Savory Protein Crêpe

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Pancakes have a bad reputation healthwise, but they don’t have to be so. Here’s a very healthy crêpe recipe, with around 20g of protein per serving (which is about how much protein most people’s body’s can use at one sitting) and a healthy dose of fiber too:

You will need

Per crêpe:

  • ½ cup milk (your preference what kind; we recommend oat milk for this)
  • 2 oz chickpea flour (also called garbanzo bean flour, or gram flour)
  • 1 tsp nutritional yeast
  • 1 tsp ras el-hanout (optional but tasty and contains an array of beneficial phytochemicals)
  • 1 tsp dried mixed herbs
  • ⅛ tsp MSG or ¼ tsp low-sodium salt

For the filling (also per crêpe):

  • 6 cherry tomatoes, halved
  • Small handful baby spinach
  • Extra virgin olive oil

Method

(we suggest you read everything at least once before doing anything)

1) Mix the dry crêpe ingredients in a bowl, and then stir in the milk, whisking to mix thoroughly. Leave to stand for at least 5 minutes.

2) Meanwhile, heat a little olive oil in a skillet, add the tomatoes and fry for 1 minute, before adding the spinach, stirring, and turning off the heat. As soon as the spinach begins to wilt, set it aside.

3) Heat a little olive oil either in the same skillet (having been carefully wiped clean) or a crêpe pan if you have one, and pour in a little of the batter you made, tipping the pan so that it coats the pan evenly and thinly. Once the top is set, jiggle the pan to see that it’s not stuck, and then flip your crêpe to finish on the other side.

If you’re not confident of your pancake-tossing skills, or your pan isn’t good enough quality to permit this, you can slide it out onto a heatproof chopping board, and use that to carefully turn it back into the pan to finish the other side.

4) Add the filling to one half of the crêpe, and fold it over, pushing down at the edges with a spatula to make a seal, cooking for another 30 seconds or so. Alternatively, you can just serve a stack of crêpes and add the filling at the table, folding or rolling per personal preference:

Enjoy!

Want to learn more?

For those interested in some of the science of what we have going on today:

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  • The Dark Side Of Memory (And How To Make Your Life Better)

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    How To Stop Revisiting Those Memories

    We’ve talked before about putting the brakes on negative thought spirals (and that’s a really useful technique, so if you weren’t with us yet for that one, we do recommend hopping back and reading it!).

    We’ve also talked about optimizing memory, to include making moments unforgettable.

    But what about the moments we’d rather forget?

    First, a quick note: we have no pressing wish or need to re-traumatize any readers, so if you’ve a pressing reason to think your memories you’d rather forget are beyond the scope of a few hundred words “one quick trick” in a newsletter, feel free to skip this section today.

    One more quick note: it is generally not considered healthy to repress important memories. Some things are best worked through consciously in therapy with a competent professional.

    Today’s technique is more for things in the category of “do you really need to keep remembering that one time you did something embarrassing 20 years ago?”

    That said… sometimes, even when it does come to the management of serious PTSD, therapy can (intentionally, reasonably) throw in the towel on processing all of something big, and instead seek to simply look at minimizing its effect on ongoing life. Again, that’s best undertaken with a well-trained professional, however.

    For more trivial annoyances, meanwhile…

    Two Steps To Forgetting

    The first step:

    You may remember that memories are tied to the senses, and the more senses are involved, the more easily and fully we remember a thing. To remember something, therefore, we make sure to pay full attention to all the sensory experience of the memory, bringing in all 5 senses if possible.

    To forget, the reverse is true. Drain the memory of color, make it black and white, fuzzier, blurrier, smaller, further away, sterile, silent, gone.

    You can make a habit of doing this automatically whenever your unwanted memory resurfaces.

    The second missing step:

    This is the second step, but it’s going to be a missing step. Memories, like paths in a forest, are easier to access the more often we access them. A memory we visit every day will have a well-worn path, easy to follow. A memory we haven’t visited for decades will have an overgrown, sometimes nearly impossible-to-find path.

    To labor the metaphor a little: if your memory has literal steps leading to it, we’re going to remove one of the steps now, to make it very difficult to access accidentally. Don’t worry, you can always put the step back later if you want to.

    Let’s say you want to forget something that happened once upon a time in a certain workplace. Rather than wait for the memory in question to come up, we’re going to apply the first step that we just learned, to the entire workplace.

    So, in this example, you’d make the memory of that workplace drained of color, made black and white, fuzzier, blurrier, smaller, further away, sterile, silent, gone.

    Then, you’d make a habit of doing that whenever that workplace nearly comes to mind.

    The result? You’re unlikely to accidentally access a memory that occurred in that workplace, if even mentally wandering to the workplace itself causes it to shrivel up and disappear like paper in fire.

