McDowell County, West Virginia. Once one of the wealthiest counties in America and home to the first billion dollar company, McDowell has been called the county that built the country. But with most coal mines closed, it is now among the poorest places, and suffers the shortest life expectancy and highest death rate from opioids of all 3142 counties in the U.S.A. Set against stunning mountain landscapes, Monty meets extraordinary people with incredible grit, determination, hope, and a deep love for one another, who shatter many stereotypes of Appalachian life.