Science
'Show up and share': How one UCLA ICU helps patients and staff live with dying
Extraordinary things happen in the cardiothoracic intensive care unit at Ronald Reagan UCLA Medical Center.
The sick rise from bed with new hearts and lungs. Machines valiantly take over for faltering kidneys, heart valves, bronchial tubes. All patients enter with grave health concerns, and the vast majority leave recovered, or at least on the road to healing.
The unit has 150 nurses, at least two dozen of whom are on the floor at any time. They are there for all of it: every intubation and needle stick, every setback, every odds-defying rebound. They bond with their patients and advocate hard for their best interests.
“Our business is living, surviving and getting whatever the patient needs to get there,” said Mojca Nemanic, a critical care registered nurse in the unit.
But sometimes, despite everyone’s best efforts, the most common thing in the world happens here, too. Heartbeats slow and then stop forever. Diaphragms release a final breath and do not contract again. People die.
And when there’s nothing left to fix, CCRN Lindsay Brant said, honoring a patient’s death can be life-affirming.
That’s the ethos behind Community, an initiative Brant proposed two years ago to support patients, their families and unit staff during the dying process.
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1. Lindsay Brant rings a bell while meeting with fellow nurses before they tend to patients. 2. Brant caresses the hands of a patient. 3. Brant, left, and unit director Katrine Murray prepare candles. (Al Seib / For The Times )
Led by a 12-member committee of nurses, the initiative gives nurses the tools to care for a patient until, and even after, the moment of death. Community allows these caregivers to advocate as hard for the patient’s preferences at the end of life as they do during their treatment, and to process their own grief after a loss.
“Having somebody survive and recover is such a beautiful story,” said Brant, a 12-year veteran of the unit. “Why shouldn’t death and the transition also be just as momentous?”
The idea for Community began with Marbel, one of Brant’s first patients in her early years in the ICU.
The unit’s nurses speak of patients in broad outlines to preserve their privacy, but even the bare contours of Marbel’s story are haunting: a wound so grievous it nearly severed her body in two; grueling daily treatments that caused as much suffering as they relieved.
Marbel had had enough. Her surgeons wanted to press ahead. In frustration, Brant planted herself in front of the door to her hospital room, barring entry until doctors acknowledged what the patient wanted, which was palliative care and a peaceful death.
The experience sparked a realization, Brant said: A system set up with the noble goal of saving people could at times inadvertently overlook their humanity.
Brant took a course on care for the dying at Upaya Zen Center in Santa Fe, N.M. She became a certified death doula, a person who helps others prepare for life’s end and supports them during the process.
By 2023, she decided to approach her boss, unit director and CCRN Katrine Murray, with an idea for an initiative that would come to be called Community.
Molly Mayville, Allison Kirkegaard and Tony Estrada, from left, of the Threshold Choir prepare to enter a patient’s room to sing at their bedside in the cardiothoracic ICU at Ronald Reagan UCLA Medical Center.
(Juliana Yamada / Los Angeles Times)
Murray was immediately interested. The ICU was still reeling from the trauma of the COVID-19 crisis, in which staff cared for a seemingly endless wave of the pandemic’s sickest patients.
Studies have found critical care nurses to be at significant risk for anxiety, depression, post-traumatic stress disorder and burnout since the pandemic, thanks to the toxic combination of unrelenting work and the moral distress of watching patients suffer, and often die, without their loved ones present.
“People dying alone — that was one of the things we’ll never get over,” Murray said.
Even before the pandemic, intensive care nurses reported dissatisfaction and frustration with hospital procedures that failed to honor patients’ preferences at the end of life.
A 2018 study of intensive care nurses found no physical procedure or patient diagnosis that correlated with nurse distress. Witnessing a patient’s death, respondents said, was not in itself upsetting.
Brant, left, and Murray, right, discuss which patients the Threshold Choir will visit.
(Juliana Yamada / Los Angeles Times)
But they were three times as likely to report severe emotional distress if they felt that their patient died what they perceived as a “bad” death: afraid, unheard, their wishes and dignity overridden by those around them.
“The dying process is part of humanity, and therefore the process itself needs to be respected, just like the patients themselves need to be respected,” Brant said.
Starting in June 2023, Brant started surveying colleagues about their comfort and experiences with caring for dying patients. She started small group trainings and circulated “cheat sheets” of advice for supporting patients and their families.
Community officially launched in summer 2024. It encompasses a swath of programs intended to comfort patients and make meaning from death.