    Important reminder

    The above psychological technique is to psychological trauma what painkillers are to physical pain. It can ease the symptom, while masking the cause. If it’s something serious, we recommend enlisting the help of a professional, rather than “self-medicating” in this fashion.

    If it’s just a small annoying thing, though, sometimes it’s easier to just be able to refrain from prodding and poking it daily, forget about it, and enjoy life.

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  • When should you get the updated COVID-19 vaccine?

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    Updated COVID-19 vaccines are now available: They’re meant to give you the best protection against the strain of the virus that is making people severely sick and also causing deaths. 

    Many people were infected during the persistent summer wave, which may leave you wondering when you should get the updated vaccine. The short answer is that it depends on when you last got infected or vaccinated and on your particular level of risk. 

    We heard from six experts—including medical doctors and epidemiologists—about when they recommend getting an updated vaccine. Read on to learn what they said. And to make it easy, check out the flowchart below.

    A flowchart that helps you answer the question of when to get the 2024-2025 updated COVID-19 vaccine based mainly on whether or not you were infected with COVID-19 or received a COVID-19 vaccine in the last three months. The chart also says that if you're over 65, immunocompromised, or high risk you should consider getting vaccinated as soon as possible.
    A flowchart to help you decide when is the best time to get the 2024-2025 updated COVID-19 vaccine.

    If I was infected with COVID-19 this summer, when should I get the updated vaccine?

    All the experts we spoke to agreed that if you were infected this summer, you should wait at least three months since you were infected to get vaccinated. 

    “Generally, an infection may be protective for about three months,” Dr. Ziyad Al-Aly, chief of research and development at the Veterans Affairs St. Louis Health Care System, tells PGN. “If they got infected three or more months ago, it is a good idea to get vaccinated sooner than later.”

    This three-month rule applies if you got vaccinated over the summer, which may be the case for some immunocompromised people, adds Dr. Peter Chin-Hong, professor of medicine at the University of California, San Francisco. 

    If I didn’t get infected with COVID-19 this summer, when should I get vaccinated?

    Most of the experts we talked to say that if you didn’t get infected with COVID-19 this summer, you should get the vaccine as soon as possible. Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, emphasizes that if this applies to you, you should get vaccinated as soon as possible, especially given the current COVID-19 surge.

    Al-Aly agrees. “Vaccine-derived immunity lasts for several months, and it should cover the winter season. Plus, the current vaccine is a KP.2-adapted vaccine, so it will work most optimally against KP.2 and related subvariants [such as] KP.3 that are circulating now,” Al-Aly says. “We don’t know when the virus will mutate to a variant that is not compatible with the KP.2 vaccine.” 

    Al-Aly adds that if you’d rather take the protection you can get right now, “It may make more sense to get vaccinated sooner than later.”

    This especially applies if you’re over 65 or immunocompromised and you haven’t received a COVID-19 vaccine in a year or more because, as Chin-Hong adds, “that is the group that is being hospitalized and disproportionately dying now.”

    Some experts—including epidemiologist Katelyn Jetelina, author of newsletter Your Local Epidemiologist—also say that if you’re younger than 65 and not immunocompromised, you can consider waiting and aiming to get vaccinated before Halloween to get the best protection in the winter, when we’re likely to experience another wave because of the colder weather, gathering indoors, and the holidays. 

    “I am more worried about the winter than the summer, so I would think of October (some time before Halloween) as the ‘Goldilocks moment’—not too early, not too late, but just right,” Chin-Hong adds. Time it “such that your antibodies peak during the winter when COVID-19 cases are expected to exceed what we are seeing this summer.”

    My children are starting school—should I get them vaccinated now? 

    According to most experts we spoke to, now is a good time to get your children vaccinated. 

    Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at the Brown University School of Public Health, adds that “with COVID-19 infection levels as high as they are and increased exposures in school,” now is a particularly good time to get an updated vaccine if people haven’t gotten COVID-19 recently. 

    Additionally, respiratory viruses spike when kids are back in school, so “doing everything you can to reduce your child’s risk of infection can help protect families and communities,” says epidemiologist Jessica Malaty Rivera, science communications advisor at the de Beaumont Foundation.

    For more information, talk to your health care provider.

    (Disclosure: The de Beaumont Foundation is a partner of The Public Good Projects, the organization that owns Public Good News.)

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • An Important Way That Love Gets Eroded

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It is unusual for a honeymoon period to last forever, but some relationships fair a lot better than others. Not just in terms of staying together vs separating, but in terms of happiness and satisfaction in the relationship. What’s the secret? There are many, but here’s one of them…

    Communication

    In this video, the case is made for a specific aspect of communication: airing grievances.

    Superficially, this doesn’t seem like a recipe for happiness, but it is one important ingredient—that it’s dangerously easy to let small grievances add up and eat away at one’s love and patience, until one day resentment outweighs attachment, and at that point, it often becomes a case of “checking out before you leave”, remaining in the relationship more due to inertia than volition.

