I once took a drive on the back roads from Brooklyn, New York to Pittsburgh, Pennsylvania. Cruising 55mph from small town to small town, I couldn’t help but notice all the billboards advertising treatments for illnesses and ailments: back pain, fibromyalgia, asbestos exposure, cancer. This wasn’t the America I was used to. Bombed-out Main Streets, sad sack bars, Wal-Mart, and lots of pain pills. It was depressing.

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I grew up privileged: private grade school, high school and college. I got a master’s degree from Columbia University. I have a trust fund. But I wasn’t totally unfamiliar with this other America. Somewhere deep inside, coal runs through my blood. When I think about where I come from, I don’t think of the suburbs of Washington, D.C. I think about my grandfather Angelo Rotondaro, an immigrant coalminer from Scranton, Pennsylvania.

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Growing up, hearing stories of grandpop’s life – how he emigrated from Italy at the age of five, left school in fourth grade to become a breaker boy in the anthracite coal mines, where he worked his entire life to provide for his family – he became like a saint in my life. I loved and revered him, even though we never met. He died before I was born.

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[caption id="attachment_69782" align="alignnone" width="500"] The author’s grandparents on their wedding day (left) and with their children (right). (Photos courtesy Vinnie Rotondaro)[/caption]

So it was always a little strange to visit family in Scranton for Easter as a child, peer out the backseat window and think: Grandpop’s city looks cloudy. Even when it was sunny, Scranton had a gloomy feel. It didn’t back when my dad was growing up nearby in Pittston, Pennsylvania. The area was hardworking and quintessentially American, populated with immigrants, jobs and optimism. These were communities built on the American Dream.

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But now all that optimism is gone. Today Scranton is a “Rust Belt” town. Its residents are no longer “blue collar,” strong and proud. They’re “white working class,” almost a pejorative. What happened? There is something going on in this country that “deplorable” alone cannot explain.

In 2015, Angus Deaton, winner of that year’s Nobel Prize in Economics, and himself the grandson of a British coalminer, co-authored a study with Anne Case showing that middle-aged American working-class whites have been in the throes of an unprecedented 22 percent rise in death rate since 1999, largely attributable to alcohol, drug abuse and suicide. The change “reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround,” noted the study, explaining that “Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work … all point to growing distress in this population.”

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In attempting to understand the forces that the led to the election of Donald Trump, it is vital to understand the world of pain in which many white working class Americans live. It is a world in which “people are not proud of their jobs, not proud of their house, not proud of the future they see for their children,” as a relative of mine from Scranton put it; a world that drug makers continue to saturate with opiates even as overdoses surge. This is a world that too many other Americans do not seem interested in understanding.

Interviews with pain researchers and social critics – conducted in advance of the election – paint a picture of white working-class life that is riddled with pain, chronic and persistent, physical as well as emotional. If left untreated, pain roots itself into a person’s psyche, compounding or even creating somatic illness through stress and depression. What happens to a culture or a people that has been dealing with a painful socioeconomic reality – the pinched nerve of economic decline, social marginalization, offshoring, automation, globalization – for 30-plus years with no end in sight? What happens to a group of Americans who, unlike others, were once fortunate enough to believe in the American Dream, only to see that dream shatter before their very eyes?

* * *

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Earlier this year, a previously little-known author named JD Vance published the memoir Hillbilly Elegy, covering his Scotch-Irish ancestry and his childhood move from Jackson, Kentucky, to Middletown, Ohio. He writes about the struggles of his family; of his dysfunctional mother and distant father; of his “mamaw,” or grandmother, who provided the stability and safety that he credits with saving his life; of his rise through the Marines and out of the downward spiral that claimed so many he knew growing up; and of his unlikely cultural emigration into the ranks of the liberal elite, attending Yale Law and becoming a principal at an investment firm in San Francisco.

The book became a New York Times bestseller and now serves as a kind of Rosetta Stone for intellectuals who want to know about the white working class. Vance characterizes the white working class as people dealing with “bad circumstances in the worst possible way.” I asked him if it would be fair to characterize his book more generally as a story about pain.

