Beth Macy’s newest book had its origins in a remark overheard by her dying mother’s bedside.
“My evangelical sister Cookie and I were visiting Mom in her memory care unit,” Macy said. “There was a hospice nurse there. It was the Saturday after the 2020 election. Suddenly that afternoon, the hospice nurse’s phone blinks, and she goes, ‘Ah, they’re calling it for Biden’ — although she said ‘Bidden,’ which was weird — and my sister goes, ‘It’s fraudulent. You wait, he won’t win.’”

Her older sister’s certainty that news of Biden’s victory would prove phony stunned Macy into silence. An award-winning writer for The Roanoke Times turned author of the nonfiction bestsellers “Factory Man” and “Dopesick” — itself the basis for a Hulu limited series that earned an Emmy for star Michael Keaton — she struggled to process how her sister’s worldview could be so stunningly different from her own.
Her latest title, “Paper Girl,” might at first sound to Roanoke Valley readers familiar with Macy’s decades of reporting like a straight-up autobiography — and the name does come directly from her job delivering papers as a young girl in her hometown of Urbana, Ohio. However, the subtitle, “A Memoir of Home and Family in a Fractured America,” provides a clue to the book’s scope.
Published by Penguin Random House, “Paper Girl” launches worldwide Tuesday. “The book takes place in my hometown, but my hometown is really a microcosm for the rest of America,” Macy said. “I think this is the most important issue of our lives, showing what’s happening with this country now — and I didn’t know it was going to go this way when I started it.”
During an interview in her Southwest Roanoke home that she shares with her husband, filmmaker and educator Tom Landon, and their energetically friendly dog Pippa, the 61-year-old author spoke about the shock and puzzlement she felt that day in the hospice. “Of course, that doesn’t sound unusual now, because we know how divided we are. But back then, it took a while to figure it out,” Macy said.
The month after Biden’s election victory, Macy recounted the incident in an essay in The New York Times called, “If I’d Stayed in My Hometown, Would I Be a Trump Voter?” In the essay, she reflected on the circumstances that allowed her to become the first in her family to earn a college degree, which was her ticket to leaving her hometown on a path to becoming a journalist.
“I lucked into getting a bachelor’s degree during that brief window in our nation’s history when it was possible for a promising poor kid to get a degree; probable, even, that she might join the middle class,” she wrote.
During the short time that the newspaper kept her essay open for online comments, the responses floored her. Hundreds of readers shared their own anecdotes of families split apart by political rancor and discussed the hard choices of accepting radical differences or cutting ties. “I thought, ‘Wow, this could be my next book,’” Macy said. “My agent suggested that, ‘Rather than just write about polarization and telling your own personal story, why don’t you actually go home and research how your hometown has changed in the 40 years since you left?’”
‘Level of trauma’
In the book, Macy recounts growing up poor, with an alcoholic father and a supportive mother who struggled to keep the bills paid. She describes her childhood home as the shabbiest on her neighborhood block. Yet a Pell Grant covered the entire cost of her college education — impossible now, as the program’s funding, slashed during the Reagan administration, has fallen well behind rising tuition costs. “Now the average Pell Grant pays just 30% of a poor kid’s public school tuition,” she wrote.
Upcoming: ‘An Evening with Beth Macy’
When: Oct. 16, 6 p.m.
Where: Charter Hall, City Market Building, 32 Market Square S.E., Roanoke
Program: Panel, “Roanoke’s Foster Care Crisis,” 7 p.m.; Beth Macy presentation, 7:30 p.m.
Admission: $40. Tickets include a signed copy of “Paper Girl.”
Proceeds support the Great Expectations program serving former foster care youth at Virginia Western Community College.
When she returned to Urbana to conduct interviews, she met high school students whose circumstances and abilities could be compared to her own when she was the same age, and found the obstacles they faced to be far more dire than those she overcame. As a result, “Paper Girl” revisits nation-altering issues explored in her earlier books, in ways that she expected and in ways that surprised her.
“I knew globalization was going to play a role,” Macy said, referencing her bestselling 2014 debut “Factory Man.” Macy points to free trade agreements initiated under the Clinton administration that sent millions of well-paying manufacturing jobs overseas, and offered nothing substantial to take their place, as a prime reason why the Democratic Party has lost the trust of communities in rural America.
