even higher off new money from fracking. It’s a place with a long history of taking. The people and the earth carry that pain.

West Virginia has always been God-fearing. Unlike other red states, religion wasn’t always the central voting value. West Virginia used to be deep blue, driven by union-based politics. Bill Clinton won West Virginia by 13 percentage points in 1992. Trump took it by more than 40 in 2016. It’s complicated, but coal’s death brought about a cultural shift, a retreat away from progressive economics in favor of cultural conservatism. Poverty in the state is staggering; nearly 20 percent of residents are poor.

In an interview with the news site 100 Days in Appalachia, Davitt McAteer, the former head of the federal Mine Safety and Health Administration under President Bill Clinton said, “The old maxim used to be that miners went home to Jesus and John L. Lewis. Now you just see Jesus Christ.”

Faith is what is left.

According to a recent Pew forum study on culture and religion, only 20 percent of people in the state believe in evolution “due to natural processes,” 83 percent believe in heaven, and 58 percent of West Virginians believe that abortion should be outlawed in all or most cases—cases that include rape, incest, or a pregnancy that endangers the life of the mother.

*

We’d welcomed our second daughter—one of Keats’s two older sisters—a year after we moved to West Virginia. I had struggled to get pregnant with Iris; there are five years between our two girls. Throughout my pregnancy, I imagined Iris as a perfect partner for Josephine, a better sibling than I’d been to my own identical twin sister Cara.

I named Iris after a tattoo Cara had inked on her forearm to cover her track marks. By then, Cara had been dead for a decade. She was twenty-eight years old when she jammed a needle filled with fentanyl-laced heroin into her arm on a sunny June morning.

In the last days of Cara’s life, she and I weren’t speaking. I’d thrown her out of my Massachusetts home after I caught her shooting heroin in my bathroom. On the day she died, seven days after I’d told her to leave, Cara was living back at home with our mother. I woke that morning with a feeling of terrible remorse. I had the keen worry that I had abandoned my sister; I’d left her thinking I didn’t want her in my life. All I ever wanted was for the sober her to come back to me.

I dialed Cara’s number right after breakfast. She didn’t answer. I kept calling. I called more than thirty times. She never answered; she was already gone, her head tipped forward, her face purple and still with blood. The sun shone through a window behind her; in death, her body was warm with light. When I heard the news, it was sundown. I screamed so hard that the force of my voice, and the tension of my body, tore the straps of the dress I was wearing.

Twelve years later, I birthed my son on my sister’s death day.

I thought I was done with our story. I’d even written an entire book about grieving her. I packaged and published that story into something past tense—a thing with a beginning, middle, and end; sisterhood, life-exploding trauma, a new chance. But twins have boundary troubles; they’re always stepping uninvited into each other lives.

Now I know we are never done.

I’m in a haunted place, in my home and in my body. I’m bargaining. I can’t let that darkness touch my son. My love, she died; but we are still here. I tell myself that a baby arrives when he wants. Sometimes a day is just a day. But sometimes, too, a person is unable to manage the weight of the meaning of the thing right in front of her.

*

Iris was a year old when the test came back positive. Two pink lines for one new boy.

Caring for two young girls while working full-time was exhausting; and though I relished watching Josephine and Iris share their lives, I felt I’d given enough of myself, of my body, and our girls had each other. I was forty years old. I didn’t want to be pregnant again. I felt there was not enough of me.

As a young woman in New York, I’d had an easily-accessed surgical abortion during my junior year of college. Cara had helped me come to the decision to terminate my pregnancy; she wanted the best for me, to see me into a life where I lived up to my potential. We were twenty years old and sat huddled together on the floor of the apartment we shared, talking through my options. We both knew that carrying a pregnancy to term would effectively end my career and leave me in a position to raise the child alone—most likely in poverty, just like our mother had raised us. I didn’t make the choice to abort lightly—it was the hardest decision I’ve ever made—but it was a choice I was lucky to have the ability to make, and that I’d hoped I’d never have to make again.

I think often about the women I waited with in the recovery room all of those years ago, all of us covered with warming blankets. We were asked to fill out long forms and to reveal our race, our income, our birth control method. Those forms struck me as a kind of control. We deserved our privacy. We deserved to grieve alone. I refused to fill one out, my protest. The women beside me quietly scribbled their names.

After my positive test years later in West Virginia, I called my OBGYN to make an appointment. I have a history of ectopic pregnancies, so I was seen right away by a young physician on call. I lay on his table and stared at the ultrasound monitor as the doctor pointed to a beating heart that looked like a flashing star. I was six weeks gone.

“I want an abortion,” I told the doctor.

He looked at the floor. He was sorry he couldn’t help, he told me, but that’s just the way it was. He stood up from the little wheelie stool where he’d been sitting, wished me well, and closed the door.