In the Goals of Care component, nurses talk with patients about their hopes for treatment and comfort with extreme measures, conversations that are documented and used to communicate patients’ wishes to their medical team.
The unit became an early adopter of UCLA Health’s 3 Wishes program, which helps caregivers carry out final requests for patients and their families: a hospital room wedding, a plaster mold of the entwined hands of a patient and their spouse, a last trip outdoors (no small feat, considering the armada of medical equipment that has to come along).
Brant cares for a patient in the unit.
(Al Seib / For The Times)
Brant connected with the Threshold Choir, a national network of volunteers who sing at the bedsides of the ill and dying. Members of the choir’s Westside chapter visit the unit every Thursday to sing soothing harmonies to patients in need of comfort, regardless of their prognosis.
There is the Moment of Silence, a ritual after a patient’s death in which nurses and doctors join the patient’s loved ones in the hospital room to honor their passing.
And for the staff, there is Show Up and Share, a quarterly session on Zoom and in person to debrief about challenging experiences on the unit. Some people vent. Some people cry. Some participants don’t say anything, but write in the chat how much it means to hear colleagues voice a similar emotion.
The hospital previously made social workers and counselors available to unit nurses, but uptake for their services was low, Murray said. In contrast, Show Up and Share “just works, because we’re doing it for each other as opposed to someone else,” she said.
In late 2024, CCRN Quentin Wetherholt was caring for a patient with a long-term illness when he sensed a subtle change in her demeanor. He initiated a Goals of Care conversation with the patient, her family and doctors that reviewed possible options for treatment, nearly all of which she had already tried. After hearing her choices, the patient spoke up: She no longer wanted life-prolonging measures.
From that point on, the patient’s attitude “was just nothing but joy, ironically. It caught me off guard. Normally, when people realize that they’re facing death, it’s a very sad environment to be in. But with her, it was freeing,” Wetherholt said.
“It was a very difficult road that she was on: lots of pain, lots of surgery. And so for her to have that just instantly be gone, and she could enjoy her time the way she wanted to enjoy it — it brought her back her sense of self.”
“The dying process is part of humanity, and therefore the process itself needs to be respected, just like the patients themselves need to be respected,” Brant said.
(Al Seib / For The Times )
The patient asked relatives to fly in from overseas. She asked for a milkshake. She died peacefully about a week later, with family around her bed.
After the patient’s death, the unit held a Show Up and Share session to grieve for her and for others who had recently passed in the unit.
“Before, it was almost like a point of pride — you know, ‘Death doesn’t affect me, this is what I do for a living,’” Wetherholt said. “But now it’s become such a nice thing to go through with your co-workers, to be able to have this forum to really heal and to not have to bottle it up.”
Early data are promising: In a survey of nursing staff five months after the Moment of Silence began, 92% felt more connected to their patients and families, and 80% felt closer to their teammates. Brant has applied for a grant to share the Community program with the hospital’s six other intensive care units.
“We are a family here, and we treat patients like they’re an extension of our family,” Brant said. “Nursing is the best excuse in the world to love on strangers, to treat all humanity as if it was your closest friend and loved one. And it’s such a gift to be able to do that.”
Science
Why new dads shouldn’t panic about low testosterone
Three months after his son was born, Kevin Maguire felt alone.
It was 2019. He had recently moved to Barcelona with his wife and daughter and was working on marketing projects for Fortune 500 companies. The birth of his son, Bodhi, should have been a joyous event. But Maguire, now 43, became sad and irritable, and didn’t want to be around his newborn. He withdrew from family and friends, often playing video games late into the night or finding excuses to get out of the house.
“I would take the dog out for a walk,” Maguire said. “I wanted to get far away enough that I wouldn’t bump into anyone I knew and I would just sit and cry.”
Desperate for answers, he entered his symptoms online. Maguire, author of the recently published book “The New Fatherhood: Why Everything They Told You About Being a Dad Is Wrong, and How Embracing It Will Transform Your Life,” knew to look for signs of the “baby blues” in his wife. But he was surprised by articles that said men could experience postpartum depression too. The diagnosis resonated and he began writing about his condition and the trials of fatherhood on Substack.
New dads face psychological pressures, from sleepless nights to sky-high bills, which can contribute to postpartum depression. So can shifting hormone levels.
