Sawbones: A Marital Tour of Misguided Medicine - Black Lung Disease

Episode Date: June 15, 2021

As any proud West Virginian knows, the history of mining in the United States is tied tightly to the history of the labor movement. This was partially to address something known as coal worker’s pneumoconiosis, also known as black lung disease. Though unions may have won the battle for recognition, the war against this disease continues to this day.Music: "Medicines" by The Taxpayers

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. Hello everybody and welcome to Sawmones. for the mouth. Hello everybody and welcome to Somones. A metal tour of misguided medicine.

I'm your co-host Justin McRoy. And I'm Sydney McRoy. How's it going, Sydney? Justin, this episode, this week, is near and dear to my heart. Yes. And yours, perhaps. I don't know, maybe. I think so. As well as for Indians, I think this is something that we grew up hearing about.

But maybe you could learn a little bit more about it. Yeah, I think sometimes I take for granted as a recipient of a Golden Horseshoe. I really didn't get a Golden Horseshoe. Yes, yes. And I did. I only made it to the state level and then I didn't. So in West Virginia, we obviously take West Virginia history. You probably took a history of your state where you live, probably.

Yeah, I would think. Probably wasn't as interesting as ours, but that's fun. First settler, West Virginia, that they tell you about is Morgan Morgan. I always remember that. Classic. Not much else. No, I did not. If you take the test in West Virginia history and make it to the top

Be the best in West Virginia history in the state then you get a golden horseshoe I don't know. I mean, assuming it's like a physical golden horseshoe, right? Yeah Each student kneels and with a tap of the sword on the shoulder is dubbed either a knight or a lady of the golden horseshoe society How did I know man? I wish I had done that Although I would have demanded that I want to be a knight. Of course, of course. I am no lady. But no, I didn't make it that far. I did do well, but not that well.

Anyway, because of that, sometimes I take for granted that there are aspects of our history, and in this case related to our medical history, that everybody just knows. But that's not necessarily true. And so I thought it would be interesting to talk about something that I take for granted because it's pretty that it's very common, but that's Black lung disease. Black lung disease is the name for it is technically Cole workers, new maconiosis, but I think most people are familiar with black lung. The history of the disease itself

is deeply entwined with the history of not just coal mining and West Virginia, and I mean, Appalachia as well. This is not obviously just a West Virginia entity, but that is the history I know best. But also with the history of labor unions and workers' rights, all of that is tied very tightly to our understanding of black lung disease,

what causes it and the continued effort to, you know, diagnose it and treat it, or perhaps dare I say prevent it effectively. Hey, why not? So first of all, I don't know how much if you haven't been exposed to this since birth, how much everyone is familiar with sort of the history of coal mining and unionization. I think everybody's probably somewhat familiar with it. It's something that we talk about so much in school that like, you don't hear the word matewan

and not know exactly what somebody's referencing. Yes. Yeah. But I wanted to just briefly kind of cover that piece of the history, because it is relevant. It does tie into where we go with Black Long. So first of all, as you may already know, the coal companies came in to the Appalachian region, you know, in West Virginia,

Kentucky, Virginia, Ohio, all different parts of this area that have coal. And basically plundered all of our natural resources. It's still very rude, by the way. Destroyed our mountains, polluted our air and our water, generations suffer. Not much. A wide variety of environmentally related diseases as a result of this industry. This is not news, I think. Mining happens all over the world, obviously, and if you live anywhere where this specific type of mining, you know the specific issues and any mining causes damage to the environment and to the people who live in that environment.

However, they also employed like everybody for a while. Yeah. Not so much now, but for a long time, that's where you work here. Yeah, if you wanted to feed your family, this was your option. And, you know, co-companies usually owned and run from out of state, but the laborers were people in state had little concern for the safety of minors, especially when we're talking about the early days of mining, like the early days of industrialization, the idea that the people who were doing the hard labor had value was not necessarily intrinsic.