Maude, an activist doctor friend, told me that my OBGYN’s practice would perform an abortion— I just needed to see the right doctor. I called the office again. I told the receptionist that I wanted to get in as soon as possible to have an abortion, please. I was raw and scared; there was no hiding. The line went silent. “I don’t know what you’re talking about,” she said. Then more forcefully, “We don’t do things like that here.”

“But you do,” I countered. “Help me.”

“I can get you in two months from now,” the receptionist answered, amused.

That was too late, as she knew: a woman must be fewer than ten weeks along to be prescribed RU486. I lay down on my living room floor and curled into a ball.

I called every doctor I could find in Pittsburgh, the nearest city, who performed abortions in-office. None would see me because I wasn’t already an established patient. And anyway, it was a two-hour drive and clinics require a waiting period.

The only abortion clinic in West Virginia offering out-in-the-open RU486 prescriptions and surgical abortion is in Charleston, a three-hour drive. After an initial consultation, I would need to abide by a twenty-four-hour waiting period. I’d take pills to end the pregnancy, and that process would take days, too. After that, I’d have to return to the clinic to make sure my uterus was clear of the pregnancy. If my husband traveled with me for the support I needed, who would care for our daughters while we were gone? Would we stay in a sterile motel as we went through the hardest moment of our marriage?

A few hours after I hung up with the receptionist, my phone rang. It was the doctor at my OBGYN’s office who could help me. Maude had called her on my behalf. The doctor told me she could end my pregnancy by prescribing RU486, but I shouldn’t tell a single nurse—or anyone on staff—why I was there. If I had complications, I’d be better off calling her cell phone. Not too long before, she’d helped a teenager have a surgical abortion and a nurse had seen it on the girl’s chart. It caused upheaval; her staff and nurses had filed a formal complaint against the doctor. She feared for her job and probably for her life. This, though abortion is legal.

The doctor told me that she must provide mandatory counseling advising me against the procedure. She recited the list of all the bad things that could happen to my body should I terminate, the least of which was regret.

It all made me uneasy. A medical procedure shouldn’t be a hidden thing. There are always risks. I worried too that some nosy nurse would see my name, that I would be outed and publicly shamed in our small town. I worried that I might suffer infection, or be turned away from the hospital if I needed help. I worried that I would bleed to death. I didn’t just walk out of my abortion in my twenties and back into normal life. I bled for weeks. There was cramping and pain. I’d slept the whole car ride home, and when I got home I crawled into bed and cried. I didn’t stop crying for days, and not because I’d made the wrong choice, but because sometimes the right choice hurts.

And sometimes you don’t have much of a choice after all. In the weeks after my conversation with the West Virginia doctor, I’d like to be able to say that my anger and shame over my lack of choice disappeared, but it didn’t. Caged by my body, reduced to a vessel, I grew angry and bitter. I’d done what good girls do, by default, and got myself slow with children. What I wanted to do was fight. I wanted to kick and punch and scream. My body was heavy. And I had to pee. I could only breathe by half.

I dreaded prenatal appointments. The kind doctor would touch me and I’d recoil. The depletion that comes with a full-bellied, unintended pregnancy—with every swift kick and turn that is the miracle of your baby thriving—it’s a primal reminder that the state believes it knows better than you do. You know less than nothing, and even less than that about yourself.

Yet it was never the feeling that it was me against Keats, my life for his life. We both lived in my body. We both needed that body to be considered and cared for.

Slowly, I let down my guard. I let myself love Keats. I played him music. I talked to him. He heard all about his sisters. I promised he belonged and was wanted in our family. I promised I would protect him. I knew how hard that would be.

*

According to the United Health Foundation, West Virginia has among the highest infant and child mortality rates in the country. The mountain terrain is so rugged it can defy progress. West Virginia also has one of the lowest rate of internet connectivity in the country, meaning some people have extremely limited access to information. Many women here must travel two hours for prenatal care, and then to give birth.

Over the years, reproductive rights in the state have been eroded. If a woman wants an abortion, she must receive state-directed counseling designed to discourage her from terminating her pregnancy. Following that session, she must wait twenty-four hours before moving forward with the procedure. If a minor needs an abortion, her parent must be notified and provide consent. All abortions after twenty weeks of gestation have been outlawed. A recent amendment to the state’s constitution makes it illegal for Medicaid to fund most abortions; that’s nearly all of them. In 2014 there were five clinics in the state that provided abortions. Today there is one.

There is a clear connection between diminishing abortion access and higher mortality rates for mothers and infants. Across the country, states that make abortions hardest to get also tend to be the least generous in providing safe and successful care for women and children. In Texas, the maternal mortality rate grew after the state closed more than half of its abortion clinics and severely cut funding for Planned Parenthood. South Carolina, with numerous restrictions on abortion, saw a 300 percent increase in maternal mortality, the highest since the turn of the century. Their outcomes for children are among the worst in the country.

