How I Got the Story: Breathless and Burdened

Published February 13, 2017 | 5 min read

It all started with an advanced copy of a government report on the 2010 Upper Big Branch Mine disaster that killed 29 miners in southern West Virginia. “We knew that some other news organizations also had it, and we were thinking, ‘What can we do that’s different, that’s not going to be the same as what they did?’ says Chris Hamby, who was then a reporter working with the Center for Public Integrity.

Then, Hamby found that in the Governor’s Task Force’s hundred-plus-page document, there was one page describing autopsies on 24 of the 29 men who died. The findings: 17 had signs of black lung.

That launched Hamby on a reporting quest throughout West Virginia, southwestern Virginia, eastern Kentucky, and the rest of central Appalachia, investigating the resurgence of the disease.

What came out of that year-long journey was “Breathless and Burdened,” a multi-part series that highlighted not only the resurgence of black lung, but a system that makes it nearly impossible for miners to claim their benefits once they’re stricken with the disease.

Here, Hamby breaks down how he reported the series, which won the 2014 Pulitzer Prize in Investigative Journalism.


Coal industry’s go-to law firm withheld evidence of black lung, at expense of sick miners

In the first part of this series, Hamby chronicles the fight of Gary Fox, a miner stricken with black lung, and his lawyer, John Cline, against the seedy practices of Jackson Kelly PLLC, a law firm that serves the coal industry and which, Hamby uncovered, consistently withheld information proving miners had black lung.

Step 1: Make Connections

“We’d been in touch with John Cline when we were there previously doing the story just about the resurgence of the disease because there really are almost no lawyers who practice in this field. He’s sort of a natural connection to miners who have the disease if you’re looking to talk to them.

He sent me some information about what had happened to Gary Fox. I read that and said, ‘If this is true, if we can prove that this happened and it’s a pattern of practice, then that is a really big, important story.’”

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Step 2: Get the Information

“These cases aren’t like normal court cases. The actual case files are protected under the Privacy Act, so you can’t just get them. There’s a lot of really sensitive medical and financial information in those files. The only way that I could access them was to get permission from the miners or, in most cases, it was their surviving family members. I just got in touch with all of them and told them what I was doing and that I’d be interested in looking at the files and would they be willing to fill out and sign a form saying that I could look at them. Then I took that to the Labor Department, got boxes and boxes and boxes of these files, went through them, and logged everything. A lot of evidence emerged for the first story from that.”

Step 3: Study the information to Connect the Dots

“It took anywhere from a few days to a couple weeks to go through an individual case, and then obviously those led to a lot of other reporting that I wanted to do to flesh out some of those details.

A lot of these files that I was looking at, I was looking at them primarily for the withholding of evidence issue by the lawyers and started to see a lot of the names in there.”


Johns Hopkins medical unit rarely finds black lung, helping coal industry defeat miners’ claims

In this second story, Hamby lays out a damning case against doctors at Johns Hopkins University who steadily testified for coal companies. These doctors, specifically Dr. Paul Wheeler, were hired by coal companies for upwards of $750 to read a single X-ray. But, according to Hamby’s reporting, they almost never found cases of black lung, resulting in lost suits by sick miners like Steve Day.

Step 1: Use the Tools at Your Disposal

“Fortunately, the Labor Department has a website where anything that’s reached the level of the administrative law judges — their file decisions are posted online, and actually in searchable PDFs.

I really couldn’t have done the numerical part of the second story without that because there was no database of how many times doctors had weighed in on certain cases.”

Step 2: Note the Patterns

“Searching through the files, I started to see these repeat players, but the biggest one that jumped out on this site was the outsize influence of Johns-Hopkins and, in particular, Dr. John Wheeler. You start talking to people and everyone knows who he is and everyone’s kind of thinking, ‘Well, I don’t think I’ve ever really seen him find black lung, ever.’ And I’m saying, ‘Boy, that would be interesting to know what his record actually is.’ There really isn’t any way of determining that other than searching for all variations of names in these searchable PDFs and then read through every one of those that popped up and logged all of the information into the spreadsheet.”

Step 3: Make Your Case

“It seemed like everybody knew he sort of had this bend toward coal companies. But when you can just say, ‘This is his record. The numbers don’t lie; this is what he did,’ there’s a certain power to that, even if it just sort of provides really concrete evidence to what some people suspected.

From there I also wanted to make it very clear high up in the story that this is not going to be just something where it’s a few cases. This has a really huge, widespread impact on thousands of people over just a few years. This is not going to be one of those stories where we say, ‘Some doctors say this; other doctors say that.’ I just didn’t want to tell the usual suspects kind of thing.”

Step 4: Find a Powerful Anecdote

“As I was logging cases into the spreadsheet, I was also reading decisions and getting a basic sense of the facts and how critical Dr. Wheeler’s opinion was in the ultimate decision. I started running back the ones that looked like it was most clear that he had led to a wrongful denial of someone who’s very ill. There were maybe 20 or 25 of those and I just started calling all the people on that list and getting their personal stories, and Steve Day’s for some reason just jumped out at me as the most compelling. He had a really strong sense that he was very, very sick and it was clear from the record that Dr. Wheeler was almost the entire reason that he lost his case.”

Step 5: Don’t Back Down

“When Johns Hopkins refused to comment, there wasn’t a lot I could do other than to lay out everything for them in advance and say, ‘Here, this is what we have, what we’re going to say.’ You obviously don’t give them the story or anything, but we give them a lot of detailed information.

In their case, they were basically challenging us saying, ‘You don’t know what you’re talking about. We’re the doctors here.’ I decided to send them all of the primary documentation, the key stuff, so they could tell us where we’re wrong. I put together a box of documents along with some questions about them for them. They promised to respond to those and didn’t. That was what I referenced in the story is they just didn’t, just that same sort of blanket statement again. But, I had read the stuff so many times and checked and rechecked and bounced it off of other doctors and stuff that I just felt pretty good with what we had.”


As experts recognize new form of black lung, coal industry follows familiar pattern of denial

This part of the series takes a deep dive into the history of how black lung is detected, and how the coal industry consistently denies and hampers efforts to change diagnostics.

Step 1: If You’re Chronicling a Problem, Master the Subject

“To get the history, there were some really good books that sources had recommended I read. One that was really helpful to me was Penn State Professor of Labor History Alan Derickson’s book called Black Lung: Anatomy of a Public Health Disaster. That really details the shameful history of the industry and the medical professionals denying the existence of black lung in this country.

So just a lot of reading, and a lot of talking to key people.”


Inside a coal company exam

This part of the series takes the reader inside a doctor’s office (specifically, one who has a history of siding with the coal industry) as he performs an exam to determine whether or not a miner has black lung.

Step 1: Find a Subject

“I got connected with a miner when I knew he was going into an exam. I’d heard a lot about some of these run-them-in, run-them-out in large numbers sort of exams that are conducted by someone who comes down from some other medical center to some coal field community little clinic or hospital so they can do a bunch of these exams in one day, and I wanted to be in on one of them. So I got connected with a miner and had an upcoming appointment for one of these and he was perfectly willing to have me come along, so I just went with him.”

Step 2: Be Honest

“I showed up and walked back with him for the exam and, of course, Dr. Gregory Fino asked who I was and I immediately told him that I was a journalist. I’d obviously thought that through and you want to be completely honest, so I never tried to tell him anything other than exactly what I was doing. He was originally not terribly pleased with that and he left the room and called the law firm that had retained him. Then he came back in the room and said, ‘Oh, okay, I have nothing to hide,’ and he continued and I just stayed.”

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