“I definitely think there’s an element of that,” he said. “As I write in the book, my mom first turned to prescription opioids after my grandfather died … and in some ways, opioids, whether it’s heroin or the prescription stuff, it’s the way of coping with a variety of different problems that they have, whether that’s emotional pain, or whether that’s cynicism or hopelessness, which I guess is a form of pain.”

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I brought up the concept of psychological pain, of pain as a state of mind. “Absolutely,” Vance responded. “What’s fundamentally going on in these communities, in my community, is a fear of the future. A sense that things are extraordinarily unstable, and that maybe tomorrow is going to be worse than today, and yesterday. That is a state of mind, and it sort of takes on a life of its own. It wants you to feel so pessimistic about the future that it starts to color everything you think and everything that you feel.”

According to the American Psychological Association, “people often think of pain as a purely physical sensation. However, pain has biological, psychological and emotional factors. Furthermore, chronic pain can cause feelings such as anger, hopelessness, sadness and anxiety.”

It doesn’t take a rocket scientist to see how Donald Trump exploited economic woe and cultural pain to fuel his presidential run. In a country where 51 percent of all American workers make less than $30,000, Trump dominated the “white inequality” vote. A recent Brookings Institution analysis found that the 2,600-plus counties Trump won combined to generate only 36 percent of the country’s economic activity last year, while the fewer-than-500 counties Clinton won combined to generate 64 percent.

Trump also won the “oxy vote.” A study out of Pennsylvania State University documented Trump’s strong support in counties where opiate overdoses are rife. Speaking to Business Insider, the study’s author, Shannon Monnat, explained: “I expected to see it because when you think about the underlying factors that lead to overdose or suicide, it’s depression, despair, distress, and anxiety. That was the message that Trump was appealing to… such a sense of hopelessness that it makes sense they would vote for massive change.”

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Scores of traditionally blue counties that have been hit hard by the opiate epidemic flipped red, according to research conducted by historian Kathleen Frydl. In Pennsylvania, where fatal drug overdoses increased fourteen-fold between 1979 and 2014, “only four of 33 high-overdose counties” failed to flip from Democrat to Republican.

The day before the election, Trump held a rally in Scranton. He spoke in a manner that seemed designed to appeal to people in pain, and gave that pain an immediate sense of context. “Hillary has openly stated that she wants to shut down the mines and ban shale production,” he said to a chorus of boos (it was an oft-repeated campaign claim that fact-checkers ruled half-true at best). “You folks can’t be too happy about that.”

Scranton and the rest of Northeastern Pennsylvania, or NEPA, used to vote solidly blue. But around the time that the effects of globalization began to kick in, the party drifted away from blue-collar whites. Democratic leaders began targeting “professional” workers, like doctors and lawyers – many of whom previously voted Republican – and emphasized outreach to “minority” voters and women to provide a new base for the party. Working-class whites, once part of the in-crowd, were now out. Their votes were still wanted, of course, but the bloc brought baggage and was no longer essential, so the Democrats stopped knocking.

Trump exploited this to maximum effect. He took the truth and twisted it. He told his audience that they had been screwed. And in many ways, they have. The trade dealscrafted in globalization’s wake have been anything but kind to the working class.

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In 2015, the middle class ceased to be the country’s economic majority, representing a shift of historic proportions. In cities and states across the country, people were voting for increases in the minimum wage by huge margins and across party lines. Trump and Bernie Sanders emerged out of nowhere, drawing giant crowds and captivating swaths of the electorate. The writing was all over the wall. But in the end, only the Republicans picked an outsider with populist appeal.

At the rally in Scranton, Trump played with his audience’s emotions. He told them they had been duped and dumped by the Democrats. The chants of “lock her up” carried a quality of contempt that might otherwise be reserved for a cheating ex. He promised to unleash an “energy revolution” in Pennsylvania. “We will put our miners back to work and we will put our steelworkers back to work,” he said. Nevermind if any of it is possible. Cheers and cheap catharsis. He told the people what they wanted to hear. He eased the pain, if only momentarily, like a pill.