*

Six years before Cara died, she was a young MFA student in Massachusetts. On an October afternoon, while out walking her dog in the woods in a crime-heavy area, she was brutally raped and tortured by a stranger. He dragged my sister down a rocky and secluded path. He smashed her teeth. He tore her clothes. He held a broken bottle to her throat. He used her body until she felt it no longer belonged to her. In the wake of the attack and all that it cost her, she suffered crippling anxiety and depression. She was rage-filled. She turned that rage inward. She lost all faith.

Strangers who have read my book often ask me what I think would have happened to Cara had she not been raped. Most people asking that question want me to tell them that regardless of the attack, Cara would have died. They want to hear this because it puts Cara’s fate in her own hands; one event can’t tip fate. Nobody wants to believe that they stand on the blade between sanity and madness. But I tell them what I believe: I imagine she would be a married mother living in suburbia now. That’s what she most wanted; to be rescued and lulled by motherhood, to be able to choose those things.

My sister’s death was a woman’s death. It was a death of choice, but not hers. What happened to her was a matter of place and time. When she was alive I couldn’t reckon that. I never said so to her, but I sometimes thought she bore some responsibility for the attack by having been in those unsafe woods in the first place.

*

Our house in Morgantown, West Virginia sits atop a hill. There are deer that sleep on our front lawn, like in a fairytale. Cardinals sing so loudly at sunup I have to close the windows to sleep. They perch on a power wire and stare blankly at me as I draw the blinds. In June the fireflies number in the thousands. Our daughters run after them barefoot, Mason jars in hand. Wild flowers blossom everywhere, their perfumes sweeter than cake. The neighbors bring food and comfort and kinship; there’s the feeling in town that we’re all in this together. Leaving feels impossible; even when it is done out of love, it’s betraying another loyalty. We invest in one another to make this place survivable. We don’t speak poorly of our state the same way we don’t speak ill of the dead.

But when the foliage falls and winter begins, the view from our back porch changes; the place is not what it appeared to be. Where there had been green, the town’s waste transfer station flanks the river, spewing acrid fumes that smell like burning tires, as if it hadn’t been there all summertime and for decades. Coal and gravel trucks plow through town day and night; some trucks carry radioactive coal ash with nothing but a flimsy tarp as cover. The deer that were pretty on the lawn are dead along the highway. There’s a majestic old bridge in walking distance from our house; beneath it, people sleep heroin’s dead sleep. Sometimes they never wake up. The place serves as a painful daily reminder of my sister; I can’t look away from the dealers on the bridge or the people shuffling around them like zombies, their pupils the size of pins. That bridge offers the fastest walk to campus, but most faculty avoid it; it’s much safer to take a different route. But that’s the way I take. I do it out of a kind of responsibility: I feel I should be able to.

*

The first night of his life, I held Keats against my breast, trying to nurse him. The IV poked into my hand during labor was covered with soggy medical tape. I struggled to keep his weight from pulling at the needle. Keats arched his head and wailed, his arm against his side, his body turned toward mine for warmth. He nosed around at my nipple, smelling for his life-food, unable to latch. By the next morning his skin had yellowed, and continued until almost goldenrod. And though Keats was scoring dangerously high for jaundice and was a probable candidate for phototherapy—a treatment with ultraviolet light that reduces bilirubin levels in the body—the doctors sent us home. There was no room in the hospital. We packed to leave. My hair remained uncombed. Dried blood streaked my legs. I could barely hobble back and forth to the bathroom. I yelled at every nurse, staff member, and doctor I saw. “I’m a writer,” I warned them. “Do something.” Writers tell. But the threat of words was nothing next to the reality of not enough resources.

My baby, my bird, my Keats; brown eyes at the brim, he looked like a hatchling forced ruthlessly from the nest. I’d brought us to this godforsaken state. Mothers can be so wild and cruel.

I took Keats to see the pediatrician every day. He needed his blood drawn to check his bilirubin levels. The results of each test showed he was only a hair away from needing to be hospitalized. When I pleaded with the doctor to give my boy light therapy, the doctor told me to place him in the sun beneath a window at home.

In the summer’s first heat wave our air conditioning was broken. It was too hot to put Keats in the sun. I lay naked in bed with my son atop my chest, him in nothing but a diaper, our sweat running together. Unclothed, I walked him over to the window and put us both in the light, moving in and out, so the heat wouldn’t touch him. I didn’t even think about the neighbors. I held my baby son and it felt like I was a skydiver pulling the ripcord. We were falling together and I couldn’t hold him hard enough. He was going down on my watch, just like Cara did.

