Taking Healthcare by Storm: Industry Insights with Steve Grant

In this episode of Taking Healthcare by Storm, Quality Insights Medical Director Dr. Jean Storm speaks with Steve Grant, author of Mailman: My Wild Ride Delivering the Mail in Appalachia and Finally Finding Home.

Steve shares his journey from corporate marketing to becoming a rural letter carrier in Appalachia, a transition that brought profound personal growth and healing. Through his memoir, he highlights the importance of community connection, physical labor, and resilience in reinventing oneself after facing medical and professional challenges during the pandemic.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website.

The views and opinions expressed by the host and guests are their own and do not necessarily reflect the views, positions, or policies of Quality Insights. Publication number QI-021326-GK

Transcript

 Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

Hello everyone, and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director here at Quality Insights, and today I am joined by Steve Grant and I am very excited about this conversation. He is the author of Mailman My Wild Ride, delivering the mail in Appalachia, and finally finding home.

I highly recommend this book. I listen to this over audio while I  was working out over a couple days and I just wanted to work out more because I loved listening to the book so much. This book is a funny, heartfelt, and deeply human memoir about finding purpose in unexpected. Places. After losing his corporate marketing job during the pandemic and facing a cancer diagnosis, Steve took a job as a rural letter carrier in the Blue Ridge Mountains of Virginia.

What began as a desperate search for health insurance became a profound journey of healing, humility, and rediscovery, reminding us how community connection and even hard physical work. I recommend hard physical work.  I think it's very valuable that these things can restore meaning to our lives. In this conversation, we're gonna be talking about what inspired his story, the mental and physical health lessons he learned along the way, and what it really means to find home.

Steve Grant, thank you so very much for joining us today. Jean, it is a pleasure to be here on your podcast.  Thank you. You had a long and successful career in marketing and behavioral economics before writing this memoir. So what inspired you to turn such a difficult and unexpected chapter in your life into a book?

It's funny, in a, couple of the reviews of the book a guy named Harper in the Atlantic that wrote a wonderful review.   I'm not, bagging on the review. It was great. But he mentioned that I might've been thinking of a book option as I took the job. Nothing could have been further from the truth.

I really did take it 'cause it was sort of in extremists needed healthcare. And even in training a lot of my friends are also in the professional managerial class and they were like, God, what's it like? What are you doing in there? you know, I Would tell these stories of the training we went through and the people I met and what was happening out on the route.

And they were like, man, you gotta write a book. You gotta write a book. And I was like, nobody wants to read a book about delivering the mail. And I have another book I wrote as of yet unpublished, but it was a detective novel set in Charleston, West Virginia, where my father grew up. And I talked to an agent and he's like, look, I really love your writing, but I don't do fiction.

It's a heartbreaker. Do you have any nonfiction? And I'd had two small essay ETS that I had written about my time as a letter carrier. And I said, well, I've got this stuff I wrote when I was a letter carrier for the US Postal Service during the pandemic. And Granger, who's my agent was the editor-in-chief at Esquire Magazine for almost 20 years.

And I did not know this Chance favors the prepared. And, but he has a kind of a mild obsession with the US Postal Service. Ran several articles about it over his time as the editor in chief. He's said, oh, oh, send me that. So I was like, all right, it's a Hail Mary pass. But I sent it to him and I sent it to him on a Friday, on a, on Saturday.

I  I got one of his classically short emails back. It was just like, we're gonna sell this book. I was like, okay. And so I kind of, fell into it, but then as I began to work on it  I realized it was like. There is a book in here. This was actually kind of a remarkable thing that happened to me.

I think there's something inherent in the Appalachian culture of it, like you don't make a big deal outta stuff. it didn't occur to me that what had happened was all that exceptional and that the real story is that United States Postal Service is actually quite an exceptional organization and the experience of working there  was probably one of the big adventures of my life.

Yeah it's definitely came out that way, came across that way. And I'll say, if you ever wanna publish that other book we're based in Charleston, West Virginia, so Charlie West the unofficial capital of Appalachia, so, yes. Yeah. So  you described that delivering mail in Appalachia has saved your life.

So  what did that transformation look like emotionally and mentally  and how the, did the job change your outlook or your sense of purpose? Yeah. I'd spent the previous  really three decades of my career of building a career of really looking at data and.

Solving business problems and making presentations and all desk jockey stuff. And at 50 to go from that to working outside all day long. Doing work that is, at first it was extremely mentally taxing, but once you got the hang of it you know, you just had to execute. And it was such a change in.

