Early on in Elaine McMillion Sheldon’s latest short film “Heroin(e),” one can see Jan Rader cruising around Huntington, West Virginia, the city where she serves as chief of the fire department, unable to drive more than a few blocks without spotting houses where people have died from an opioid overdose.

“When you add hopelessness and unemployment and lack of education on top of all that, it’s like a recipe for disaster,” Rader laments. “I fear that we’ve lost a couple generations. Not just one generation. I fear that we’ve lost more than that.”

The statement carries considerable weight on its own, but particularly so when Rader tells this to McMillion Sheldon, who has dedicated herself over the last several years to in her home state chronicling the vicious cycle of socioeconomic conditions that have stymied West Virginia and decimated its population. With her husband Kerrin, the cinematographer on all her films, the documentarian has made a series of short films that have played out virtually as a nonfiction version of “The Wire.”

First venturing into McDowell County for her innovative “Hollow,” McMillion Sheldon documented how others her age began to flee coal country for more urbanized communities, leaving behind an older population that had been ravaged by injuries suffered by working in the mines, and leaned on prescription pills to take away the pain — a precursor to heroin addiction. A follow-up for Frontline, “Betting on Trump: Coal” looked at how residents poured their hopes into the President-elect’s promises to turn the coal industry around, even as alternative energy continues to grow in popularity, while “Timberline,” a short for Field of Vision showed another employer in the state – the NSA – plans to sell off its base in Sugar Grove, raising fears amongst the locals that their town will lose any status it has and inch closer to irrelevance.

McMillion Sheldon’s gift has long been for bringing out the light amidst such dire circumstances around West Virginia, yet “Heroin(e)” may be the first to lead with hope, despite its unflinching portrayal of the drug addiction that has spread there. The film follows three women doing their best to tend to the precarious situation in Cabell County, focusing on Rader, a frequent first responder to opioid overdoses; Necia Freeman, a realtor who spends her free time luring prostitutes off the street with the promise of a warm meal through her Brown Bag Ministry; and Judge Patricia Keller, who shows compassion from the bench in presiding over cases where there’s often more of a need for counseling than sentencing. Although the film is viscerally arresting, thrusting audiences into one tense situation after another that each of the three women face on a regular basis, the immediacy of the 39-minute short is limned with a sense of history as deep as if one were to chop into a West Virginia pine tree, with the filmmaker envisioning the opioid crisis as if they were the rings inside – the outermost layer that has hardened after years of poor working conditions, the eventual loss of jobs, such as they were, and the poverty and chronic pain that followed while those with the deepest roots have stayed to fight further attrition.

After a premiere at Telluride, “Heroin(e)” debuted on Netflix, bringing the attention of the world to Huntington and as the film is being considered for the Oscars, for which it was recently shortlisted for Best Documentary Short, McMillion Sheldon spoke about how the film was born out of happenstance, treating her subjects with the dignity they deserve and how each of her films has built on one another.

Jan Rader and Judge Patricia Keller in "Heroin(e)"How did you get interested in this?

I grew up in West Virginia, and this is a problem that is obviously all across the country, but it has been in my own backyard for a while. I’ve had a lot of friends and classmates caught up in it, whether they’ve been addicted themselves, serving time for crime or in rehab. It’s really impacted a lot of people around me, so I was looking for stories of hope that potentially could help us work towards solutions and get a conversation started. When I met Jan Rader on a reporting trip to Huntington in February of 2016, she was really clearly very compassionate, but also very connected within her community and introduced us to many other people, two of which are Judge Patricia Keller and Necia Freeman.

We filmed with them for about a week in early 2016, but we didn’t really have any funding for [for a full-fledged film] and we didn’t know what it was going to be, so we focused all of our efforts on making a feature as well about four guys who went to recovery, embedded with [them] through their rehab experience, and let this footage of the three women sit on our hard drive. The Center for Investigative Reporting had this call out for women-directed films about women making change and my husband and I realized that we had these three amazing women that we had filmed and that we should go back and try to make this film. So it was a happy accident. We weren’t actually sure this would turn into anything and we’re really lucky to have the partners and support we did to make it happen.

