Many of the events depicted in the Netflix movie are taken directly from the book. Among the film setpieces that really happened are Bev Vance (Amy Adams) deliberately crashing her minivan into a telephone pole after her then-husband demanded a divorce. She also really did rollerblade through the hospital in which she worked as a nurse after stealing opioids from her patients, leading to her getting fired.
One of the film’s most memorable lines, about “good Terminator, a bad Terminator or neutral” is also inspired by the book. Mamaw really was a huge fan of Terminator 2: Judgement Day, though in the memoir it is J.D. who wonders about good and bad Terminators.
The real-life Vance also had to watch as his mother got arrested, leading to him spending more time with his grandmother who he called Mamaw (Glenn Close). The movie also takes its general structure from the book, with Mamaw helping J.D. onto a better path that eventually saw him going to Yale.
J.D.’s girlfriend in Hillbilly Elegy is also based on the real Usha (played in the movie by Freida Pinto), a former Supreme Court law clerk who in real life he married and had two children with.
The movie, however, did make some changes or condense some details of the book Hillbilly Elegy. Though Bev was hospitalized due to drug overdoses a number of times, the specific time she overdoses in the movie causing J.D. to return from Yale is fictional. The moments in the film where J.D. is close to losing his job at a law firm after he returns to see his mother, for example, or when he paid for his mother’s rehab over four credit cards also did not happen—or, at least, they are not in the book.
The book also gives more history to Middletown, Ohio, where the movie is set. An early passage, for example, reads: “To these folks, poverty’s the family tradition. Their ancestors were day laborers in the southern slave economy, sharecroppers after that, coal miners after that, and machinists and millworkers during more recent times. Americans call them hillbillies, rednecks or white trash. I call them neighbors, friends and family.”
Vance explained to Fresh Air exactly where the title of the book came from: “It’s something that my grandma once told me, we’re allowed to call ourselves hillbillies—and we did—but nobody else is allowed to call us hillbillies. So it’s very much a term of endearment for the people who use it about themselves and their families. "
In a piece for Journal-News, Vance’s cousin Bonnie Meibers said that Bev in real life now is very different from who she was in the events of the book and movie.
“Aside from J.D., the one person in my family who has seen the most transformation since the book was released is my Aunt Bev,” Meibers said. “As a kid, my mom would task me with watching the pill cabinet whenever Aunt Bev would come over. In January, I proudly watched her accept her five-year sober coin, something I’m not sure she ever thought would happen.”
Hillbilly Elegy is streaming now on Netflix.