My day to day life to go from every minute being scheduled and doing project related work to really working as a team there in the office. And then after that, you're on your own. You are you're a man on horseback out there in the real world. And it was a profound shift in terms of like. I was now in a service job. I had customers. Every address on my route was somebody that I was there in, in their service, was a representative of their government. you know, during the pandemic, people were very isolated. There was a sense that gosh, were things ever gonna go back to normal? And I, I think for a lot of the people that I encountered.

Seeing the mailman, which is about as normal as the thing gets, there's always been a mailman as long as there's been in America. I was a sort of a ambassador of normalcy and people were genuinely excited to see me most of the time. And you know, when you're an AD executive, I don't know if people are genuinely excited to see you even if they even know what you are.

And to be something that was so recognizable and the mythology of, the country that people have in their heads. I was very proud to do it. I was very proud of the work I did. And that was a big, that was a big change. It was also like, I, you mentioned in your intro that it was a, a humbling experience and it was you do a career for 30 years.

To survive that long in it, you must be good at something, right? You grow used to being very competent in your little narrow kingdom and to have to learn something totally new midlife and go out there and, people are waiting on you, you have to execute on it. I was, I know I was terrible.

I was a terrible mailman for the first three, four months that I did the job. I was just good enough to stay employed and get the mail out there. And that was a shock and it, my, my psyche had to deal with that. And the thing I realized that I, could do was I would have to learn to be good at the job, but the number one thing I had to do was like, get used to not being great at first and to just to persist.

To stick with it, to try to be resilient  of everything I did, that was probably the hardest thing psychologically. Yeah, I think that is so important.   I think we have a culture in the, in our country that's like, you know, you have to be good at it. You have to be killing it.

You have to. But to be not good at something I think is I mean, I'm just, as a physician, I think it's healthy for your brain you know, your new neural connections.  It's good. It's good, but it's scary. It is very scary. And I have to tell you that kind of like. There were days at particularly at the beginning where you could almost feel the engine overheating  in my brain pan from just all the new stuff that I was having to do, right?

If you've ever seen real time PET scan images of people learning a new task, You just see how much of sort of the general cognition areas of the brain are lit up. You just, your brain is just burning glucose, leveraging kind of general skills to be able to tackle this novel circumstance that you're in, and you feel like that for a long time.

There's no one thing that's difficult about delivering the mail, but the presence of mind to go through the sequence and to do things, the right things in the correct order. Then problem solve, problem, solve one thing after another. Particularly as a, rookie you don't realize how paired down your own competencies are as a professional.

You're like, oh, I kind of slid into it over decades. Right? And that, to be outta your comfort zone like that, I do think I think it was tremendously liberating for me to go, all right. I am bad at this, but I'll get better. And I did. And you walk through life for me afterwards. I have a sense of like, I thought I had reinvented my career several times over the course of the last 30 years, but nothing is drastic.

A pivot is this. and ironically then to become a writer, somebody that a memoirist and write something, book length was a whole other journey. On the other side of it. When I was done. Yeah. So you talked a little bit  about the pandemic and I think most people, probably including myself, would rather forget about it, but it was a huge uncertain time and you lost your job and you faced cancer, which are huge challenges.

And you were facing those things. During the height of the pandemic where there was all this fear and there was all this uncertainty and things were very scary. So how did those experiences affect your mental health? And so like how did you navigate that time personally? It, it's funny I was really the diagnosis for my prostate cancer was quite new.

It had, I had just gotten the news really in the couple of months prior to the pandemic. And anybody that you get a new diagnosis and you're like, my father had had prostate cancer and been successfully treated for it. My uncle as well, his brother. and so as I dove in and like began to understand the Gleason score and, talked to a couple friends of mine who are doctors.

And understood more of what the pathologist had said about the, biopsy results. And I was like, all right, I have a low Gleason score. There's no such thing as a benign cancer, but  I had it about as close to benign, I think as you, you could have, which it is apparently not uncommon in, in a lot of the a lot of the presentation of, prostate cancer.

And I was classified as low risk according to my PSA score. And so I said, alright, that's a future problem. And in many ways, getting laid off and having to deliver the mail was a gift. I was really spinning on the diagnosis prior to that, and I said, okay that's a known unknown. There's not a whole lot we can do about that right now.

It isn't acute. and I can't do anything about it without healthcare. Because I'm not independently wealthy, and so I said, we're just gonna, we're just gonna focus on the job for right now. And a, solution, the ability to address this in a more responsible way will come in time. to that extent, it was, it was sort of a gift.