Once you made that decision, did you find those three stories complimented each other well and that it had a natural structure?

Yeah, they work in three different spaces in the same community, so they often touch the same lives, but at different sectors, so you’ll see Jan often revive the people that Necia is trying to get into rehab and then once they’re in rehab, potentially, they get into drug court, so they actually work with the same people over and over. These women fit perfectly with what the Center for Investigative Reporting was looking for, which was women making change – and you can’t really tell from the film because it’s a short, but they’re all friends and the way that [these women] touched the many levels of society was an interesting experience for a film, like how to go in and out of [their individual experiences], fighting their own battles and seeing the ups and downs. It’s not always pretty and they’re not always successful in their efforts, but there’s many people working towards change and positive efforts in Huntington, West Virginia and they’re all in this together, so being able to interweave the three made sense for a short documentary.

You’ve certainly been privy to emotionally charged moments before, but given the subject, was this a particularly challenging shoot in that regard?

Yeah, it’s something Kerrin Sheldon, my husband, and I thought a lot about when we were going into these overdose and emergency scenes that we made sure that we weren’t getting in the way of what was happening. The most important thing at that moment wasn’t us getting the best composed shot, but the fact that [paramedics or police] could bring back that person through a potentially deadly situation. So it was emotionally a lot to sit and watch those moments. When you’re filming something though, you pretty much look at it through that square – that viewfinder – and you’re focusing on your “characters,” so it all feels quite surreal. You pretty much stay in that moment, and it’s only really afterwards when it hits you like what you just filmed.

[For instance] talking to the woman came to [out of an overdose in the film, whose identity is never revealed], I followed her out to the ambulance and had her sign the release form, really talking to her about what just happened. I told her, “I will try to protect your privacy” because for me, that’s not a moment to be taken lightly. That’s not an opportunity to exploit someone. Hopefully it shows reality, but [we] protect someone’s privacy because you know that woman is someone’s sister, mom, daughter and I know plenty of people who have been in that situation. You have to emotionally be connected with people in those moments because you really don’t know what you’re walking into when you’re going in with first responders and you certainly don’t want to get in the way of what they’re doing.

How did you figure out how you’d shoot the courtroom scenes? You compose shots of those standing trial in a way that really gives them dignity.

We went to drug court about three or four times before we actually filmed and talked to people about what we were doing. The judge hadn’t given us access yet to film at that point, so we kept showing up over and over to let her know that we weren’t there trying to get something [specific] and then leaving. We’re really interested in how drug court works because it was a pretty fascinating criminal justice system, and we live an hour away and we’re here to stay. We were in court without the cameras for a while, but once we did bring the cameras, they knew what was going on and compositionally, we did try to get as close to them as possible. My husband Kerrin, the main [cinematographer], was on the actual client, and I was on the judge, trying not to obscure their view, but also trying to get as close to them as possible.

One of the many awkward moments of documentary filmmaking is you’re setting up the camera and you have no clue if what you’re about to film is incredibly boring or intense, especially for that person in their individual life, so there were some moments where we felt really bad that we were filming because we’re like, “Oh, this sucks for this person.” But that’s the reality. That’s what you do as a documentary filmmaker is navigate how you’re sensitive in those moments, so we just tried to let people get as comfortable with us as possible. We told them why we were doing it. We’re natives of West Virginia and we relate to them and are proud of them, quite frankly. Following four guys in recovery from heroin for our feature documentary, it’s just talking a lot about the courage that it takes to overcome addiction – not only the withdrawals, the physical [toll], the brain chemistry and all the science behind it, but the actual soul and courage that it takes to overcome demons. It’s really intense, so we did respect them and we wanted to them to be seen as people who were doing their best in a complicated situation.

A scene from Elaine McMillion Sheldon's "Heroin(e)"This is my own impression, but given how many other filmmakers have passed through Appalachia to make films about the poverty or addiction that exists there, your films have been particularly sensitive, perhaps stemming from the fact you’re from there. Are you conscious when making your films of the other narratives that are out there?

