Lisa Emery loves to talk about her "boys". With each word, the respiratory therapist's face softens and shines with pride. But keep her talking, and it doesn't take long for that passion to switch to hurt. She knows the names, ages, families and the intimate stories of each one's scarred lungs.

She worries about a whole community of West Virginia coal miners — including a growing number in their 30s and 40s — who come to her for help while getting sicker and sicker from what used to be considered an old-timer's disease: black lung.