Macy knew well that Urbana, once anchored by a prosperous family-owned manufacturing business, had endured the same hollowing out of bedrock middle-class income jobs she documented in “Factory Man.”
“But I didn’t think I was going to be writing another opioid-related book,” she said, referencing “Dopesick” and its sequel “Raising Lazarus,” which chronicle the greed-driven causes and the devastating effects of the opioid crisis in Appalachia, and shine spotlights on the people who tirelessly strive to help those plagued by addiction despite daunting odds and scant government support.
“Paper Girl” is “very much another opioid-related book, because that’s what the research, the interviews, bore out,” Macy said. In addition to chronicling Macy’s own experiences and those of her family, the book follows the fortunes of numerous others in Urbana, especially Silas James, a talented college-bound student whom Macy’s sources identified as someone who could be thought of as a younger version of herself.
Yet in the 2020s, Silas’ circumstances are harrowing in ways that Macy’s were not. “Silas was homeless for most of his junior and senior years,” she wrote in “Paper Girl.” “His mom was in jail on another round of drug charges, and his dad died of a methadone overdose, combined with COVID and a heart blockage, his junior year.” Silas soon ended up becoming the guardian and de facto parent for his two teenage half-siblings. “As I would soon learn, Silas’s level of trauma is not an outlier among Urbana students today.”
On Oct. 2, a new op-ed from Macy appeared in The New York Times, “Why Can’t Working-Class Kids Make Their Way Out of Ohio?” The piece almost doubles as an epilogue for “Paper Girl,” providing an update on the fate of Silas James.
Elaborating on how he’s faring might, arguably, constitute a spoiler — however, Macy said, “He’s doing good.” James joined her for a book launch event held Sunday in Urbana.

‘Mind and notebook open’
Macy’s reporting dives deep into a complex web of economic woes, social ills and inadequate or even downright disastrous governmental policies that have led to the widespread embrace of conspiracy theories such as those propagated by QAnon, as well as the rejection of fact-checked stories from established news outlets. She discusses how the collapse of the newspaper industry has led to populations galvanized by anger-triggering national controversies while completely unaware of serious issues troubling the communities where they live.
She also shares her attempts to bridge seemingly unbridgeable gaps with her own politically conservative family members, and how some efforts fail and some succeed. “If we’re going to get beyond this division,” she said, “there are techniques we can learn, and we have to start with people we know.”
Since becoming a full-time author, Macy has engaged in activism as well as advocacy. In a recent article on her Substack blog, she described ways to give help to immigrant families living in fear of U.S. Immigration and Immigration and Customs Enforcement raids. “I still do journalism, but writing books and op-eds isn’t the same as newspapering,” she said. “I’m my own boss. Where we are now as a nation is wholly unprecedented, and so I’m stepping more into a volunteer and activist role.”
There’s a possibility that this role could lead to her running for office. In another Substack column, she described 6th District Congressman Ben Cline as “the Republican No Show who refuses to hold a town hall.” (He’s since held one, in Lexington).
“People have asked me to consider” challenging Cline in the 6th District, she said. “I’m researching my options.”
Another much higher-profile Republican figures heavily in the potential reactions to “Paper Girl.” With its examination of the ramifications of poverty and the opioid crisis in a working-class Ohio town, the book possesses traits in common with “Hillbilly Elegy,” the runaway bestselling memoir by Vice President JD Vance — who is mentioned a handful of times in “Paper Girl” and characterized as “the not quite-hillbilly reared just down the road.”
“I’ve written about the similarities and differences between me and Vance,” Macy said, pointing toward another New York Times op-ed, “I Grew Up Much Like J.D. Vance. How Did We End Up So Different?” Early readers told her they thought of “Paper Girl” as a response to Vance’s memoir, “in that it deals more with the systems that have historically ended up marginalizing people in Appalachia and other left-behind communities — globalization, the government’s failure to prevent or ameliorate the addiction crisis.”
Rebutting Vance, though, was not the goal. “I went into this project with my mind and notebook open. I just wanted to plumb how my hometown became a place I no longer recognized.”