    Which, in turn, will likely start to cause resentment on the other side, and eventually things will crumble and/or explode.

    In contrast, if we make sure to speak our feelings clearly (10almonds note, not in the video: we think that doing so compassionately is also important), the bad as well as the good, then it means that:

    • things don’t stack up and fester (there will less likely be a “final straw” if we are regularly removing straws)
    • there is an opportunity for change (in contrast, our partner would be unlikely to adjust anything to correct a problem they don’t know about)
    • all but the most inclined-to-anxiety partners can rest easy, because they know that if we had a problem, we’d tell them

    This is definitely only one critical aspect of communication; this video for example says nothing about actually being affectionate with one’s partner, or making sure to accept emotional bids for connection (per that story that goes “I knew my marriage was over when he wouldn’t come look at the tomatoes I grew”), but it is one worth considering—even if we at 10almonds would advise being gentle yet honest, and where possible balancing, in aggregate if not in the moment, with positive things (per Gottman’s ratio of 5:1 good moments to bad, being the magic number for marriages that “work”).

    For more on why it’s so important to be able to safely air grievances, see:

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    Want to learn more?

    You might also like to read:

    Seriously Useful Communication Skills! ← this deals with some of the important gaps left by the video

    Take care!

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  • 5 Steps To Quit Sugar Easily

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Sugar is one of the least healthy things that most people consume, yet because it’s so prevalent, it can also be tricky to avoid at first, and the cravings can also be a challenge. So, how to quit it?

    Step by step

    Dr. Mike Hansen recommends the following steps:

    • Be aware: a lot of sugar consumption is without realizing it or thinking about it, because of how common it is for there to be added sugar in things we might purchase ready-made, even supposedly healthy things like yogurts, or easy-to-disregard things like condiments.
    • Recognize sugar addiction: a controversial topic, but Dr. Hansen comes down squarely on the side of “yes, it’s an addiction”. He wants us to understand more about the mechanics of how this happens, and what it does to us.
    • Reduce gradually: instead of going “cold turkey”, he recommends we avoid withdrawal symptoms by first cutting back on liquid sugars like sodas, juices, and syrups, before eliminating solid sugar-heavy things like candy, sugar cookies, etc, and finally the more insidious “why did they put sugar in this?” added-sugar products.
    • Find healthy alternatives: simple like-for-like substitutions; whole fruits instead of juices/smoothies, for example. 10almonds tip: stuffing dates with an almond each makes it very much like eating chocolate, experientially!
    • Manage cravings: Dr. Hansen recommends distraction, and focusing on upping other healthy habits such as hydration, exercise, and getting more vegetables.

    For more on each of these, enjoy:

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    You might also like to read:

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  • What’s the difference between autism and Asperger’s disorder?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Swedish climate activist Greta Thunberg describes herself as having Asperger’s while others on the autism spectrum, such as Australian comedian Hannah Gatsby, describe themselves as “autistic”. But what’s the difference?

    Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.

    Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.

    When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of autism spectrum disorder is made.

    Where do the definitions come from?

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.

    Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.

    In 2013, the DSM-5 collapsed both diagnoses into one autism spectrum disorder.

    How did we used to think about autism?

    The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.

    Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.

    Children in a 1950s classroom
    Kanner and Asperger described different thinking patterns in children with autism.
    Roman Nerud/Shutterstock

    Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.

    The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.

    Today, as a legacy of the recognition of the autism itself, the majority of people diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.

    What changed with ‘autism spectrum disorder’?

    The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.

    It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.

    The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.

    The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.

    Why do some people prefer the old terminology?

    Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.

    The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, Tony Attwood and Carol Gray, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.

    What about identity-based language?

    A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.

    The neurodiversity rights movement describes its aim to push back against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.

    Boy responds to play therapist
    Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
    Alex and Maria photo/Shutterstock

    The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.

    However the social model contrasts itself against a very outdated medical or clinical model.

    Current clinical thinking and practice focuses on targeted supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.

    A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.The Conversation

    Andrew Cashin, Professor of Nursing, School of Health and Human Sciences, Southern Cross University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital

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    McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.

    Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.

    It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.

    Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.

    “There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.

    In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.

    But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.

    In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.

    McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.

    “This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”

    Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.

    Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.

    The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.

    “I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”

    The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.

    In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.

    While audits show few McAlester patients get financial aid, many get taken to court.

    Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.

    Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.

    “Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”

    The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.

    “It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.

    Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.

    At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.

    Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.

    Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.

    For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.

    Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.

    Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.

    Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.

    Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.

    McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.

    At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.

    After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.

    “All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”

    About This Project

    “Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.

    The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country. 

    Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.

    The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability. 

    KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.

    Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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