We all bring the camera into situations with our own backstories, so no matter where you grew up or what that situation is in which you were raised in, you bring your experiences of the world into every shot. I love the region, I’m conflicted by the region – I’m often very mad at the region. [laughs] But it is a place I’m rooted in, it is a place I care about and it’s a place that I hope to have a longterm vision for and watching how Appalachia was portrayed on the nightly news, whether that was national [news] or in documentaries growing up, it was just very clear that there was a lack of people understanding how to portray dignity. Certainly Appalachia would face a lot of issues. We’ve got poverty, lack of education, drug abuse, but behind all those topics are people that are resilient and the people that you see are hopefully overcoming something that a lot of us really don’t understand because we don’t have firsthand experience.

So I’m not the person to say outsiders can’t tell Appalachia stories because I think playing that guard dog is not healthy and it’s not a role I’m interested in playing. But I certainly hope if someone watches my husband and I’s films, they feel connected because we certainly feel connected to the people we’re staring at through a viewfinder and we certainly do care about them, whether we agree with them or not. And that’s the big thing. People always ask me, “Well, do you agree with this? And would you cover it even if you don’t agree with it?” Being a documentary filmmaker, for me, is not about whether I agree with someone’s lifestyle or condoning their choices. It’s about expressing the story that’s right in front of my face. Certainly, we all have biases and my bias is that I love that place, as conflicted as it is, and it’s the place I feel I can add most to a conversation around.

From my vantage point, it also appears that you’ve methodically explored pieces of the socioeconomic climate in West Virginia in each film that can add up to a whole when watched together. Do you feel these films have built upon one another in terms of how you go about making them?

The stories absolutely bleed into one another and I actually think each story I tell, I’m choosing it because each story that preceded it allowed me to understand it. Every story that I’m challenging myself to tell, I’m not comfortable with telling it at first. I myself haven’t suffered from addiction, and I certainly feel very closely to it because of what’s happening to my own classmates and getting close to that was scary, but it took the work that I did in “Hollow,” talking about how many prescription pills have flooded into one town and then the murder of this mayor for drug money that I had been filming [to push me to make “Heroin(e)”], so every little thing builds on each other.

After the election, there was an intense magnification on Appalachia and the working class [here], like, “Who are these people?” That’s interesting that people [nationally] were reawakened to this group of people, but that comes and goes and I hope my work lasts a little longer than those flash-in-the-pan moments where society remembers people live differently than they do [in other parts of the country] and people have certain beliefs that are different than they do. Some people feel left behind in this country and the next projects [I embark on] will build on the knowledge that I learned moving forward, but it’s also really just me fumbling around trying to better understand the place that I’m from because as much as I feel I intimately know it, it’s still a learning curve for me and I think I’ll be interested in it until it’s not. I go out in the field and meet people and we’re exchanging our last names – like our ancestors’ last names – to see if we have anyone in common, [asking] do you know this holler? Do you know this person? I’m lucky to have those connections because I’ve been working there so long, but that’s what it comes down to. They all build on one another and hopefully, I’ll keep learning through them all.

What’s it like to share your home with the rest of the planet through Netflix?

It’s crazy. It’s just a really big honor to be able to have access to that many eyes and ears all across the globe. To this day, Jan will send me Facebook messages, e-mails and handwritten letters that she has been receiving and I think there was one from Sweden today and Brazil. [There’s] just an incredible outpouring of people showing their support for her. And we’ve had well over 50 community screenings that have requested the screening guide that Blueshift Education made for us – the film is available for educational screenings, which is that if you’re a church, nonprofit, rehab, school anywhere, you don’t have to pay us a screening fee, but the catch is you have to stream it from Netflix and then we provide and educational guide. So it’s just been an incredible honor to have this many people be able to watch and respond to the film.

It’s the dream as an independent filmmaker that you make work and people see it. It’s a joke Jonathan Franzen made – someone asked him, “Oh you know, you’re an author, what have you written?” Because it’s very rare that you can name something as an author, and I would also say as a documentary filmmaker, that people have actually seen because there’s just so much content out there. We’ve been in several situations – very random ones – where people have seen the film, and not from an ego point of view, but this is a story that I feel needs to reach people and it is and that’s a dream.

“Heroin(e)” is now streaming on Netflix.