Appalachia Floods Threaten Years of Rising Overdose Deaths

There is a gate across this road, and it is called the flood warning system, or the emergency relief fund, or the county health clinic, and the modern administrator, looking at the budget, says “I see no reason for this; the flood was two years ago; let us remove it.” The wiser man says “The flood was two years ago. That is exactly why I will not let you remove it. Go away and think about what happens in the second year, and the third, when you can no longer see the water.”

The study in question - and I take the study’s own word for its authors, though I have learned to distrust the men who invalidate research they dislike by simply pronouncing it invalid, a trick fashionable among financiers and bureaucrats alike - tells us that the people of rural Appalachia face a rising risk of fatal overdose for years after the flooding recedes. The conventional mind finds this puzzling, because the conventional mind thinks of disaster in the tense of the news bulletin: the water rises, the water falls, the story ends. But the fence was never protecting against the water. It was protecting against what the water reveals.

Consider what actually happens when a flood strikes a hollow in Appalachia. The pharmacy floods and does not reopen. The clinic’s records are ruined and the clinic itself, perhaps, is not rebuilt, because rebuilding is expensive and the flood was, after all, two years ago. The mill or the mine that gave a man his reason to get up closes for good, not because of the flood exactly, but because the flood was the excuse everyone needed. What is left is a man with a shoulder that never healed right, a pharmacy forty minutes further away than it used to be, and a grief he has not been permitted to name because grief, in that country, is not a word men use. The overdose that kills him in year three is reported as a private tragedy, unconnected to the public disaster, and this is the great convenience of measuring catastrophe by the news cycle: it lets the fence come down quietly, one plank at a time, while everyone congratulates themselves that the emergency is over.

The reformer who wants to close the clinic because the flood has passed has confused the symptom with the disease, which is precisely the confusion the fence was built to prevent. He did not ask why the fence was there. He assumed, as clever people do, that if he cannot presently see the water, there is no water. Somewhere in that hollow a man is still drowning, two years late, in a flood that officially ended in the first week.