Keats’s little head tipped back and over my arm during those hard days. The fact of him almost made me believe that Cara had come back to me. If I believed, there was a reason for all of that pain. And at the bottom of my life, that fantasy held me like I held Keats. I prayed to the past and hoped it would spare him.

I took Keats to the doctor’s office for ten days straight. I’d place him on a table to be weighed. A nurse would measure his head, then stick his heel with a pen-like push-needle. He’d yowl as she squeezed his blood out. Next the doctor would come in and blame me, my milk— I was the problem—yet I’d nursed both my girls beyond their first year.

I didn’t trust them. I took Keats to a dental surgery center in Pittsburgh. The doctor strapped him into a Papoose atop a surgical table. He laid hands on Keats as if he were putting together a valuable broken thing. A surgical lamp illuminated Keats’s mouth, which he kept open. We all marveled that he didn’t cry or try to break free. He just stared up at the light. The doctor looked inside Keats’s mouth and nodded. The diagnosis? A severe lip and tongue tie. He could take care of it. “There will be a moment of pain,” he said. “Keats won’t remember a thing. You, you’re a different story.”

*

When I’d just started my job in West Virginia, I’d gone to a dinner with a group of academics. We sat around a table talking, finishing a bottle of wine and a meal made from scratch. The conversation turned to origin—from where and when we had come to America, ourselves and our ancestors. I was the only one in the group who didn’t know my bloodline. All the people who would remember in my family are dead. My mother lost her parents when she was young. Both of Mom’s brothers are dead. They were the eldest of her five siblings, and the only ones who talked to the many aunts and uncles from Italy who have now passed. Our family rushed to assimilate, as so many immigrants do. There had been poverty and hardship in Italy; all that was past held that stain. Immigrating offered a chance at a better life. As a result, little was preserved. Our family forgot.

Once I’d unpacked the last of our boxes in Morgantown, I took Josephine to New York to visit my mother. I insisted Mom hand over whatever information she had about our family’s immigration from Italy to the United States. I refused to believe there was nothing left of our history. Mom went into the attic and brought down a large plastic container that held her dead brother’s belongings. He’d been into genealogy right before he died. She pushed the box over to my side of table; that box was the only worldly thing she had of her brother’s.

We rooted through the box together. Mom told me her grandfather had wanted to be a painter. Instead, he worked as a glass blower. All day he stooped over, torching color into vases for rich people. In the box, she found a map folded into a square. I opened it up and spread it over the table. It was a crude illustration of the town where her grandfather had lived and worked, the place he had come to from Sicily. The town was in West Virginia, ten miles from my new front door. I was home.

*

As you make your passage into West Virginia from western Maryland or up from Virginia, you drive over peak after peak. Before you know it, you’ve crossed state lines. There’s the feeling of being swallowed as you go in—as if you can’t turn back, the same way you can’t relive yesterday. Where you are headed and where you have come from are indistinguishable. The view is such a miracle that you don’t mind that you might never leave. There are fewer people. Rest stops dwindle. Homes are like teeth in a rotten smile. There is a convergence of the hideous and the divine. The mountain is an embrace, and all those houses are in briar-tangles and the view is vast and you know you are in God’s hands because the hills don’t end and the fog is the dividing line between the earth and the afterlife.

I know how I’m supposed to end this story, with the good mother’s admission that our children are proof of how life continues. In my case that seems demonstrable: there was Cara and there is Keats, as if they are one out of the world for one in.

But I don’t believe. That idea negates the severity of my loss of choice, and of every other woman who has lost hers. It erases my pain and replaces it with a child. That’s not how it works. Don’t you think I wish it did?

What remains: Keats was born into a world that hurts women—through physical violence and politicized restrictions, through scorn and blame and silence. I can take my experience of that fact and let it break me like it broke my sister, or I can release it with faith that someone hears.

Writers tell.

I love my son. I love how his hair is actually a kind of fuzz, a downy, sparse, and unnamable shade of brown. I love his dark eyes and long toes and blond lashes. I love the bald flat spot on his head, from where it meets his mattress. Nine months later, I’m still tracing my fingers over his collarbone. When I hold him sometimes it feels like we’re breathing together, that we’re body travelers sharing the answer to the world’s greatest riddle and the answer to that riddle is love.

I love my son, now and always. His is the face of my God.

Christa Parravani

Christa Parravani is the author of the best-selling Her: A Memoir. Her was an Indie Bound Next Pick, a 2013 Books for a Better Life nominee, and a Wall Street Journal, Salon, and Library Journal best book of the year. Parravani's writing has appeared in Catapult, The Washington Post, Salon, The London Times, The Guardian, and DAME, among other places. Her book about the troubled marriage of a young CIA case officer struggling with the terror of an abusive husband while fighting the global war on terror during the bin Laden years is forthcoming in 2020. She's also at work on a memoir about her life in West Virginia. Parravani is an assistant professor at West Virginia University.