Is still something maybe we struggle with as an American society, the idea that people who do hard work deserve to be safe and cared for and compensated. But they basically held their employees hostage in a sense by paying them in script. So this was money issued by the coal company that could only be used in businesses run and owned by the coal company. So in the little mining town, if you were an employee of the mining industry, you would probably live in a house that was built by the mining industry. You would shop at in a house that was built by the mining industry. You would shop at the company store

that was built and owned and run and operated by the mining industry. The church in your town was probably built by the co-company. The park, if you had one, was built by the co-company. The whole ecosystem was completely beholden. Yes, to the co-company. And because of that, living and working conditions were subject to whatever the, you know,

the big, big business cats. Whoa, careful there. Thought we're really Bruce really going after them. That was acceptable. Shagel Vera, the big business cats and their big bore rooms of business. Shish. It's the I try not to get too emotional about this issue because the history of West Virginia is that we live in a state where most of our land is owned by people who don't

live in our state. Which is that statement still makes me so angry. Wow. Yeah. People just milked all the money out of here and then left. I'm not saying we're perfect, guys, because I know there are a lot of you out there right now saying like, yeah, but Joe mentioned and like, no, we get it. We get it. We get it. Well, you have to understand the roots of the thing. This is a people who have never expected any better. And this is why better, and this is why.

Like, this is why. And we talked about this sort of idea, what I'm trying to, the picture I'm trying to paint, we talked about this same concept with the great fog of London, the idea that when we talked about the similar event that happened in the United States, that the idea of an industry sort of both abusing but also employing an entire town creates this weird loyalty among the people who are being most abused by the industry to that industry. And it gets really hard to protect people sometimes because this is also their only livelihood.

It's the only option they have. This is the job. You do this or you starve. And you got a family support to support your kid starve. But by the end of the 1800s and throughout the turn of the century, there were calls for organization, right? And this was getting louder and louder. There was the United Mineworkers of America

was already in existence. And they had organized strikes in several different states. Violence was part of this interaction pretty much from the beginning, not necessarily always on the part of the miners, but the people who were trying to suppress the strikes and stamp out the unions. In West Virginia, miners in paint creek and cabin

creek had already started to strike in 1912 that early. But the Baldwin Felt's detectives who were employed by the mining industry basically to sniff out any sort of union activity and stop it by any means necessary. Would you know, use intimidation, violence, turn your family out on the street if they found any of this sort of thing going on? Now, of course, this culminated in West Virginia in, you know, when I said mate mate one, the mate one massacre of 1920, which was basically the result of some of the minors in that area who, and mate one, is a tiny little coal town down on the border of West Virginia on Kentucky, I believe.

Minors who signed up for the United Mineworkers of America were about to be evicted from their homes for signing up for the union, by Baldwin Felt's agents. But the police chief in Maywan said Hatfield and the mayor of the town actually both were on their side. They were on the minor side. They were not in Kahut's with the agents of the coal company. And so when they showed up to evict people, the police chief stepped in, the mayor stepped in. They were like, come on, we're not going to do this. No, this is not going to fly. And there is a disputed account of who shot first. Yeah.

But the violence started and by the end, 11 people were killed. There's a film about this. Yes. An unfamiliar John sales made called Mate 1, came out in 87. Sid Hatfield was, uh, uh, uh, Davis, Dr. Theron. Oh, I didn't realize that who returned to do another last Virginia movie. Try onfully returned for we are Marshall. That's right. Uh, Davis, right there. And basically, I want to read West Virginia at this point because of this. Hatfield was brought up on charges, which he was acquitted of.

But, um, later, he would be brought up on conspiracy charges again for like, well, but you helped the unions, even if you're not in trouble for this, you're in trouble for this other thing, and he was gunned down on the courthouse steps during that trial. In response to that, an army of thousands of miners would march to the coal company in Mingo County to demand that they be recognized as a union.

On the way, in their path of their march from right outside Charleston to the Coal Company, that's their capital, they had to get over Blair Mountain. This is if you know where I'm going with this. They were met atop Blair Mountain by the Logan County Sheriff and his officers and fighting broke out. This is the Battle of Blair Mountain. This is a battle. They have a battle that we did here. Yes.

When the President Harding had to send US Army troops into West Virginia to back the Logan County Sheriff to suppress the mining, the unionization, the striking of the miners. After several days of fighting, 16 men, including 12 miners were dead. And this really put a dent in union activity until the 30s. The UMWA really struggled to stay alive after this military action to stop the unions. But I think if you have ever looked at West Virginia and wondered, this is not as much the case anymore. It's semi the case of Joe Manchin.