I was able to like really just focus on being present tense and executing on my job. And. And put it to the side in a way that I, rather than being kind of repressing it and sitting on it I literally put it in a drawer, not literally, but mentally. I said I'm just gonna file this away.

Can't deal with this right now. again, after this experience, I've realized it's like In, uh, dialectical behavioral therapy, they talk about natural emotion and manufactured emotion, right?  And natural emotion is, you have something happening to you in the moment you injured yourself or somebody insulted you, or a situation is a and some, kind of externality has happened and you're frustrated.

Those are real but they fade. They have a pretty fast decay curve on them, right? Manufactured feelings are, you get into a story you tell about yourself. It's kind of a poisonous metacognition. You start thinking about it, it ties into some, schema that you, tell yourself about what your life is like, and then you start rattling around in that and you have second and third and fourth order thoughts, and you can be in there as long as you want to be in there.

And a lot of people aren't aware of the, and that's the danger of it, is just like, well, my feelings are real and my thoughts are real, and they are. But what was the root cause of it? Right? And I'm still dealing with this stuff. you don't run across terms like dialectical behavioral therapy in your everyday life.

I'm  I've been in therapy for many years But I've come to realize after delivering the mail and, going through the situation in life and being, IM impressed, not to sound proud, but less just like, you know, I, I did an okay job at dealing with a pretty tough hand that I was dealt. and then you go back and you, if you think about it like an engineer, you go, okay what, worked?

Why was I able to do that? And in other times when I've received. Setbacks and have not dealt with them as well. What was my pattern of behavior there? it was one of these things that, because it was such an edge case in my life up to that point, I think being in that extremity helped me do an ab comparison.

And it's been something I've been able to carry forward with me after that. That was a very therapy talk. But I was just gonna say, I wrote down poisonous metacognition. I think that be a great banding. Anyone wants. That's how you can tell I was a copywriter at one point. Right. Yeah. You can see a bullet point of that on a slide right now.

Poisonous, metacognition. Right, exactly. Right. So you talked about actually having the experience and then there's this  writing the book, right? Yeah. So  it's  I've never written a memoir, but I've heard it can be cathartic. It can be painful. So how did revisiting those moments.

 Like your job loss  your illness, your reinvention. How did that impact your healing?  Did it change? Did writing the book change how you viewed that experience that you had? I think so, and I don't, and I don't think you can and again I wrote a book to tell stories.

 I tried to be. Entertaining and engaging and insightful as I told that story. There's a reason that a lot of different modalities of psychotherapy use writing and journaling though. It externalizes your, your thought process  and then when you have to go back in a really deliberate way I think good the difference between an autobiography and a memoir is that a lot of times you'll get, somebody famous, old, your Britney Spears or whoever, and you wrote a autobiography and that, and autobiographies are sort of like, and here's what happened to me. And then this thing happened next. at Samuel Beckett says that the history is a one damn thing after another. and that's, that's kind of autobiography.

There's no insight into the person, into what they were feeling or the perspective of time. So I went back and I read a lot of memoirs that I really admire or memoir stick fiction. It's like the things They Carried by Tim O'Brien is fictionalized, but there's a character in it named Tim O'Brien and it's his year in Vietnam.

Tobias Wolf wrote another Vietnam memoir.  He's a phenomenal short story writer and also wrote this Boy's Life but his Vietnam memoir is called in Pharaoh's Army. And both of those writers play with time in a way where they write about the thing that happened, but then they also shift back to their present self, the writing self, and talk about what it meant to them to have gone through that and what they learned from it, or how they were wrong then.

Or they misunderstood or misapprehend something. And so I, I didn't set out to process a bunch of emotions when I wrote the memoir, but I, think it did wind up happening. Something that I didn't know was gonna happen when I was delivering the mail was that my father was gonna pass away.

In the couple of years after the action of the book and. When I wrote the first draft, he had just passed away. And that, altered how I  it was a different book than I think it would've been. Here was a man, incredibly important in my life. Incredibly hardworking guy and Appalachian all the way through from West Virginia.

The grants had have lived in West Virginia. From the 1780s on and so it put the book and its narrative into a perspective. It put my relationship with him into a perspective and I feel very fortunate that I got to write a book that was about delivering the mail and the pandemic, but it was also a chance to write some about him and tell his story.

I think that helped me a lot. You did mention wanting to forget about the pandemic I ran into a, reader at the National Festival of Books that the Library of Congress holds. And got a chance to be on cspan, which was pretty awesome. Yeah. And, And she came up afterwards and she's a practicing clinical psychotherapist.