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32 Comments on “Life and Death in West Virginia

  1. As an editor and writer, this is one of the most powerful essays I’ve ever read. Thanks for enriching my day, Christa.

  2. I’m a fairly new transplant to WV as well — and for a TT job in an English dept. And this piece has perfectly gotten into my gut…from the beauty to the wreckage.

  3. There is access to abortion in West Virginia outside of Charleston and there is definitely access in Pittsburgh without having to be an established patient. I question whether the abortion really was impossible to get, or if the author knew it would make for a nice political rallying cry to spice up an otherwise overly-dramatic essay that exploits the usual West Virginia stereotypes without adding anything new to the conversation.

    1. Yeah, she didn’t have an abortion so she could write this essay. A baby for an essay—that makes sense. *extreme eye roll*

  4. Breathtaking! Tragic & beautiful & full of good. You touched my heart as a woman, mother, and sister who has lost…

    Your gift for a capturing feelings and putting them on paper is breathtaking. Thank you for your work & sharing those deep vulnerable places.

  5. Gorgeous essay. I read and re-read so many lines, like “Homes are like teeth in a rotten smile.”

    Thank you for sharing some dark and painful truths so beautifully. The love you have for both your sister and your boy buoys the reader as you face down loss, violence, death, misogyny.

    Bravo. Keep telling it like you do.

    Writers listen, too :)

  6. Thank you for this article.
    I am from New Jersey, and went to WVU in the late 70’s and early 80’s, and loved it. Everything you describe about the topography of the state rings true. I also enjoyed reading your take on West Virginia and the struggles that that state – and its people have endured, and still do. Although I concede that it is your choice to make, it remains extremely challenging for me to reconcile how one child is disposable, and the other child is “the face of God.”
    I just can’t see that.

    1. I have had two abortions. I have vascular Ehlers Danlos and before you go spouting off about why no birth control in the abortions, I was on it- it fails sometimes especially when navigating WV broken health care system and doing their best docs. My husband and I tried to keep the pregnancies but with little control over the course of my illness and the damage the prescribed drugs had done-even my pro-life OB understood in their own way. I travelled to MD on both occassions. It was horrible my state didn’t trust me or my hubby’s decisions. But my life was saved and to me and really all that matters is my and my hubby’s opinion, we showed mercy to the fetuses. You don’t have to like abortion. Hell, no one is going to force you to have one but this wonderful essay shows that choice all the choices even abortion need to remain safe legal and rare.

  7. Hey, I thought I would chime in here as someone who actually not only lives in Morgantown but is also from West Virginia and has been here longer than three years and has more to say than, “I went to college there” or “I came here for a job.”

    It’s hard for me to criticize the whole article because to be honest, it’s hard to read all of the garbage lies this person in expelling. Some immediate thoughts is that the bridge Christa is talking about is the Walnut St. Bridge where all those supposedly scary heroin addicts are sleeping and dying. First, Christa didn’t walk that bridge. She lived in the snuffy part of South Park that looks down on that bridge. It’s why it’s so scary to her and worth mentioning. To regular West Virginians? Yah know, actual working people? It’s just a dirty bridge. Those heroin addicts aren’t dying. They are grinding out a very sad living as functional addicts. I have live in Morgantown for nearly 20 years. Nobody has died under that bridge from a heroin overdose. Don’t believe me? Do a google search. Kids commit suicide on that bridge, but that doesn’t fit the stereotype of our state, does it? This is just one aspect of how this essay is elitist snobby crap that people from Brooklyn and California continual come here to write about.

    Christa was in Morgantown, WV. It’s one of the safest nicest places to live. Those coal ash trucks only covered by a tarp that come in the winter? No. She’s talking about Greer limestone trucks. They aren’t even coal trucks. It’s coming from a limestone quarry in Preston County that pass through a state road on my end of South Park, not up on the hill where Christa lived. She lived in the historic nice homes that were owned by white people that owned slaves. Those trucks that run day and night come through my part of the neighborhood down by the river and down by that scary bridge she didn’t cross daily, that’s not a scary bridge at all. I walked that bridge twice today. This morning someone said excuse me and on my trip home I carried my phone and a pizza. I guess all the heroin addicts were asleep and dead so they couldn’t rob me, huh?

    What I’m getting at, is just like how the Hatfields and McCoys were about state to state extradition. Christa is following the liberal outside history of telling the world that it’s about two backwoods inbred families just a shootin’ and raisin’ hell. When you write crap like this, it dehumanizes us to the outside world. When peripheral regions are dehumanized, it allows for things like resource companies to exploit those regions. Christa never fought for us. She wrote this bullshit and jumped ship.