If you've ever looked to West Virginia in the past and thought, how did Democrats keep winning in such an incredibly red state? This is what like this is this is it. This is the moment because you have to understand this event here because it is like it goes to like union. It like they fought. They literally like died for it. Yeah. So like yeah, we're a couple generations out now. And obviously, so those ties don't run as deep. But like that is how Democrats went one here for so long. Well, it's it's ridiculous that we come from this history

to just this year in our state legislature. We passed, you know, union busting legislation to stop the teachers unions. Yeah. Because they were, you know, powerful and using their power to do the right thing on behalf of students. And they didn't like that. Anyway, this is also interesting

part of so that the term redneck, where that term came from is often sort of disputed. The original impetus of the word is probably from farmers who would get sunburns on their necks and would be called red necks. It is often used to refer to these early miners who were organized, part of the U.M.W.A. These early striking miners who would wear red hankerchiefs around their necks. And we're therefore called red necks. It's interesting, you know, history of the term. But anyway, it wouldn't be until FDR that real support for labor rights grew.

And this is where you get this democratic origin story of West Virginia. All of these union backed democratic candidates took office and won during the 30s. Because the Democratic Party was the party of for unions. They were the party for laborers, for workers' rights. That's where you went. And so as a result, there was more and more support for the workers. Obviously, now I don't wanna overstate too much.

They were still making sure the coal companies were happy. Sure. There's a long history of that here. Like nobody wanted to, yes, we wanted to support our miners because they're voters. But we also don't want these industries to get too angry with us because they employ all of us.

And they also give the elected official lots of money. That's more accurately, yes. And sometimes they are our elected officials, like our governor, perhaps. A coal baron. Yes. And failed business, man. So anyway, it was this force that I have just sort of described, because at this point throughout the 30s, like the mining union grows and by like 46, it's huge.

You know, it is a huge presence throughout all of Appalachia, throughout the mining industry and definitely in West Virginia. The unions fighting for safer conditions to like, you know, pay, work, pay minors in money, maybe. Yeah, you know, you know, pay, work, pay minors in money, maybe. Yeah, why not? You know, money. In a lamb shop of the muskets. They have like living conditions that are, you know,

livable and sanitary and working conditions that are safer, I wouldn't say completely safe, but safer. So throughout the first night, through the first half of the 1900s, mining during this whole time is becoming more and more mechanized, right? We're going from a time where like, I don't know, you're going in there with whatever. Pick. Pick.

Pick, pick, pick, pick, yeah, and a shovel, and a bucket. And you're going into drilling and ways to get into their faster, which is good in some ways, you know, for the miners themselves, I mean, for the laborious parts of the process, but it's bad for specifically cold-dust, you know. Even as we see some improvements in the mines in terms of explosions and caveins, you see more and more cold-dust being created. And as more and more cold us is being kicked up by these machines, we see that more and more coal miners are developing what was initially sort of just

vaguely referred to as miners asthma. And this starts to be recognized really early on in the process. It's one of those things. You know how like everybody pretends that we didn't know smoking was bad for us. Right. Yeah.

Until the search engine was you that report. You see, actually, we were grandparents all the time. Like, we didn't know it was bad for us back then. Well, my grandparents didn't tell me that. My grandpa said, you know, we always say that, but I used to call them coffin nails back in the day. So like, we knew something was up. Yeah.

I think it's the same thing. We knew that there was something bad about inhaling lots of cold us for a long time, and we just sort of vaguely called it, you know, you got miners asthma. But we didn't know how bad that was until this mechanization started to take place. And this is where I want to get into Black lung and the history of that. But first let's head to the billing department. Let's go. A medicine that has killed it my God, before the mouth. I'm Riley Smirl. I'm Sydney McAvoy, and I'm Taylor Smirl.

And together, we host a podcast called Still Buffering, where we answer questions like, Why should I not follow sleep first at a slumber party? How do I be flea? Is it okay to break up with someone using emojis? And sometimes we talk about buzz! No, we don't. Nope.

Find out the answers to these important questions and many more on still buffering a sister's guide to teens through the ages. I am a teenager. And I was to... But, but, butt, butt, butt, butt. So Miners Asma, as it was initially called, was not always seen on X-rays. Once we had X-rays, you couldn't always see it right away. So people would come in with some shortness of breath.