And she said she's, given the book to several of her clients who are dealing with depression. And she said  one of the things I was struck by when I read, your book was, wow, the pandemic really sucked. And I have really repressed a lot of how bad it was. And when I read your book, I, it took me right back to that and I realized I haven't really.

I think I'm still dealing with what happened to me, what happened to everyone during that time, I think that's true. The whole country  I'm not gonna play sociologists right now, but in my current work, looking at a lot of survey data, longitudinal stuff over the last 10 years, and there's just so many things that go off a cliff in the immediate aftermath of the pandemic people's sense of security.

Their optimism about the country their sense of economic precarity and precarity around their own health.  Just  you pick the indices that you wanna measure. Most of it went down big time after the pandemic, and, and I just think we, we still haven't really come to terms as a country with what happened to us.

Yeah  I would agree. I mean, I'm in. The position I'm in now because of some burnout that I experienced, but  I'll agree. There's a lot to unpack.  Yeah, during that time  I can't imagine what it was like to be a, physician in that time.  my pandemic, everybody was stuck at home.

I had a new job and was out in the world. I got to see everybody stuck at home. I had this. A unique opportunity to really be cross-sectional be able to see all of these different models of people trapped in their homes during that time. And again, that's another way in which I feel lucky.

I didn't have the isolation that other people had during that time. I got to be out and be in the world helping people. Yeah. So you're a behavioral. Economist. Yes. And you're a writer obviously, so you understand what motivates humans. how did your understanding of behavior and resilience shape the way you told your story?

Or even how you recovered from Yeah. Yeah. It's The stories as a writer and as somebody that's had a lot of therapy at this point  I should list it as one of my hobbies, I think.  But the stories that we tell ourselves about ourself, about our families, about the communities that we're in, about our country and about the world, they are  really powerful and.

I, I always will tell my clients humans think two ways. They think associatively. That's their sort of  the pattern matching part of the human mind where, oh, this is like a thing that happened to me before. Or, uh, oh, when that bird calls, there's an animal nearby. and that's sort of like associative thinking.

But the way humans make sense of the world is, story. Story focuses in on one thing, even in our episodic memory, right? When you don't remember everything, you're not, it's not like rolling back a videotape. Your mind picks up on the salient details of an event, decides that it's an event, it has edges, right?

and says these are the important things from that. So when you tell a story you have some choice about the story that you tell yourself. And I went on about this, about at, on some, at some length in earlier drafts of the book, and it got compressed down because I, think I was talking to myself more than maybe talking to my reader, but.

Early on  I gotten laid off. I had the diagnosis, all these other sort of like difficult things that I was dealing with were happening. But then I said to myself, Hey, as a letter carrier, I have a chance to be a part of a different story. It'll be a heroic story of the country needs me.

Yeah, it's a little Walter Mitty, right? I'm, it's not like America was waiting with bated breath for me to come off the bench and become  a letter carrier. But I was able to cast it in my mind of  Hey, rather than seeing this as a setback, this is gonna be a great adventure. and you're gonna learn new stuff, and you're gonna get to do new things, and you're gonna get to see all this stuff.

As the job unfolded I saw more and more of that. And it becomes reinforcing. I'm like, oh, this is so cool. This guy that has a huge train set showed me his train set. This woman that runs a jewelry supply business out of her home showed me that a guy that was a professional woodworker that made all the big kind of non-standard.

Doors for the Virginia Tech campus. He made them in a wood shop behind his house. I was delivering him some new tools that he used and I was like, wow, I'm really lucky to be here seeing all this stuff. On the good days. When I was able to tell myself that story, it made a tremendous difference in my life.

I would be lying to you if I said that, that was always the story. I told myself that the self hating stories of like, you're a loser. I'd just screw your life up so that you wound up getting laid off to begin with. And this is always where you were gonna wind up blah, blah, blah.

These old bad stories. And you know, there's the old saying of like, which dog are you gonna feed? Right.  The good dog or the bad dog. and I, I would offer that the stronger metaphor is which story are you gonna tell yourself about what is happening to you? And there, there's a lot of that when they study psychological resilience.

It is the attitude the story. People tell themselves, Victor Frankl's work man's Search For Meaning is really all about that, of locating those moments where you get to decide what the story is that you're gonna tell yourself about what's happening to you. 'cause you can always choose the story that you're gonna tell yourself.

It's a dangerous thing too. People tell themselves delusional stories all the time, stories that are not grounded in reality, stories that are not gonna take them to the place that they would like to go or would be a healthier place for them to be. And so we have to be careful. Anytime you have a powerful tool, a chain saw you gotta be careful with what you're doing with it.

