Decades ago, a grassroots uprising forced Congress to enact long-overdue legislation designed to virtually eradicate black lung disease and provide fair compensation to coal miners stricken with the illness. Today, however, both promises remain unfulfilled. Levels of disease have surged, the old scourge has taken an aggressive new form, and ailing miners and widows have been left behind by a dizzying legal system, denied even modest payments and medical care. In this urgent work of investigative journalism, Pulitzer Prize winner Chris Hamby traces the unforgettable story of how these trends converge in the lives of two men: Gary Fox, a black lung-stricken West Virginia coal miner determined to lift his family from poverty, and John Cline, an idealistic carpenter and rural medical clinic worker who becomes a lawyer in his fifties. Opposing them are the lawyers at the coal industry's go-to law firm; well-credentialed doctors who often weigh in for the defense, including an elite unit from Johns Hopkins; and Gary's former employer, Massey Energy, a regional powerhouse run by a cantankerous CEO often portrayed in the media as a dark lord of the coalfields. On the line in Gary and John's long-shot legal battle are fundamental principles of fairness and justice, with consequences for mines and their loved ones throughout the nation. Taking reader inside courtrooms, hospitals, homes tucked in Appalachian hollows, and dusty mine tunnels, Hamby exposes how coal companies have not only continually flouted a law meant to protect miners from deadly amounts of dust but also enlisted prominent doctors and lawyers to help systematically deny much-needed benefits to miners.