[caption id="attachment_69783" align="alignnone" width="611"] A billboard leading into the town of Shamokin, in Northumberland County, Pennsylvania. Since 1930 the town’s population has dropped by half as industry declined. In recent years the anthracite mines and associated businesses have closed, depressing the town further. Photographer Joel Anderson explores the coal mines near his Pennsylvania hometown for his project “Hard Coal.” “What I assumed were tough jobs of economic necessity revealed themselves as an intricate brotherhood going back generations, and deeply woven into the community,” he explains.[/caption]

“You have one day to make every dream you’ve ever dreamed for your country and your family come true,” he said. “You have one magnificent chance to beat this corrupt system and deliver justice for every forgotten man, every forgotten women and every forgotten child in this nation.”

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The lure of Trump’s message was that of rolling back time: of erasing all the hurt, and going back – back before you were forgotten, back when you had something to believe in, back when you were strong.

* * *

By any account, my grandfather lived a very hard life. He and my grandmother Rose lost two children, one in infancy and one at the age of six. Grandpop himself died of black lung, which is a terrible way to go, a form of suffocation caused by a lifetime of exposure to coal dust.

“The life of a miner is brutal,” my father told me. “Brutal. But it was for him a way of providing for his family. So it was hard, but it was purposeful.”

My father was the second Rotondaro to go to college; he earned a master’s degree and PhD. We Rotondaros have done well for ourselves. We are journalists, researchers, doctors and lawyers. “We made it,” my dad said. For my grandfather, “having a hard life, that was how you provided well for your family,” he said. “It wasn’t just a matter of putting food on the table – that was part of it – it was also a question of, you could reach, you could aspire, you could move out.”

[caption id="attachment_69780" align="alignnone" width="500"] Left: The author’s father graduating college. Right: His grandfather wearing a hat showing support for Jimmy Musto, a Democrat in Pennsylvania’s House of Representatives. (Photos courtesy Vinnie Rotondaro)[/caption]

I asked my dad if Grandpop ever felt beaten down by life. Hardly, he said. “Here was a guy who had the most brutal job imaginable, a job that was as dangerous as virtually any job in America, and he would come home and he would garden roses.” The flowers, my dad told me, provided “that extra bit of beauty in his life that he needed.”

Grandpop believed in the American Dream. “People like my father believed that you come here, you work hard, and you can get ahead, or at least your kids can get ahead,” my dad said.

“I think that the sense of hopelessness that exists in some of the communities you’re talking about,” my dad added, “is there after so many years of being ignored, if you will, by the political parties, by the elites. We did not have that in my day… We felt powerful … We could take on any problems, any obstacles.”

“I think of pain for so many blue collars today as something like Greek tragedy,” he said. “It’s a fall from a high place to a lower place. With blue collars, with miners, with people who feel like they have no options, it’s like being in an abyss, and you can’t climb out. You’re not yourself anymore… To me, that would be a brutal kind of pain, one that would certainly have deep psychological effects, and one that, I imagine, would have physiological effects as well.”

* * *

I know how pain can affect your mind. When I was sixteen I had a major back operation: correctional surgery for scoliosis. My spine had wandered sixty degrees in the wrong direction and the docs said they needed to wrangle it back. I can still remember the anesthesiologist looking down, sticking me with the needle and counting back from three as the world spun away. The surgeon broke through my ribs, severed nerves, dislocated my spine, fused vertebrae and slapped an iron rod on top. I’ve been dealing with pain ever since.

Daily pain. Standing in line at the store pain. Sitting down to dinner pain. It’s just part of my life. For a long time it didn’t really bother me. I felt invincible in my twenties. I’d play basketball, lift weights and drink till I dropped, wake up and do it again. When I was 23, I pulled a muscle in my lower back, and didn’t take any time to let it heal. It nagged, but I just blasted through. I was able to. But things changed when I hit thirty. That muscle in my lower back was hurting more and more. I was living in New York City – fun enough – but all of a sudden it felt like the city was living on me. I proposed to the love of my life, Audrey. Two months later her father died, out of the blue. It was crushing. I felt like I had to be Atlas. I felt like I had to hold up the world, but my back was killing me and I didn’t want to admit it. Something inside me broke.

It wasn’t my spine. I saw my old surgeon and took some x-rays, and he assured me his work was solidly in place. But the pain was still there, relentless, growing; tension in my body, tension in my mind. Life wasn’t as fun anymore. The pain got in my brain.

