The stories in this collection are great examples of contemporary Appalachian fiction--what Andi Stout calls Appalachian Modernism. Josh provides stories from a lot of different perspectives, different narrators, and different positions in society, but they share several common themes. One of the most important themes is alienation, which is pretty ironic considering Appalachia's reputation for close-knit families and communities. But in these stories, family and community often figure more as a threat or a burden. Many of the narrators feel trapped by their responsibilities to family, often having to work hated jobs to support wives and children, or family represents some kind of threat with strict/abusive fathers or tenuous romantic relationships. And rather than being a source of support--as it is in much Appalachian lit--community often figures as callous or uncaring, if not an outright threat through hazing or fights.
Another recurring theme is the danger of mining communities, either for those directly working in the mines (often reluctantly in these stories) or those who live around the mines. Characters frequently lose children or spouses, and while the causes of these deaths aren't clearly attributed to the mines, there's always an implicit connection to the way mining communities are organized and the sacrifices they demand of health and safety. While this kind of criticism of mining culture and the exploitation of miners/mining communities is not uncommon in Appalachian lit, it is still in stark contrast to WV politics and economics, which puts a disproportionate emphasis on keeping mining alive (despite the death of the industry from over-mining, and that several other industries employ many more West Virginians than mining does).