    West Virginians went to an actual literal war to stop natural resource companies from killing us. The US government stepped in and bombed us. Read about the Battle of Blair Mountain yah fuckin’ liberal twits. You want to blame West Virginians for the mess we are in but refuse to learn about us. You refuse to take any stand with us. The Republicans fucks us and the Democrats report to the world that we are subhuman and asked to be fucked. Well, fuck you.

    When you see that the state went Trump, you see coal stacks, or you see how the beauty of our state is ruined. Ask why and how are we exploited. And look past your fuckin’ nose. Less than 5,000 people voted for Trump in this state. More than 2 million people voted for Trump in New York. Which narrative do you see getting passed around? West Virginia is Trump country! People like Christa, who know nothing about the state and move here, never leave their little Morgantown bubble, they are afraid of talking to working West Virginians because of the stereotypes and their fear, and then they leave thinking they have a good view of what is going on here. It’s complete bullshit.

    There is more than one place for abortion access.

    “Homes are teeth like a rotten smile” give me a fuckin’ break. What a classist, bigoted, stereotypical description. I bet one of you dickhead lot nerds got a fuckin’ boner off that line thinking of our magical hills and our mystical scary snake handlin’ ways.

    Plenty of grammatical errors because I’m pissed and this shit barely deserves the time I took to write this. Am I fitting into your enraged hillbilly stereotype yet? You have definitely fit into the outsider savior entitled classist poverty tourist stereotype for me.

    1. Also, I love a guy telling me how many abortion options I had. The story here is the insularity that disallows personal story telling. I have every right to describe any place as I choose. But more that, the piece is about health care. To be more offended by descriptive writing of a place where I live and raise a family, as opposed to the egregious political crime against the women in our state? That’s one of our biggest problems to start with.

    2. Hey man, if you’re the Bryan Richards from Travelin’ Appalachians Revue, I have a ton of respect for you and I think we have some friends in common. And I don’t want to get into a flame war with you on the internet or insult you or anything. But I do want to respectfully suggest that your theory of Christa Parravani is mistaken: she’s not who you think she is. I know Christa a bit and she’s a good person. I think the essay is beautiful and sad and is not unrealistically negative about WV; we can disagree about that. She’s not a child of privilege or a poverty tourist or somebody who runs down WV every chance she gets; there are plenty of those folks in Morgantown, but she’s not one of them. I think if you look closely at how she described Morgantown and WV, you’ll see that she acknowledged a lot of the dynamics that you mention: the poverty porn, the history of resource industries exploiting this place and the people here, the dim (or no) view that most outsiders have of the place. She says in the essay that her house looks down over the bridge. It is the fastest route to school from where she lives; if she says that’s how she walks, I’m sure that’s how she walks. I don’t really feel unsafe when I walk over that bridge. But then again, I’m not a woman walking alone. And with regard to overdoses, my wife did come upon a man sitting slumped and unresponsive on the sidewalk in the middle of that bridge last week (my wife is a nurse; she didn’t leave the guy there, she waited to see if he got up and would have called for help if he didn’t). I don’t know whether anybody has died of an overdose under that bridge, and neither do you. Those deaths barely get reported on because, sadly, they’re too common. And it’s not true that less than 5,000 West Virginians voted for Trump; maybe you meant less than 500,000? In any case, I just wanted to put in a word for Christa, and suggest that maybe you let your anger get away from you a bit here, and it would be a better idea to try to engage with what she’s written.

  8. I have already posted this on the Guernica Facebook page, and wanted to post here as well.

    The pain and suffering from the author’s sister’s addiction and overdose are tragic. Oppression of women because of lack of access to abortion are real and infant mortality and poor post-natal care in this country are deeply shameful. But what is not ok is perpetuating and making money and recognition off of derogatory class-based stereotypes about entire groups of people as a vehicle for telling your personal story, which is what Christa Parravani is doing. West Virginia does not “defy progress” because of its rugged terrain, it is a stolen land that has been heavily exploited for centuries in an ultra capitalist nation state to satisfy the interests of the few. The only positive thing in the article that she had to say about West Virginia is that she has fawns nesting in her front yard and there are lots of fireflies, and thank God there are at least a few activists and artists to save us from all the other backwards rednecks. West Virginia is not a dead relative! People who are addicted to drugs are H U M A N B E I N G S not zombies! I am aghast that the author let alone the editor of this magazine would think it’s appropriate to compare people’s homes in one of the poorest states in the country to “teeth in a rotten smile”. She blatantly says near the beginning that she encouraged her creative writing students to stick it out in bleak and dirty West Virginia because there is plenty to write about, like fracking, fentanyl, and white supremacy. Right, nothing hopeful or positive to stick around for here! If anyone is looking to West Virginia to be a container for the rest of the nation’s misery, you can look elsewhere. If only all the racists in this country lived in the one state of WV. It really irks me that people make money off of extracting both others’ culture and suffering for the sake of their own “art”. Not holding my breath for her memoir, if it’s anything like this shining display of poverty porn and culture mining from academia.