The stories that we choose to tell ourselves are probably one of the most powerful tools that we have for meaning  and for resilience. If you're going through a hard time, but it means something you can bear, that burden If you're going through a hard time and you're like, this is just another example of the world, dump it on me.

It becomes very difficult to come through that in an un bloodied way. Yeah  poisonous metacognition yet again. Yet again, I, that, that may be the organizing thought for this uh, for this podcast. Yeah I, I love that. I mean, Really, what story are you gonna tell yourself about what is happening?

I wrote that down is after you said it, and I think so powerful. That is the purpose of therapy, right? That is the purpose, right? It is the purpose of therapy and, I would say. What story are you gonna tell yourself? That, and that is clear-eyed, right? And it's hard. It could be very difficult to step outta yourself and see what is happening to you and around you with, clear eyes.

It can't just be wishes, hopes, and dreams. Um, But if you can break things down Into steps that you can tackle or you can write something off and say, Hey, this just isn't gonna work. I have been clear-eyed about it you know, we talk about cognitive dis distortions or, cognitive biases.

And, uh, sunk cost fallacy is a very real thing, right? And people can go at stuff that they want. Go at it and go at it and not see that they're never gonna get what they want, at least through that path of action or that, method that they're pursuing. But they'll think of it, I've been trying so hard and to be able to see that in a clear eye way too.

it's funny the, piece and that ran in the Wall Street Journal it was a selection from a passage that I had written in the book and I talked about something, the grit. But the grit in the Appalachian character is also a double-edged sword, right? And so I if you get knocked down, just get back up again.

If you try and it doesn't work, try harder. that's a very American story too. And it's often the case, it's like you, you tried nine times and it didn't work, but on the 10th time it did. Sometimes it's also not gonna work on the 10th time and I think the purpose of therapy is also to be able to interrogate that stuff and go, okay, why do I keep making the same mistake over and over again?

What's the story that I'm telling myself that I keep making the same mistake over and over again? Yeah. So finally, now that the book is out in the world, what has surprised you most about reader's reactions and especially those who may see themselves in your struggle to find identity health belonging after something big happened, like a big upheaval?

you know, when you're writing a book, you do it alone, right? You're alone with yourself staring at a computer screen. I knew a lot of people from Iowa that they wrote longhand on paper and kind of would only type things in late, in the late in the drafting process.  I've always been a guy that works from notes direct to the screen.

I composed the keyboard but irrespective of how you do it, you're doing it by yourself. You're alone, right? And then the book is done and you get this printed thing in the mail.  Looks like a book. And you think that's it. You don't think of it as a telephone. And the number of people that either emailed me or reached out to me through LinkedIn that were like, Hey, I just wanted you to know I read your book.

And then they'll tell you a story about what happened to them and difficult circumstances. They found themselves in how they had to reinvent themselves. And I've had so many people. Share with me that they saw similarities in their life and that they felt like I had been talking right to them. And the fact that like now in 2025, people can find me and they can close that loop and talk back to me.

I've been really delighted by that. And. To get that kind of real time sense that like someone read this book and they got something out of it. I worked really hard on it, on the book. to have someone reach out to me and say, Hey, this meant something to me has been a real gift.

I honestly didn't. I didn't think that was gonna hap, it just never occurred to me  that would happen, that people would be moved enough to write me and contact me. Has been a, a really unexpected pleasure from having done this. Yeah  I, again, I highly recommend this book you know, if you're traveling, if you're working out, the audio version is fantastic.

Steve has provided his voice for the book, and if you're into reading as well  I would pick it up. It's amazing if people want to hear more, know more about you, how can they do that or know more about the book. there's Steve Grant works.com, the website for the, for me and for the book.

 I'm on LinkedIn as many people have already discovered. We have a Instagram account for the book where if I'm speaking at a, bookstore, I just did a bunch of stuff up in Connecticut and Westchester area here in New York. And. Spoke to libraries and spoke at a couple different bookstores and we're always putting stuff like that up on the board.

I've got some literary festivals I'm gonna be part of in the summer  coming up, the paperbacks coming out in July, and so we'll be posting more of that up on the Instagram as well. Fantastic. I encourage everyone to, check those things out, and we will link in the podcast. Steve Grant, thank you so much.

This was delightful. I really enjoyed the conversation. I never saw myself on a medical Insights podcast, but I'm uh, delighted to be here. Thank you.

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website. We would love to hear from you.

So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.