Appalachia Can't Breathe: Coal Miners Are at a Political Choke Point--Again.

• Author: Catte, Elizabeth
• Position: Progressives in a dilemma over the black lung epidemic resurgence in Appalachian Region

MY FIRST ENCOUNTER with black lung, the miners'disease, came when I was a small child visiting relatives in the coalfields of southwestern Virginia. It was so long ago I do not remember their faces. But I remember the sound of their labored breathing, which is to say I remember the sound of death.

This is how you die of black lung.

You are born by chance into a world where a mineral is more valuable than your body. From a young age, you learn to equate work with danger but also brotherhood. You will outlive friends among these dangers--faulty electrical writing, flooding, roof collapse--only to return one day from the doctor knowing the mountain you pulverized for coal is now part of you, embedded in your lungs. You thought coal was in your blood, but now it's in your chest.

The disease you have is fatal. Your body, in trying to heal the unhealable, has wrapped the coal dust and silica in your lungs in tissue that will become fibrosis. You will feel like an elephant is sitting on your chest; every organ will work harder to compensate for your body's lack of oxygen as you slowly suffocate.

There is only one treatment that might significantly prolong your life: a $1.2 million lung transplant. You might feel guilty that your family must bear the cost of your illness and suffer with you. You would have preferred, if your life had to be cut short by work, to die quickly in an accident. You will think of the mines and you will think of your friends and you will say "We killed ourselves" over and over, long before you are dead.

More coal miners are dying from black lung than ever before, and many are dying younger. I've read this fact many times over the past two years, in news stories that also generate now-predictable Twitter comments. "I refuse to cry over folks who created their own problems," reads one. "Miners are a big reason why we have Trump___Too bad they didn't all pass away sooner and we wouldn't be in this mess," reads another.

Trump campaigned heavily on promises to revive the country's dying coal industry, and Appalachia's roughly 30,000 miners bore the brunt of the reaction. By mid-December 2016, with Trumps Inauguration looming, the progressive-aligned political website Daily Kos was telling its readers to "be happy" that coal miners' federally backed health care and pensions would soon be on the chopping block.

It's not surprising, then, that news of a black lung epidemic in Appalachia has failed to capture the public's sympathies. With a country awash in crises, why should progressives champion a group of sick workers attached to a dying industry who linked their own fortunes to Trump's impossible plans?

But the black lung epidemic represents a dilemma that progressives must confront in order to find the heart and soul of the values that will take them into 2020. Workers are dying because politicians on both sides of the aisle were willing to rank their lives below the promise of industry. People are suffering because they cannot afford medical care. Will we be the country that maintains this system of acceptable casualties, or will we build something better?

In 2016, the National Institute for Occupational Safety and Health (NIOSH)...