Maybe it's a little harder to get up and downstairs or to do the work that they were previously doing. Maybe they had a cough or something, but it wasn't always obvious at first what was going on. Now, eventually what they began to see in some minors is this condition that started with some, what looked like maybe some asthma or chronic bronchitis or infosimum similar to maybe the picture

in some of the minors who were also smokers, that kind of thing. What they did see was that in some patients, it progressed to low oxygen levels, necessitating the use of oxygen, eventually being completely debilitated, and in some patients it was fatal. And when they did start to see that there was a corollary

to things on X-rays, what they saw were the small, round nodules initially, and then eventually this could progress to these larger, what we would know on autopsy, were black masses in the lungs with dead tissue in the middle. And then eventually sometimes complete fibrosis of the lungs, which is sort of like thickening scarring of the lungs. And as you can imagine, our lungs are supposed to be bouncy and elastic.

And when they are thick and scarred, it'll work very well. Yeah, it's bad. They don't get, oxygen doesn't exchange through them very well to get into your bloodstream and they don't allow you to inhale and exhale effectively. So, what is happening in this condition is when you inhale cold dust, it never goes away. Your body can't clear it. You just keep it just stays in your lungs. It's in your lungs.

It's in your lungs. Yes. So you inhale it, it gets into your lungs, it gets into the little air sacs, the alveoli. Macrophages, which are a type of immune cell, will like try to engulf it, try to eat it, to get rid of it. But once it gets engulfed by the macrophage, it just sort of sits there in your lungs. And then it triggers this immune response. So in the area around it, you get inflammation and scarring. And the more you accumulate of these little teeny, teeny cells filled with cold dust, the more of those that clump together, the more damage you get, the more inflammation,

the more scarring, right? Is this a unique reaction to, in the case of cold dust, or are there other like, infiltrators in our lungs that work the same way? This is very similar to silicosis, so if you inhale silica, it's the same idea. And a lot of the... Well, inhale silica, it's the same idea. And a lot of the... Well, I inhale silica.

What is that? Well, I mean, in coal mining, you do inhale silica too, because that's part of the coal. There's silica in there. So there's silica dust. But in different industries where silica is being processed, you can inhale it. And then initially, that's what they tried to say

about coal mining. Well, this is just another form of silicaosis. It's nothing different. We don't need to distinguish this as a clinical entity. It took a while to figure out that, well, there's silicon coal, but also the cold dust itself is a problem. What you'd think you'd know from like looking at lung tissue

and seeing these black areas that are filled with cold dust, that probably shouldn't be there. Anyway, the longer you work in the minds, the more you inhale. This can go from everything from someone who lives in an urban area or probably lived in these cold fields who inhaled a lot of cold dust regularly, would have anthricosis, which is just sort of like a little bit of evidence of this, but not necessarily progressive to any sort of actual disease, just like something you might see on autopsy,

but wouldn't necessarily be relevant in your life to co-workers pneumoconiosis and then progressing to complete pulmonary fibrosis, which is the worst case scenario. So there's a range and the longer you work, the more you inhale, the more risk you're at. The US Public Health Service started studying this and investigating it as its own condition as early as 1924, reporting on incidents of this.

And again, in 1945, and they knew about it in Britain because in 1943, they took the step of officially recognizing, yes, there is a lung condition specifically related to coal mining. So again, we knew this was a problem. Somebody figured it out. Somebody figured it out. They figured it out in the UK. But in the US, the standard medical opinion is that, look, if you work in a mine, it's gonna hurt your lungs

a little. So stop whining, stop complaining, stop being lazy and get back to work. And that was really how it was seen initially. Like just because we saw something on an X-ray doesn't mean it's a problem, like man up. I mean, that was really the kind of the attitude. It wasn't until the 60s when rates of disease

really started to climb because of increased mechanization. And that's when you see this sort of demand for action that followed. The other reason it took a while for anything to happen is that union leadership had been really reluctant to fight this issue. The actual mine workers themselves, like the union, you know, didn't,

they wanted to focus on pensions, they had other priorities they wanted to focus on. And the other thing is, like the union, you know, didn't, they wanted to focus on pensions, they had other priorities they wanted to focus on. The other thing is, for a while, the UMWA president was pretty friendly with the cult companies and wasn't really necessarily wanting to pick big fights with them. And they knew that this black lung thing was going to be a big battle once they undertook it. The only reason that finally changed is there was a large mine explosion in Farmington, West Virginia in 1968.

