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 devastating and 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 raise 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 a group of radiologists at Johns Hopkins; and Gary’s former employer, Massey Energy, the region’s largest coal company, 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 longshot legal battle are fundamental principles of fairness and justice, with consequences for miners and their loved ones throughout the nation.

Taking readers 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 well-credentialed doctors and lawyers to help systematically deny much-needed benefits to miners. The result is a legal and medical thriller that brilliantly illuminates how a band of laborers — aided by a small group of lawyers, doctors and lay advocates, often working out of their homes or in rural clinics and tiny offices – challenged one of the world's most powerful forces, Big Coal, and won.

A deeply troubling yet ultimately triumphant work, Soul Full of Coal Dust is a necessary and timely book about injustice and resistance.