“One thing I found in my lab’s research is that when new dads have really low levels of testosterone, they might report more symptoms of postpartum depression,” said Darby Saxbe, a professor of psychology at USC and author of the recently published “Dad Brain: The New Science of Fatherhood and How It Shapes Men’s Lives.”
While hormonal shifts can create challenges, they also help men adapt to fatherhood, Saxbe explained. Several hormones can spike in men when they become dads, including oxytocin, linked to better relationship quality; vasopressin, associated with emotional bonding; and prolactin, which promotes lactation in women and caregiving behavior in guys.
New dads can also experience a decline in testosterone. According to a 2011 paper from University of Notre Dame professor Lee Gettler, part of the largest study on fatherhood and testosterone ever conducted, men averaged around a 25% drop in testosterone after becoming fathers.
While dads have reasons to be concerned by plummeting levels of testosterone, a modest dip isn’t necessarily a disaster — in fact, it can make men better parents and partners.
“We often get invested in the idea that men should always have the highest possible levels of testosterone,” Saxbe said. “What the research tells us is a little more nuanced. You really want flexibility. You want a hormonal system that can adapt to the different demands of your life.”
The prospect of a decline might scare soon-to-be fathers, especially those on TikTok and Instagram, where accounts push the idea that having “high T” is the key to being a “real man,” according to a recent study in the journal Social Science & Medicine.
Influencers stand to profit persuading men there’s a widespread “masculinity crisis,” the researchers found, noting that 72% of the accounts they analyzed had a stake in testosterone supplements and treatments.
But studies show more testosterone isn’t always better. “We found that when dads have higher testosterone, even before birth, they’re less invested [than men with lower testosterone] in co-parenting a few months after birth,” Saxbe said. High T fathers were more stressed from parenting than their lower T counterparts, and had partners who were less satisfied in their romantic relationships.
This jibes with the challenge hypothesis, which says, in multiple species, testosterone levels rise when males battle for attention from potential mates and go down when it’s time to take care of the young.
While a small decline can be adaptive, dads face mental health risks when their testosterone drops too low.
There is no “normal” level of testosterone, said Dr. Jesse Mills, director of the Men’s Clinic at UCLA Health. Experts recommend that men should consider treatment if their levels dip below 300 nanograms per deciliter (ng/dL). But men metabolize testosterone in different ways, meaning a healthy level for one might be low for another.
“If a new dad comes to me and his testosterone is 298 [ng/dL], he’s below the threshold,” Mills said. “But if he has zero symptoms and everything else is going great — he’s over the moon with his new child, he’s so happy — that’s not somebody I’m going to treat with testosterone.”
He notes that the drop in testosterone fathers experience can partly be attributed to the stresses that come with a new kid: less sleep, a poor diet and fewer trips to the gym. That means there are precautions that expectant fathers can take that don’t involve testosterone replacement therapy (TRT).
Still, while some guys with low testosterone levels might not need TRT, others in the “normal” range could benefit from treatment. (Dads who want another kid soon, beware. Mills notes that testosterone replacement therapy can take a man’s sperm count to zero.)
Both Mills and Saxbe stress that men should be paying attention to symptoms of low testosterone — such as depression and low libido — rather than trying to reach or maintain an ideal number. They also agree that tending to mental health concerns is hugely important for new fathers.
Eventually, after Maguire researched his condition, he recovered after time spent meditating, exercising and bonding with his son.
“A lot of new dads don’t realize how much they’re struggling because they feel ashamed or because they don’t realize it’s common shortly after the birth of a baby,” Saxbe said.
When they struggle, fathers can fixate on testosterone because that’s what modern culture tells them will make them feel better. And sometimes testosterone replacement therapy works. But Saxbe stresses a lot of men could use psychotherapy or support groups that bring dads together, as well as more time bonding with loved ones in general.
“The thing that predicts a man’s well-being and longevity is the quality of his relationships with other people,” said Saxbe. “You can be the world’s best weightlifter. You can have a low body-fat percentage. You can be killing it at work. Those things don’t predict how happy you’re going to be at 80.”
Science
Video: NASA Announces Artemis III Crew
new video loaded: NASA Announces Artemis III Crew
transcript
transcript
NASA Announces Artemis III Crew
NASA announced the crew of Artemis III mission, which will fly to low-Earth orbit to test rendezvous and docking maneuvers with one or two lunar landers.