And during the coverage of this event, the UMWA president was seeing like standing alongside coal company officials defending them and saying, basically like, I mean, the attitude, which is just wild to think about, is part of your job as a co-minor means that sometimes things might explode and you might die, or sometimes the whole thing caves in and you might die. And that's just it. And you should accept it. And then, like, the idea that we should be doing more to keep you safe is really just not accepting the inherent dangers of your job.

Yeah. Which is like gaslighting basically. So this led to outrage. It led to a change in union leadership. The whole company. This was also a time period for talking about the late 60s where the idea that our workers should be respected and that they needed to be, that they had their own rights was a lot more fashionable. If you think about the cultural milieu of the

late 60s, early 70s, the hippies and all that. They were a lot more likely to fight big business and the suits. Suddenly, mining safety became a priority, not just in West Virginia, but of like the Nixon administration on a federal level. Because of the explosion. Because of this explosion and because of all this issue with the union. The issue of black lung suddenly could be added to the table. So first of all, on the state level in West Virginia, miners wanted to start organizing to make sure that when the next session came up something was going to be passed to prevent and

Recognize like prevent black lung and recognize it as an entity and compensate those who are no longer able to work or who have died or You know from black lung So first some miners in Fayette County. There are a ton of counties in West Virginia Yeah, we got a lot of counties. We got so many counties. Oh, I believe it. It's ridiculous. We're so little. We got so many counties.

So a bunch of minors in Fayette County enlisted some doctors to like work with them. Kentucky though. Kentucky got a lot too. Yeah. Kentucky's right across the river there just county after county after county. We just, it's these states have, like they have all these little counties, which are all these little fiefdoms where everybody gets to run the show in their own way. It's a problem.

120 counties, by the way. 120. In Kentucky. You really got 55. Yeah, I know. So, like, let's, you know, hey, Kentucky, how about remove the plank from the eye and own eye? I don't think, I don't think Kentucky was yelling about this.

You don't know. You know who's listening? Some Kentucky and it was like, what about all the counties? First miners in Fayette County enlisted a couple doctors to help them explain to other miners. This is what BlackLong is. This is what's causing it.

This is something that you should be compensated for because they could be doing things to reduce dust and they're not. And as a result, you've got this condition. And so first there was the education piece, then the organizing started to spread. And in January of 1969, miners met in our capital, Charleston, to rally for legislation on the state level. After that, 282 miners in Rally County went on strike, then most of Southern West Virginia followed. By February of that year, 2,000 miners gathered in the state

capital to demand a bill to address it that session. At first, they were told like, listen, maybe we'll do a special session later and address this later. Like, go, please, go back to the mines. Please go, go to your work. We'll get to it. We hear you.

We hear you. We see you. We're going to get to it. And so they moved into the lobby to say, no, we're not leaving. So they introduced a pretty weak bill in the house and say, no, we're not leaving. So they introduced a pretty weak bill in the house and said, like, well, how about this? Does this work? And the miner said, actually, all 40,000 of us, every miner in the state went on strike.

Right. And said, and a bunch of them came to the Capitol and said, no, not until you do something about Black Long. So as a result of this, a much better bill was passed on a state level to recognize, try to prevent and compensate those who have suffered from Black lung. This inspired Congress to pass the Co-Mine Health and Safety Act, where standards were placed on like cold-us particles that were created to try to prevent the condition. And there is also a federal Black lung program,

which is mainly aimed at compensating the surviving family members of someone who has died of Black lung, which still exists today, of course. And the thing is, you know, this seemed to address things for a while, like Black lung benefits were robust. And there was a robust robust program and a lot of impetus on coal companies because like if you're going to have to pay out a lot of money when somebody gets black lung, you probably want to do better to try to prevent it. Which you can do by finding ways to decrease the production of cold dust in the industrial process.

You're going to say that I don't actually understand and maybe you can maybe understand this better than me. Why can't they just wear some sort of breathing apparatus? I mean, why does that, but that does it's not effective? It's not enough. Part of it is like enforcement of that. Part of it was the comfort too. I mean, to be fair, a lot of miners have told me before.

It's incredibly uncomfortable on a coal mine and then you put on one of these big masks and it's almost impossible to breathe down there. And, you know, what plays into this is the idea that like, and this still exists today, coal miners are expected to work long brutal shifts with no complaints. And to just show up whenever, I mean, like the loyalty they're expected to show to the coal company, that still persists today. So, you know, it's a difficult problem to tackle. The coal companies had the money to tackle it. The problem is that over the years, the mining companies got tired of paying out so many millions to minors. And the standards for reporting have gotten a lot stricter.

