Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through “the system.” The riveting stories in Fall or Fly tell what foster care is like, from the inside out.

In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people’s children? Why? What’s money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?

In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation’s greatest asset.

Wendy Welch is the executive director of the Southwest Virginia Graduate Medical Education Consortium and the author, coauthor, or editor of six books, including Fall or Fly: The Strangely Hopeful Story of Foster Care and Adoption in Appalachia (also from Ohio University Press). She advocates for social justice in health care and other critical areas of development across Appalachia.