Otto is an independent journalist working on a monograph (New Press, under contract) about health care in Central Appalachia. The region faces some of the most formidable health care challenges in America. There are grave shortages of doctors, dentists, and mental health providers. Her book project is a journalistic narrative exploring life and death in this territory: the long history of suffering and medical need; the rise and fall of an innovative miners' health care system here in these hills; the union power and optimism that built it and the struggle and despair that have followed in its wake.