I asked Kim Gorgens, a neuropsychologist specializing in brain injuries at the University of Denver, about how a person’s psychology can influence their experience of pain.

“It is really a false dichotomy to think that we can separate the psychological from the physiological,” she said. “There is a huge emotional or psychological component to the physical experience of pain. It can exaggerate the experience of pain … In psychology, we think of pain almost as an emotional state.”

When pain gets in your brain, you get negative. You stop seeing things clearly, and problems begin to multiply. “It is your physiology,” Gorgens says. It results in “higher levels of atherosclerosis [blocked arteries], the risk for stroke is much higher – and these are just a few examples out of a thousand.”

Could this explain the economist Deaton’s documented 22 percent death rate increase among the white working class? Gorgens thinks so. “Their occupational exposure is related to increased risk for disease,” she says, “but there is likely this other layer, which is that the experience of feeling helpless is related to the increased incidence of disease, and increased susceptibility to disease.”

Social isolation also plays a role. Think Trump’s appeal to the “forgotten man and woman.” As Emma Sepal, of Stanford University’s Center for Compassion and Altruism Research, has written, “…loneliness hurts. A brain imaging study showed that feeling ostracized actually activates our neural pain matrix.”

[caption id="attachment_69781" align="alignnone" width="598"] “Buck,” who only provided his first name, is a co-owner with his father of a mine that employs five people in Schuylkill County, Pennsylvania. The old mine had been worked for thirty years when the coal seam ran out. They moved equipment a quarter-mile away to dig exploratory trenches.[/caption]

I reached out to Greg Hood, a Kentucky-based physician who’s been researching the role that loneliness plays in opioid addiction in Appalachia – which his findings suggest is home to the combined peak of opiate death and self-reported loneliness.

“We know that social isolation has become as potent a cause of death as smoking fifteen cigarettes a day,” he told me, “and not just depression and addiction, but dementia, hypertension and suicide, all of which are more prevalent among isolated, lonely people.”

“Appalachia in particular is geographically isolated and is increasingly economically isolated,” he said. “There are a lot of injuries from the mines, and now with the administration’s priority on not using coal, there have been massive job losses … and so you have these core, injured people without any new opportunities, and they’re stuck. They can’t go anywhere.”

So how do you break this cycle?

David Bresler, a pioneering researcher in the field of pain management, explained how chemicals in your brain can affect a patient’s tolerance for pain.

“In pain medicine, morphine is our reference standard,” said Bressler. “We compare everything to it. So Dilaudid, which is a pretty potent narcotic, is ten times stronger than morphine. Fentanyl, what killed Prince, is one hundred times as powerful as morphine… But what if I told you that inside your brain is a neuropeptide called Beta-endorphin and that that peptide is thousands of times more powerful than morphine?”

Bressler said this likely explains fluctuations in pain tolerance. “Why don’t soldiers who are injured in battle complain the same way that civilians with similar injuries do? Why does the football player break his arm and not know about it until he gets back into the locker room? Why are people given sugar pills and told they’re powerful pain medicine, and get pain relief? All of these things probably cause the brain to secrete endorphins, which raise their tolerance for pain.”

Bresler advocates techniques like meditation and guided imagery to raise tolerance for pain. (In my own experience, meditation and breathing exercises have proven key.) He said he has patients with horrific injuries who utilize these techniques and take no pain pills at all.

“If you think about it,” he said, “pain is telling you that something is wrong. It’s trying to get your attention, that something needs to change.

“And emotional pain, depression, it’s really the same thing. I see people who have no tolerance to even the slightest disappointment, and then people who have had tragedy after tragedy heaped upon them, and they’re still chugging away.”

“There’s probably the same amount of pain everywhere,” Bresler said, “but less tolerance to it in the areas that have all the drug mills and chiropractors and people promoting pain medicine.”

It makes me think of those billboards on the Pennsylvania backroads. “Whatever you give attention to grows,” he said.

* * *

I am convinced that my Grandpop was able to rise above pain that otherwise might have ruled his life not just because he was tough, but because he believed his work meant something – he believed in the American Dream. And I am convinced that the perceived death of that dream is what is driving the decline of working-class whites.

