'I Figured It Was Going To Be A Horrible Death, And It Probably Will Be'

Thousands of coal miners across Appalachia are grappling with complicated black lung, a disease that has drastically changed their lives, their communities and their families.
Respiratory therapist Deena Neace checks James Muncy's blood pressure and pulse during a therapy session at the New Beginnings Pulmonary Rehab Clinic in South Williamson, Ky. Muncy is one of thousands of coal miners across Appalachia who are dying of advanced black lung. Source: Matthew Hatcher for NPR

James Muncy can trace his breathing problems back to the 1990s, when he was still mining coal. "I couldn't cut grass hardly," he says. "When it's hot, [I] couldn't breathe."

In 2014, he was diagnosed with the advanced form of black lung disease, known as complicated black lung, or progressive massive fibrosis. "I know it's going to kill me," says Muncy, whose brother died of the disease in 2017.

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