Va., for the past 34 years. He also directs the health center’s black lung clinic. Over the past several years, underground coal miners have seen a spike in black lung disease, which restricts breathing and in the most serious cases, is fatal. Doyle notes that several recent studies have revealed a marked increase in both birth defects and certain cancers in residents of communities near mountaintop removal sites. His patients include many residents who depend on the coal industry for their livelihood. Sitting on the front porch of his home, Dr. Doyle spoke with Between The Lines' Melinda Tuhus, sharing his views about the complicated nature of community support for and opposition to mountaintop removal coal mining.