Dr. Brandon Crum explains chest x-rays to former coal miner Wade Pauley, who has black lung disease after working 33 years underground in mines, at the United Medical Group in Pikeville, Kentucky, U.S., May 22, 2018. Dr. Crum, a fourth generation coal miner whose family members still mine coal, is the radiologist who first noticed the recent massive number of x-rays of complicated black lung in the region. REUTERS/Brian Snyder SEARCH "BLACK LUNG" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.