In Hillbilly Elegy, Vance writes about the development of his own sense of optimism as a young adult: “That feeling I had in college – that I had survived decades of chaos and heartbreak and finally come out on the other side – deepened. The incredible optimism I felt about my own life contrasted starkly with the pessimism of so many of my neighbors. Years of decline in the blue-collar economy manifested themselves in the material prospects of Middletown residents. The Great Recession, and the not-great recovery that followed, had hastened Middletown’s downward trajectory. But there was something almost spiritual about the cynicism of the community at large, something went much deeper than a short-term recession.

“To understand the significance of this cultural detachment you must appreciate that much of my family’s, my neighborhood’s, and my community’s identity derives from our love of country…If mamaw’s second God was the United States of America, then many people in my community were losing something akin to religion.”

Surveys show that working-class whites are the most pessimistic people in America. Is their Dream dead? It would hardly be the first time that a people’s dream has died in this country.

About a year ago I travelled to the Cheyenne River Indian Reservation in South Dakota – not too far from Standing Rock – to report on the present-day effects of “the Doctrine of Discovery,” a centuries-old justification for dominating native people and landscapes with origins in papal bulls.

Over the course of my reporting, I learned from a nun who works on the reservation as a social worker about the phenomenon of “intergenerational grief,” or the effect of the past on the present, and how trauma gets inherited. In Cheyenne River, I met a 65-year-old man named Zigmund Hollow Horn. As a child, Zigmund had been demoralized at a Catholic boarding school, where his language and religion were banished, and he received physical beatings. Friends received the same treatment at state-run, Protestant-inspired boarding schools.

“I’m a cancer patient,” Hollow Horn said, “I wear a heart pacer. I’ve got blood clots. I’m diabetic, and my kidneys are failing. That is where I am at today. And I just, I’ve been in pain ever since I can remember, since I was four or five. And today I’m emotionally disturbed, and physically in pain. Day in and day out. I go to bed with it.”

The American Dream never bothered to consult with the dreams of Native Americans. Instead, white America felt it needed to crush those dreams so its own could grow. “A people’s dream died” at the Battle of Wounded Knee, the Lakota holy man and prophet Black Elk said. “It was a beautiful dream.”

Today, Indian Country is beset with alcoholism, drug abuse and suicide, just like white working class America – and this is where the cognitive dissonance becomes deafening.

* * *

When my grandfather came to this country, he was called a “dago” and a “wop.” But because his skin was white and he played by the rules, he was able to advance up the economic ladder. But black people couldn’t, brown people couldn’t. They were denied, systematically stripped of their rights.

Many of my friends can’t see past the racism of Trump. And neither can I. Anyone who exploits the kinds of emotions he does should never become president. But simply saying, “Trump won because of racism,” misses the bigger point.

I asked my dad what relations were like between blacks and whites when he was growing up.

“We didn’t have any black people in Pittston,” he said. “Pittston, Dupont, Scranton, Wilkes-Barre. They were eastern and southern European heritage. Irish, Italian. They were immigrants. Sons of immigrants.”

I asked him about racism in Scranton, and he told me a story I had heard a thousand times.

“I had brought a colleague home for dinner one evening – a black professor at the University of Scranton. Lou Mitchell. A neighbor came in the next day and complained about bringing – I’m sure he used the term, a ‘n*gger’ – into the community. And pop just threw him out of the house. Told him never to come back.”

Okay, so Grandpop wasn’t racist. But were others?

My dad told another story, one I hadn’t heard before. He and Lou went to an Italian bar in Dunmore, Pennsylvania, to have a bite. “When we got up to leave, the bartender called out my name, because he knew me. He picked up the glass that Lou had drank from, and he broke it to symbolize: I don’t want any black guys in my place. Well, that was the last time I ever went in there.”

Matt Golden, a 39-year-old second cousin of mine from Pittston, who has lived in Los Angeles and spent significant time in New York City and Denver, said that racism still exists today in NEPA, but not in the way one might expect. Rather than KKK white supremacy, it’s more a combination of holdover ethnic “ball busting,” in which Irish are drunks, Italians are hot-headed criminals, Poles are dumb and blacks are lazy, and misplaced or irrationally angry. He didn’t say that racism is why Trump won here. Instead, he characterized the Trump vote in NEPA as the, “Burn it down vote.”