They have lobbied to make it a lot harder to get diagnosed and qualify for black lung benefits. That's been the main way. Like, okay, fine, we'll have this really robust benefit program. We're just going to make sure that a lot fewer people get it. For a while cases of black lung were dropping, but they're actually back on the rise.

But compensation rates for black lung disease have dropped dramatically. And in addition, you see things like very recently, now I am gonna throw a shade of Kentucky. I don't mean to, sorry. Hey, listen, you could throw plenty back our way. But in 2016, there is a radiologist in Pikeville, Kentucky, not too far from us. Dr. Brandon Crumb, who started noticing he's a radiologist.

He started noticing this uptick and diagnoses a black lung disease, which you can diagnose by looking at an x-ray and seeing it. That's how you diagnose it, by the way. You see certain patterns on an x-ray and you combine that with sometimes like a blood gas that we draw to look at levels of gas in your arterial blood and just a history of mining, history of exposure. But anyway, so he started noticing a lot more of these chest X-rays that were consistent with black lung disease.

He called this to the attention of NIOSH, which is a national institute for occupational safety and health. So he called it to the attention of NIOSH and he was like, I'm seeing more black lung disease here. Right. And just in his clinic, not like just like way too many cases for just one area. And so he called us to their attention. NIOSH followed up with some research and conjunction with Dr. Krum and they said, yeah, you're

right. No, this is happening. You're the only ones calling attention to it right now. You're the whistleblower, but like, black lung is on the rise and nobody's talking about it. And some follow up research indicated that like one in five minors are gonna get some form of this disease,

which is way above what we previously had thought. And so when this was brought to more broad attention, Kentucky responded by passing House Bill 2 in 2018, which restricted the doctors who can diagnose black lung to only pulmonologist, which was pretty targeted, specifically making this radiologist incapable of diagnosing black lung disease moving forward. And also currently, there are only two doctors in the state who do the final certification. So basically, like your doctor can say you have black lung disease, but then the state

can appeal it to one of these two assigned doctors in the state who are allowed to do the final review. And these two doctors who do the final review, who can by the way, their word can overturn, even if you have eight other doctors who say you have black lung disease, if this doctor, one of these two who review your case, if they say you don't, you don't. And that's final. And they do overturn that. In 85% of cases, they overturn it. Both of these doctors, allegedly according to the articles I've read, I don't know the

details, allegedly have ties to the coal industry. And both of these doctors are very likely to say, actually, no, you don't have black lung disease. So therefore, you don't qualify for any compensation or benefits. And the thing that's really wild to me about this is like pulmonologist totally can read X-rays. No doubt. I have worked with many pulmonologists

who are wonderful at reading X-rays. I am certain that they can diagnose Black lung. But yes, so can radiologists actually. Since reading X-rays and other radiological studies is sort of their entire thing, that's what they do. I am certain Dr. Crum and other radiologists are perfectly capable of diagnosing this. So why specifically would they make this role? Who does it help? It also in the past year during COVID was incredibly restrictive if you had to travel to one

of the two doctors. Yeah, of course, so. Who could do the final evaluation during COVID? The result is that also the percentage of Black lung cases that have actually found to qualify for compensation has dropped dramatically. Wow, amazing. What an amazing twist. Alongside this is the fact that co-companies have,

since inception, found ways to skirt regulation, falsified dust readings, that's been found in cases failed to meet safety standards. We still have, you know, caveans and explosions. It's not like that is just a thing of the past. That still happens periodically. And it's because at the end of the day, it is an industry that is built on, abusing laborers as much as you can get away with to make as much money out of them as you

possibly can and to make as much money off the land as you possibly can while leaving it in whatever condition the state will allow. And also to convince people, to generationally convince people in these areas that it is, that any sort of effort to make it safer, both for them personally and for the environment, is a targeted, you know, attack on them. Like, ecological efforts to prevent the damage of burning fossil fuels is an attack on them in their way of life, which is an idea that has been perpetrated and reinforced by all companies for generations. Oh, it's really hard.