  9. Last Monday morning I went out for a walk with a friend. We walked over the Walnut Street Bridge at about 6:15am. There was a person sitting upright in the middle of the sidewalk, wrapped in a blanket. I walk over that bridge all the time with little worry, but this registered as something between creepy and scary. We weren’t sure what to do, so we hopped over the concrete barrier and walked down the middle of the street. We made our way down High Street and back to South Park, where we live, like Christa and Bryan. My friend was sure that we had seen someone overdosing. Booze wouldn’t leave you sitting up like that. She had Narcan in her car, one of those activists mentioned in this essay and chided in the comments. We went back and forth, still not knowing what to do. Should we have approached the person? Called 911? We hadn’t expected to happen upon the situation, and I’m ashamed to admit that my reaction was lethargic. I kept myself safe, and later drove over the bridge to check and find that the person was gone.

    I should have been the one who realized it was an overdose. I am a nurse. I work with people who have endocarditis due to IV drug use. There are lots of them. Enough that I’ve heard that there will be a floor opening up in one of the local hospitals for people to stay inpatient and receive the long term IV antibiotics necessary to treat endocarditis. Because you can’t send an IV drug user home with a PICC line. The nurses I work with are adamant that there is no amount of money that would convince them to work on that floor. IV drug users are humans. They deserve respect and excellent care. And they are notoriously hard to work with.

    It’s complicated. Christa’s essay is complicated. Some of the comments are complicated, though in a different and aggressively personal way. I was moved by this essay that spoke to me of a person living through a harrowing experience in a place that is familiar to me. Christa, especially, but also those who weighed in with comments – thank you for challenging me. I don’t know how to talk about this stuff. But this essay, and the responses, make me realize I need to figure out how to. Because this is my home, and this stuff is happening.

  10. I want to add to my comment. When my husband and I moved to WV, I’ll be honest I was worried but anything had to beat the cold vacant ways of the city we were living in. I just want to say, WV is a beautiful honestly warm place where I have made a great deal of good friends over the years from all sides and walks of life. People impress me here in ways I have never even anticipated and after living here for 13 plus years now, I feel this is home. I, like the author, feel that there are things WV could work on but truly, what state doesn’t have things to do or improve? Abortion laws, drug deaths,
    Drugs, disparities in healthcare, theft of land and misuse of it, theft to a statewide population heck all of that isn’t WV specific. The fact is like my Rabbi says we need to reason together and have a meeting of the minds to save what we hold dear and that is each other and the country. Trust her story and how the author feels. See her points, difficult as they may be for some and realize we have things to work on in the country, state, etc. And especially remember abortion needs to remain legal. Thanks!

  11. This author is writing about a state that, sure, has been looted and corrupted by mining companies, a place that’s been plundered, then left to ruin, a place that’s been duped, misconstrued, and lied to by outsiders with solipsistic goals for generations, but also a place with people who have great pride for the work their grandparents did. They’re not all Trump supporters. They’re not all gun-toting fracking supporters either. You can find white supremacists, pharmaceutical companies, and government overreach all over this country. You can find tragedy in auto pollution, drought, and housing prices that white-wash people of color out of Santa Monica too. This is a narrow and overly dramatic picture of a place that seems carved out of self-serving purposes. To tell new students that this is a place worth writing about is the same dark viewpoint employed by mining companies that left so much tragedy behind. Why not ask these new students to seek a deep understanding of the peril beyond stereotypes? Look at well done examples: Heroine or Recovery Boys. Even Anthony Bourdain’s episode of West Virginia was beautifully nuanced and showed the complexities of the culture of West Virginia—while still managing to call out his own biases! Why not ask students to extend their research beyond what’s obvious: a culture commonly bullied and always misunderstood? Where’s the audience awareness, the acknowledgement and empathy for those unlike you? The only mothering done here isn’t protective. Sadly, it’s just ill-conceived. And I don’t even think the author realizes that they are committing the same kind of bullying that they’ve experienced…

    1. I do ask that of my students. You miss the point. I was not bullied. I was silenced and denied basic reasonable care.

  12. Honest writing when persecution of one’s truth is the norm. Thank you for writing and your bravery in doing so, Christa. Much love.

  13. Christa, I have been following this essay, the comments it is getting, and your responses, and I wanted to add my thoughts. You say that what this is really about is healthcare and reproductive rights. You say that elements were added and exaggerated for emotional effect, yet you also say that this is about the truth, and that people just don’t like the truth. However, this essay contains many, many things that are not the truth. Abortions are difficult to get in WV, but not impossible. There are options in Pittsburgh beyond the highly privileged ones you listed, including Planned Parenthood and the Allegheny Reproductive Health Center, but these serve mostly low income people, and maybe you felt you were above that. To bemoan your access as a cis, straight, white woman with a professorship at a major university is appallingly tone deaf. Yes, we can always do better, but this essay absolutely reeks of unchecked privilege. You have the right to write whatever you want; that doesn’t mean those of us whose personal experience is different should be silent.