“They want to see it burn. Political arson,” he said. “The system of special interests, corruption, globalization, corporate greed, you name it. They just want to see it burn. It is like rooting for the hurricane to slam into the coast.”

“Trump didn’t make a rational play,” he continued. “He was appealing to the emotional nature of people who are hurting.”

He likened Obama’s victory in 2008 to a “shot of B-12” that didn’t last. “And now Trump’s like a Big Mac on the day you have a hangover. You know it’s not good for you, but it’s sort of what you’re craving.” Culturally, he said that people in NEPA feel a “sense of change, and it’s foreign change, because it’s not something that you touch and feel. It’s this different version of America. All we see are jobs going away, and people getting poorer, and ‘now you’re changing our culture.’ We’re not seeing any of the benefits of globalization, you know?”

[caption id="attachment_69779" align="alignnone" width="651"] At the home of longtime miner David A. Lucas, a Trump campaign sign stands alongside a monument to coal miners who have died from the black lung in Hegins, Schuylkill County.[/caption]

Vance expressed a similar sentiment – that economic pain, not racism, explains Trump’s support among most of the white working class. “Racial anxiety comes in many shapes and sizes,” he said. “There are the David Dukes of the world,” and then there are those “who don’t understand why people talk about the problems in black communities so much. Maybe they see a protest against police brutality and think, ‘Those thugs need to get back inside.’

“Do I think those people have the right views of the world? Are they the views that I have? No. But I also think that with better political dialogue, those sorts of people could be made to feel a little more sympathetic to other people in our society. And if anything, calling them a racist just pushes them further to the David Duke side of the world.”

“Look,” Vance said, “here’s the day in the life of a working-class white person in Southern Ohio. You wake up, you’re looking to find a job, you open up the newspaper and you see that another kid has died of a heroin overdose. You look down the street and you see that another house is dilapidated. You go to the local store, and it’s closed down and been replaced by a pawnshop. [These people] feel pretty ignored by pretty much everyone. They feel judged by everyone. And even this little spiel doesn’t capture all of the feelings and all of the complexity. And so, is there an element of racism that is part of this complexity? Yes, but there is a lot else going on.”

* * *

Folks in NEPA are “feeling vindicated right now,” my cousin Matt Golden told me. “They’re pretty fired up. I think there’s a probably a little sense of hope for people who haven’t had much.”

Will it last?

Far from draining the swamp, Trump is stacking his cabinet with corporate execs and Wall Street fat cats. Structurally speaking, he is inheriting an economy that has added millions of jobs since Obama took office, but one where nearly all the gains have passed the white working-class by.

[caption id="attachment_69778" align="alignnone" width="661"] Coalminer Bob Shingara taking a smoke break during the closing and decommissioning of the old Little Buck Mine. This building was soon torn down, and the miners hauled their huge equipment away to a new location. His family has been mining for three generations and most of his uncles, brothers and nephews are miners.[/caption]

As Edwardo Porter writes in the New York Times, “Many of the jobs created since the economy started recovering from recession were in service industries, located primarily in large metropolitan areas – not in small towns and rural areas where the factories that once provided steady good jobs were either shuttered or were retooled to replace workers with machines.”

“Can Mr. Trump do more for his supporters than previous presidents?” he writes. “It’s doubtful. Most of his promises are empty. No matter what he does, he cannot bring back the coal jobs of yore or the old labor-intensive manufacturing economy. Some of his proposals – walling off the country with protective tariffs, for example – would make things worse for the middle and working class, while tax cuts for the wealthy will exacerbate inequality rather than lessen it.”

If Trump won’t save them, is there any way for the white working class to dig itself out of this hole?

* * *

On the morning of January 22, 1959, my father was studying for an exam at the University of Scranton when a newsflash came over the radio announcing that there had been a flood-in at the mines.

My Grandpop and others had been working dangerously near the Susquehanna River – illegally near the river, ten higher-ups were eventually indicted, and six went to jail – when the roof of the mine shaft caved in. Hundreds of thousands of gallons of cold water began rushing through the galleries. Twelve miners died in the first flash of the flood. My grandfather, alongside 25 others, wandered in the dark for hours on end, searching for higher ground. Up above, railroad cars were being dumped into the whirlpool in a futile attempt to plug the riverbed. As night began to fall, my grandfather’s group happened upon a dim beam of light. It was a mineshaft shooting straight up to the outside. In an act of preternatural athleticism, one of the miners climbed it, and called for help.

