in 1978, 40-year-old spinster ave maria mulligan owns her dead father's pharmacy in her hometown of big stone gap, virginia. ave's mother, an immigrant from italy, is the town seamstress. ave is heavily involved in her community, home delivering medications to the country folk, volunteering on the coal mining town's emergency response team, and directing the town's annual production of "trail of the lonesome pine", based on the novel by john fox, jr. ave delivers medications to nan mcchesney and is pleased to see nan's son jack, a local coal miner and a former schoolmate. jack tries to make small talk, but ave leaves when nan tells her that 40 is not too old to still have children.