The van had arrived at seven in the morning in the mine’s parking lot, a white van with the blue writing of the federal health service on the side, and Harlan had seen it from the night shift while coming up from the shaft with the others, the dust still in his throat, his hands trembling with the cold of the March air after eight hours of compressed air six hundred meters below road level, and he had thought, without formulating the thought as a thought but letting it pass the way you let pass a truck coming from the other direction, that the van was there for him, in the sense that it was there for all of them but especially for those like him who had twenty-three years of dust in their lungs and who knew, because they all knew even though nobody said it with the words the van would use, that the lungs at some point stop doing what they are made for.

He got in line.

The line was eleven people, all in work overalls, all with their helmets under their arms, and Harlan was sixth, which meant he would wait about forty minutes, because each “screening,” as they called it in the flyer posted in the cafeteria, lasted between five and eight minutes and included, again according to the flyer, a “work history questionnaire,” a “chest X-ray,” a “blood pressure check,” and a “spirometry,” which was a word Harlan had never heard before that flyer and which meant blowing into a tube connected to a machine that measured how much air the lungs were able to move, which was, if he thought about it, “rather ironic,” because air was exactly the thing that the lungs of a coal miner stopped moving after twenty years of breathing dust that was not air.

The fifth in line entered the van.

Harlan looked at the parking lot. It was a gravel parking lot with faded white lines and the miners’ pickups parked in crooked rows, because nobody parked straight at seven in the morning after a night shift, and behind the parking lot there was the mountain, which was not a real mountain but the spoil heap from the mine, the thing the company called a “temporary storage area” and which had been there for thirty-six years, six stories tall, black, with edges that crumbled when it rained.

‘Harlan.’

The doctor was at the van’s door. Young. Thirty, maybe less.

‘Come in.’

Inside the van there was a chair, a portable X-ray machine, a blood pressure monitor attached to the wall, and the spirometer, which was a white plastic tube connected to a small grey box with a screen showing numbers. The doctor asked how many years he had worked in the mine, and Harlan said twenty-three, and the doctor wrote the number on a form without comment, and asked if he coughed, and Harlan said ‘yes but everyone coughs,’ and the doctor wrote that down too.

The X-ray took a few seconds. The doctor looked at the screen.

‘Breathe normally.’

The spirometry required Harlan to blow into the tube as hard as possible, holding the breath and then releasing all the air in one go, and Harlan blew, and the number that appeared on the screen was a number the doctor looked at without changing expression, because the doctors of federal mobile health service vans do not change expression when they look at numbers, whether the number is good or is the one Harlan knew it would be, because Harlan knew, as they all knew in the line, that at some point the number goes down, the way the level in a tank goes down when nobody fills it, and the number that had appeared on the screen was the number of a tank that nobody had filled for twenty-three years.

‘We’ll send the results to your home.’

Harlan went out from the van. The sixth in line after him was already standing, ready to go in.

The March air had a smell of wet earth and diesel from the pickups and something that came from the black mountain of spoil, a smell Harlan no longer smelled, a smell you no longer notice unless someone points it out to you, and nobody pointed it out to him because everyone smelled the same smell and nobody smelled it. The cough came while he was walking toward the pickup, not the cold cough but the other one, the one that was inside somewhere between the throat and the place where the lungs end, the one the doctor would call “productive” in the report and which Harlan called, when he called it anything, “the usual.”

The white van would remain in the parking lot until five in the afternoon. The next shift would come up from the shaft and get in line. The doctor would ask how many years, and would write the number, and the spirometer would measure how much air, and the number would appear on the screen, and the doctor would not change expression.

Harlan’s pickup did not start on the first try. It started on the second.