“It was pitch dark at night,” my dad recalls, “and we heard that a group of men had been rescued. We went immediately to the Pittston hospital, because we didn’t know who had been rescued. We got there, and we found my father.”

He was worn-out but uninjured. It was the last day he ever worked in the mines.

Anyone who deals with chronic pain knows that there are times when it comes on so strong that it can feel like you are down in the mine, with the water coming in. There are times when it can feel like the world is caving in on you.

I asked the poet Thomas R. Smith about how the shared experience of pain influences white-working class life. He said, in essence, that pain is demeaning. “I myself come out of the white working class, northern Wisconsin division,” he wrote in an email to me. “So I have seen first-hand the decline that’s taken place…around my home town and environs as well as nation-wide. It must have been ten years ago that I first heard one of my brothers describe our family as ‘white trash,’ a term I never would have dreamt of applying to us.”

Like many, Smith pointed to economic woe as a cause of this downward trajectory. “What we probably need is to address the problem of income equality first of all, to reduce the material need and lack of opportunity that is driving so many families into poverty and shrinking their former providers’ self-esteem,” he wrote.

But he added, “part of the problem is certainly that there are a large number of our fellow citizens who simply cannot imagine a place for themselves in the world as it’s come to be in the 21st century. Imagination is important, and at this historical moment a failure of imagination can be fatal to our hopes for a just and equitable future.”

In my own experience dealing with pain, there were two things I needed to do before healing took hold. One, I needed to treat my body with more respect. I needed to ditch my hard-charging ways, which meant less alcohol, more sleep, healthier food, deeper breathing.

Two, I needed to tell myself new stories. I needed to shed my old skin, and evolve.

Simply admitting to myself that I was in pain was liberating. Letting down my guard, being vulnerable and open enough to admit that the pain hurts, that it makes you feel lonely, and then holding that opening – not letting let some other emotion rush in to fill the void – it opened a shaft of light in my own consciousness that I was able to climb. It took a few years, and there are still days when my back kills me, but I got the pain out of my brain.

When I look back on it, much of the pain stemmed from the shame I felt that I shouldn’t be having it at all. Grandpop suffered so I didn’t have to. I should have been stronger. I should have been more resilient. I needed to free myself from the guilt. The guilt was the pain. The guilt was depression.

I was able to climb my way out. But I have had every advantage. I have traveled the world, and attended the best schools; I was raised by wonderful, loving, wealthy parents. It’s not fair. I am the fruit of the American Dream, and the vine is dying. How do we breath new life into it?

My cousin Matt asked, “What do you think about the idea of a basic living income? What if, culturally, [the change] needs to be away from the sense that self-esteem is based on your job? What if we need to finally kill the puritan work ethic? Your sense of self worth shouldn’t be based on what you do for a living. We’re all running around, we’re pushing ourselves to work harder, and we’re being away from our kids more, marriages are falling apart… We’re not doing any of those other things that don’t have to do with work, and that maybe made us happier, or maybe gave us more self-satisfaction and a broader definition of who we are as people.”

What if, by trying to honor my Grandpop’s generation through imitation, the white working class forsakes the gift given by it? Those manufacturing jobs aren’t coming back. Those coalmines aren’t going to reopen. And even if they could, they shouldn’t. Climate change is real.

How will white working-class Americans transform their pain into something meaningful, the way my grandfather did?

It will take change from within and without, structural as well as spiritual. Maybe that will mean that we establish a basic income, with the haves giving back to the have-nots in this cruel “new” economy. Maybe it will mean that the Democrats get back to their roots, and embrace the white-working class, instead of ignoring them. Maybe it will mean better education on how to deal with pain – less pills and more mental tolerance. Maybe it will mean all of these things. Ultimately, it will take an act of imagination, both from the white working class as well as the rest of the country. Somehow we need to learn how to dream together, past our bubbles. Somehow, we need to find a way to transform our pain into hope.