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“I am excited to welcome you as the next crew in the Artemis journey to successfully return to the moon — this time to stay.” “I’m honored by the role that I’ve been given. I’m also very humbled by the task in front of us. But first and foremost, I’m grateful.” “So with that, the Artemis II crew, comrade, hands you the baton. You got the controls.” “As you know, we had a significant anomaly at our Launch Complex 36A on May 28. We’ve redoubled our efforts and are moving forward.”
By Alisa Shodiyev Kaff
June 9, 2026
Science
Santa Monica Mountains’ last steelhead trout survived the Palisades fire — and even had babies
Scientists feared the Santa Monica Mountains’ last remaining steelhead trout were dead, smothered by debris flows unleashed by the Palisades fire.
But the endangered fish surprised them: A team of biologists recently spotted 30 of the rare trout — and 21 babies — in Topanga Creek.
“There was a lot of happy dancing in the creek,” said Rosi Dagit, principal conservation biologist for the Resource Conservation District of the Santa Monica Mountains, which works with public and private landowners to conserve natural resources.
That’s because the steelhead here are endangered, at both the state and federal levels. Once, they swam in most streams of the Santa Monicas, but their numbers plummeted amid overfishing and coastal development. Increasingly frequent wildfire has further stressed their habitat. Topanga Creek, a biodiversity hot spot, is home to their last known population in the mountains that stretch from the Hollywood Hills to Point Mugu in Ventura County.
The trout that were spotted, including this one, are part of a distinct Southern California population that’s listed as endangered at the state and federal levels.
(RCDSMM Stream Team)
The California Department of Fish and Wildlife spearheaded a complex mission to rescue trout threatened by the Palisades fire that sparked in January 2025.
Time was of the essence. The fire hadn’t yet been fully contained. But rain was on the way, which would sweep massive amounts of sediment from the denuded hillsides into the water. Fish are often killed this way.
Crews stunned the fish with electricity, scooped them up in buckets, trucked them to a hatchery and ultimately moved them to Arroyo Hondo Creek in Santa Barbara County.
Within days, Topanga Creek was choked with mud. Some assumed the fish left behind were goners.
But in March, the conservation district’s team found four. The following month, when water conditions were clearer, they saw more.
“These fish continue to amaze me,” said Kyle Evans, environmental program manager for the state Department of Fish and Wildlife, who had seen the damage to the creek. “I had seen populations get wiped out in similar situations. So when I heard, I was thrilled.”
Evans surmises the fish that survived were in an area of the creek where less charred material and sediment were swept in.
“These fish likely hunkered down, were hiding under some rocks or places to try to get away from the main concentration of flow,” he said. “And luckily they weren’t buried.”
The ones that were spotted were fairly small, around 6 to 14 inches. Rainbow trout and steelhead trout are the same species, but with different lifestyles. If the fish remain in freshwater, they’ll be considered rainbows. However, they can migrate to the ocean and become steelhead, where they typically grow larger before returning to their natal waters to spawn.
Topanga Creek hasn’t fully recovered from the damage it sustained, but scientists say it’s looking better. Surveys last year were “so depressing,” Dagit said, with very few animals, and stretches that were essentially transformed into flat roads from all the sediment buildup. Some of the riparian canopy burned right down to the creek.
Then came 32 inches of rain over the last nine months, scouring out and moving sediment, creating deeper pools. Dagit said they recently found newt egg masses for the first time in years, as well as a few adult newts and many frogs. Plants that provide cover are starting to recover.
She provided photos comparing certain pools last year and this year, some dramatically transformed. In September 2025, the Shrine Pool could have been an overgrown hiking trail. This April, it was filled with shallow water.
The Shrine Pool in September 2025, left, and the same location in April 2026, right, with RCDSMM’s Isaac Yelchin donning a wetsuit.
(RCDSMM Stream Team)
Topanga Creek is home to another endangered fish, the small but hardy northern tidewater goby, often described as cute. Not long before the trout operation, Dagit led a rescue of hundreds of these fish too. Many were repatriated to the lagoon at the mouth of the creek in a moving ceremony last June.
There’s still the matter of what to do with the trout that were moved to Santa Barbara County last year. Evans would like to bring them home to the Santa Monicas at some point, but isn’t sure if it will happen. On one hand, they could bolster the small, genetically isolated surviving population. On the other, they might inadvertently bring in a disease or bacteria. There is some time to decide. Evans estimates the creek still needs to recover for two to three more years.
For now, the fish are functioning fine in their adopted creek. Experts worried the trauma wrought by the move would disrupt their spawning process, but they had babies that spring. This year, they spawned again.
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