Well, I guess that depends on what you value. In my mind, it is rarely a question of simple aesthetics. The Appalachian corrider is, for instance, an important flyway for migratory songbirds -- songbirds that help to control insects in wood-producing forests in Appalachia or in New England or South America. It also happens that the Appalachian Highlands sit atop the sub-continental divide between the Atlantic and the Gulf and so essentially form the headwaters region for much of the freshwater runoff in the Southeastern US. So, there are water quality issues, as well.

But your question does, I think, reflect our attitude, as a society, about things that are "out of sight, out of mind." The coal-bearing portion of the Appalchians has been made, in effect, a national sacrifice zone. But that was well underway before anyone thought about Peak Oil or Climate Change and I expect that process to continue.

But why should I care?
I'm being a bit smarmy here sure,

No, you've already emotionally invested in seeing Fission Power be the "way to go", so you don't care.

in the middle of nowhere.
Your 'middle of nowhere' is someone else's somewhere.

Isn't this just an aesthetic issue?

No. Educating you on heavy metal issues is pointless however, as you have shown a desire to remain ignorant.