    1. I didn’t have the option. We had had two deaths in our family. I had taken 4 weeks off for funerals. I could not take the time off of work to travel to Pittsburgh. I grew up in trailer parks on public assistance. I am
      Hardly the privileged person you paint me as. My son also went through hell too. But as a person who has the ability to write, I have spoken for women who do not have the means to travel for abortion. That is the point. There is nothing fabricated in this story. I’m not sure where you are getting that

  14. I did find this a compelling article and enjoyed reading it, but there were a few lines that pulled at me.

    “I didn’t make the choice to abort lightly—it was the hardest decision I’ve ever made”

    – this feels like desperate and unnecessary qualification. Of course you didn’t take the decision to abort lightly. Who would? “it was the hardest decision I’ve ever made” – this is a cliched phrase and, yes, that probably goes without saying!

    The other was the repeating theme of “writers tell” and “I’m a writer. Do something”. This was awkward to read. Has the tone of “don’t you know who I am!”. Sure, writing is important. But it isn’t *that* important. Certainly not when compared with the medical professionals in that room.

    Finally – and this is quite a personal criticism – I had just come to this after reading a few articles on India, the world’s most interesting country. It does rankle to hear WV described as “Godforsaken”. If WV is Godforsaken, then *what on earth* is Bihar? Or almost any number of Indian states. It did make me want the writer to acquire a more global perspective, but I understand not all readers would feel this way.

    1. Nobody said it was Godforsaken. The opposite. The motto is meant to be a statement that the place is of God, part of the divine. Many people feel that women who choose to abort do so without thoughtful consideration. It’s a stereotype that impedes our rights and is meant to make women seem careless. I’m glad you don’t feel that way and I am sorry that others do. But thank you for your critique!

  15. Christa, as an abortion storyteller myself, I support you and your story. I am sorry that you didn’t receive adequate treatment/care. I think we can all agree rural areas in particular need more options in healthcare and to help those in need access it better. Arguments like this are happening all over the country. They need to happen. Thank you for sharing your story.

  16. Christa, I live in Appalachia, too – in southern Ohio, right across the river from Kentucky and about an hour from Huntington. We have the same problems here: poverty, despair, addiction. I, too, am a transplant, and though I’ve lived here for 20 years now for the sake of my husband’s academic job, I still feel like an outsider.

    Our state government just passed a “heartbeat bill” that will prevent nearly all abortions and makes no exception for rape or incest. Now they want to outlaw many forms of birth control as well. This isn’t about babies. It’s about waging economic war on women. It’s about control. If it were really about babies, they would take care of those babies after birth. They would make sure that mothers and children alike have access to good nutrition, health care, and education. They don’t.

    I found this essay to be well-written and true to the character of the region. Thank you for telling your story, and for advocating for the rights of women.

    And thank you for telling your sister’s story, and for putting a human face on addiction (some commenters seem to have missed that entirely). I was once a heroin addict myself, following years of pain, doctors, pain meds, and more pain. I’m one of the lucky few who made it out alive. As is all too common, my addiction and my physical pain were/are closely tied to trauma, in my case caused by years of every sort of abuse when I was a child. Too often, that part of the story gets left out.

  17. My junior year at WVU, I also had trouble obtaining an abortion in West Virginia. An OBGYN lied about how far along I was, telling me that I was 10 weeks. Which I was pretty sure was impossible. But why would she mislead me? She signed me up for future months of pre-natal appointments, while I was still trying to wrap my mind around this information. When I asked about options, she gave me a brochure for an unplanned counseling Catholic charity. I couldn’t believe it. I had no idea what the laws were, but I was pretty sure 10 weeks meant I was running out of time. That experience made me even more stressed. I was in awe of my changing body and increasingly freaked out and never told anyone I was pregnant. In the end, the most accessible option for me was to get a ride to Washington D.C. I was able to have an abortion and return home the same day. (I was seven weeks, when I expected them to tell me eleven). I didn’t tell my friends about any of it. I went to class two days later. All the mental doubt and anger you describe, the horror, grief, love… all hold a candle to my experience. Thank you for being vulnerable and sharing your story. I wish I’d known you when I was 20 and walking around Morgantown asking the cold wind for help.

    1. Christy,

      What a powerful story. I am so glad to know you were able to find the care you needed. It’s important that we remain honest about the reality of health care for women in WV and in this country. When we are pregnant we are vulnerable, we must rely on doctors to tell us the truth. I’m sorry that didn’t happen for you.

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