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Most of the wealth in Dove Creek, West Virginia, is in the earth-in the coal seams that have provided generations with a way of life. Born and raised here, twenty-seven-year-old Cole Freeman has sidestepped work as a miner to become an aide in a nursing home. He's got a shock of bleached blond hair and a gentle touch well suited to the job. He's also a drug dealer, reselling the prescription drugs his older patients give him to a younger crowd looking for different kinds of escape.

In this economically depressed, shifting landscape, Cole is floundering. The mining corporation is...