This is, so by the way I should mention, there was a bill that tried to overturn this, introduced in the Kentucky legislature to this past session, but it died in committee. So this is still a problem. In West Virginia, this doesn't exist. There's no other state actually where they've taken this sort of tactic that Kentucky has. But it is not easy necessarily to get black lung benefits anywhere. In West Virginia, that is something that coal miners have routinely lobbied for and no bills have really ever gotten much traction to try to make it a little

easier to get black lung benefits and to close some of the loopholes. Coal companies have a lot of ways of just sort of prolonging this process. So like, yeah, you might get it, but it'll take you 10 years to get those benefits, which you might not have in some of these cases. So this is a problem all over. And even the miners who are fighting to make it easier to get black lung benefits, we'll still talk about, you know, part of the problem, like we're understanding of the co companies, we're sympathetic to the fact that there is a war on coal. And our co companies are under attack. And we don't want to be part of that. We just, our lungs have been destroyed from inhaling all the cold dust in their coal mines,

and we can't breathe. And we can't work if we can't breathe. And we have no way to support our families because we can't work because we can't breathe. So if you please could just give us, you know, enough money to live off of. I mean, that's really the argument. And it's hard as somebody who's outside of that industry, like, we don't have relatives in the coal mining industry. I mean, I don't think you do. No. No. We have always lived in West Virginia, but that's not

that's not our family. But this gets so personal if you talk to people. And even this doctor who is a hero for calling attention to this, even he will say, like, I have family in the coal industry. I'm not trying to do this to destroy the coal industry. I'm just saying, like, but that is the wild thing about it is that these coal companies have cast themselves as the victims because they are being, you know, persecuted for the damage they are doing to the environment.

Like, and they have done a remarkable job of marketing that to the people they are abusing, to the people that they are killing with this industry. You go, I mean, every 10th car in this state has a bumper sticker on it, this has friends of coal. For a long time, when Marshall and WVU were playing each other, it was the Friends of Cole bowl. What is Cole's friends? Cole doesn't need

friends. Cole's a rock. It is really twisted. It was genuinely disturbing. I received criticism as a six oh, is that sixth grade? I did a science fair project on the effects of acid mind drainage on the environment. And I was criticized for that. Like, well, okay, maybe, but, you know, the coal industry is, you know, that is West Virginia. How dare you associate them with these bad things

when like that's just the cost, so much of it has seen as the cost to do in business. And the human lives that are affected and the health and the years of life and productivity and healthy living and all that that's lost the environmental damage. I mean, because if we, this is not just a health crisis for these miners.

This industry is a health crisis for the whole state. I mean, if you really want to get into the sort of environmentally linked diseases that we see in West Virginia, the cancers that we see, how much of our water is toxic, and I know this isn't just a West Virginia problem. I know there are lots of places in the United States where this happens and all over the world. And that's another thing

to remember about this mining, and that was the last thing I wanted to say. Mining happens all over. Co-mining happens all over. I think once again, we are quite literally the canary in this situation in Appalachia because what this, again, I can't, I want to meet this guy, he's only in Pikeville. I got to hang out with him sometime. What he has called attention to with this uptick in cases of black lung Is gonna it's gonna happen every we're gonna see it everywhere Where we're something is going wrong and we're destroying a lot of people's lungs And if you want to get like I mean

Not to get too nightly, stick about it, but like reduction of workers rights, depowering the unions like it's not even just this. I mean, this is one version of the story that you're going to hear repeated at Nazim. Well, and maybe at the end of the day, it's a good reminder that and as a West Virginia, I know this you're not supposed to say this, but this is not the best form of energy. It's not the future. It's not. And I mean, the cost to the environment, to human life,

to, I mean, everything. Is it how, when will it not be worth it to us? Listen folks, I'm really sorry. I fell about genius. I'm sorry about my wife Sydney. You know I guess I support clean call Is a different kind of cold they found out about a while back. I don't know how they're doing it But I love the sound of it folks and I am just way deep in on clean coal that exists Thank you so much for listening to our podcast. We really appreciate it. Thanks to the taxpayers for these. There's some medicines as the internage of our program. We got a sawbun's book, both in paperbacking and hardbacked.

Hard, the paperback's newer. It's got some stuff about quarantine and other things like that. New illustrations from Sydney sibling Taylor It's a bookstores Yes, you would imagine Places you get books a place is you get books. That's gonna do it for us folks. So until next time my name is Justin Macaroi I'm Sydney Mac, and I always don't drill a hole in your head Alright! Maximumfun.org.

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