In a small bowl, whisk together salt, black pepper, brown sugar, dried sage, ground thyme, ground nutmeg, smoked paprika, crushed red pepper flakes (if using), garlic powder, and onion powder until evenly combined.

Mix with meat

Place the ground pork in a large mixing bowl. Sprinkle the spice mixture evenly over the meat. Add the cold water and optional vinegar and the optional pork/bacon fat if using. Using clean hands or a spatula, fold and gently knead the meat and seasonings together until just combined (do not overwork — about 20–30 folds) to maintain a tender texture.

Rest (optional)

Cover the bowl with plastic wrap and refrigerate for at least 30 minutes or up to overnight. Resting helps flavors meld and the salt to penetrate the meat. If pressed for time, you can cook immediately.

Forming and Cooking

Form patties

Divide the sausage mixture into 8 equal portions for small breakfast patties (about 2 oz / 56 g each) or 4 larger patties for sandwich-size. Roll each portion into a ball, then flatten into a patty about 3 inches across and 1/2-inch thick. Make a slight depression in the center with your thumb to help patties cook flat and evenly.

Heat skillet

Heat a large skillet or cast-iron pan over medium heat. Add 1 tablespoon of neutral oil or butter and let it warm until shimmering (but not smoking). If cooking many patties in batches, have extra oil or butter ready.

Cook patties

Place patties in the hot skillet without crowding (work in batches if necessary). Cook undisturbed for 3–4 minutes until the underside is nicely browned. Flip and cook the other side for another 3–4 minutes until internal temperature reaches 160°F (71°C) and juices run clear. Reduce heat to medium-low if patties brown too quickly; cover loosely for the last minute to help through-cook without burning.

Finish and drain

Transfer cooked patties to a plate lined with paper towels to drain briefly. If you made bulk sausage instead of patties, crumble and brown in the skillet, stirring and breaking up until fully cooked.

Serving and Storage

Serve hot as part of breakfast with eggs, biscuits, pancakes, or in breakfast sandwiches. For a crisp exterior, return patties to the skillet for 30–60 seconds per side before serving.

To store: refrigerate cooked sausages in an airtight container for up to 4 days. Freeze cooled cooked patties on a sheet tray until firm, then transfer to a freezer bag for up to 3 months. Reheat frozen patties in a toaster oven or skillet over medium heat until heated through.