If you were a fan of Hillbilly Elegy by J.D. Vance, then debut author Sarah Smarsh’s memoir, Heartland, deserves to be on your radar too. Smarsh comes from five generations of Kansas wheat farmers and worked hard to step outside of the vicious cycle that held back the women on her mother’s side of the family: poverty, teen pregnancy, domestic violence, broken marriages, a lack of job security, and moving all the time. Like Mamaw in Vance’s book, Grandma Betty is the star of the show here: a source of pure love, she played a major role in raising Smarsh. The rundown of Betty’s life is sobering: her father was abusive and her mother had schizophrenia; she got pregnant at 16; and she racked up six divorces and countless addresses. This passage about her paycheck and diet jumped out at me:
Each month, after she paid the rent and utilities, and the landlady for watching Jeannie, Betty had $27 left. She budgeted some of it for cigarettes and gas. The rest went to groceries from the little store around the corner. The store sold frozen pot pies, five for a dollar. She’d buy twenty-five of them, beef and chicken flavor, and that would be her dinner all month. Every day, a candy bar for lunch at work and a frozen pot pie for dinner at home.
It’s a sad state of affairs when fatty processed foods are cheaper than healthy ones, and this is still the case today: the underprivileged are more likely to subsist on McDonald’s than on vegetables. Heartland is full of these kinds of contradictions. For instance, in the Reagan years the country shifted rightwards and working-class Catholics like Smarsh’s mother started voting Republican – in contravention of the traditional understanding that the Democrats were for the poor and the Republicans were for the rich. Smarsh followed her mother’s lead by casting her first-ever vote for George W. Bush in 2000, but her views changed in college when she learned how conservative fiscal policies keep people poor.
This isn’t a straightforward, chronological family story; it jumps through time and between characters. You might think of reading it as like joining Smarsh for an amble around the farm or a flip through a photograph album. Its vignettes are vivid, if sometimes hard to join into a cohesive story line in the mind. Some of the scenes that stood out to me were being pulled by truck through the snow on a canoe, helping Grandma Betty move into a house in Wichita but high-tailing it out of there when they realized it was infested by cockroaches, and the irony of winning a speech contest about drug addiction when her stepmother was hooked on opioids.
Heartland serves as a personal tour through some of the persistent trials of working-class life in the American Midwest: urbanization and the death of the family farm, an inability to afford health insurance and the threat of toxins encountered in the workplace, and the elusive dream of home ownership. Like Vance, Smarsh has escaped most of the worst possibilities through determination and education, so is able to bring an outsider’s clarity to the issues. At times she has a tendency to harp on the same points, though, adding in generalizations about the effects of poverty rather than just letting her family’s stories speak for themselves.
The oddest thing about Smarsh’s memoir – and I am certainly not the first reviewer to mention this since the book’s U.S. release in September – is who it’s directed to: her never-to-be-born daughter, “August”. Teen pregnancy was the family curse Smarsh was most desperate to avoid, and even now that she’s in her late thirties, a journalist and academic returned to Kansas after years on the East Coast, she remains childless. August is who Smarsh had in mind while working two or more jobs all through high school, earning higher degrees and buying her dream home. All along she was saving August from the hardships of a poor upbringing. While the unborn child is a potent symbol, it can be disorienting after pages of “I” to come across a “you” and have to readjust to who is being addressed.
Heartland is a striking book, not without its challenges to the reader, but one that I ultimately found rewarding to read in short bursts of 10 to 20 pages at a time. It’s worthwhile for anyone interested in what it’s really like to be poor in America.
My rating: 
A favorite passage:
“My life has been a bridge between two places: the working poor and ‘higher’ economic classes. The city and the country. College-educated coworkers and disenfranchised loved ones. A somewhat conservative upbringing and a liberal adulthood. Home in the middle of the country and work on the East Coast. The physical world where I talk to people and the formless dimension where I talk to you.”
Heartland: A Memoir of Working Hard and Being Broke in the Richest Country on Earth was published by Scribe UK on November 8th. My thanks to the publisher for a free copy for review.
Genova’s writing, Jodi Picoult-like, keeps you turning the pages; I read 225+ pages in an afternoon. There’s true plotting skill to how Genova uses a close third-person perspective to track the mental decline of Harvard psychology professor Alice Howland, who has early-onset Alzheimer’s disease. “Everything she did and loved, everything she was, required language,” yet her grasp of language becomes ever more slippery even as her thought life remains largely intact. I also particularly enjoyed the descriptions of Cambridge and its weather, and family meals and rituals. There’s a certain amount of suspension of disbelief required – Would the disease really progress this quickly? Would Alice really be able to miss certain abilities and experiences once they were gone? – and ultimately I preferred the 2014 movie version, but this would be a great book to thrust at any caregiver or family member who’s had to cope with dementia in someone close to them.
Other fictional takes on dementia that I can recommend: 
A remarkable insider’s look at the early stages of Alzheimer’s. Mitchell took several falls while running near her Yorkshire home, but it wasn’t until she had a minor stroke in 2012 that she and her doctors started taking her health problems seriously. In July 2014 she got the dementia diagnosis that finally explained her recurring brain fog. She was 58 years old, a single mother with two grown daughters and a 20-year career in NHS administration. Having prided herself on her good memory and her efficiency at everything from work scheduling to DIY, she was distressed that she couldn’t cope with a new computer system and was unlikely to recognize the faces or voices of colleagues she’d worked with for years. Less than a year after her diagnosis, she took early retirement – a decision that she feels was forced on her by a system that wasn’t willing to make accommodations for her.
Other nonfiction takes on dementia that I can recommend: 
Dear Fahrenheit 451
I managed to miss Marlena when it first came out last year; luckily, I had another chance at reading it when it was released in paperback a couple of months ago. It bears some thematic similarities to Emma Cline’s The Girls, Rosalie Knecht’s Relief Map, Andrée Michaud’s The Last Summer, Julianne Pachico’s 
Ayobami Adebayo says sickle cell anemia is a massive public health problem in Nigeria, as brought home to her when some friends died of complications of sickle cell. She herself was tested for the gene and learned that she is a carrier, so her children would have a 25% chance of having the disease if her partner was also a carrier. Although life expectancy with the disease has improved to 45–50, a cure is still out of reach for most Nigerians because bone marrow/stem cell transplantation and anti-rejection drugs are so expensive. Compared to the 1980s, when her book opens, she believes polygamy is becoming less fashionable in Nigeria and people are becoming more open to other means of becoming parents, whether IVF or adoption. It’s a way of acknowledging, she says, that parenthood is “not just about biology.”
Eleven-year-old Deming Guo and his mother Peilan (nicknamed “Polly”), an undocumented immigrant, live in New York City with another Fuzhounese family: Leon, Polly’s boyfriend, works in a slaughterhouse, and they share an apartment with his sister Vivian and her son Michael. Deming gets back from school one day to find that his mother never came home from her job at a nail salon. She’d been talking about moving to Florida to work in a restaurant, but how could she just leave him behind with no warning?
