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AI and memory deletion: Inside the medical quest to cure grief

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AI and memory deletion: Inside the medical quest to cure grief

When Cody Delistraty lost his mother in 2014, he was surprised by the various ways that he, his brother and his father dealt with their grief. The journalist and speechwriter had expected his family’s experiences to be aligned, that there would be a, “homogeneity to grieving.” The differences led Delistraty to wonder whether loss was more complicated than advertised.

In America, grief is often framed as a journey from Point A to Point B, a linear path efficiently chugging through stages like denial and anger, ultimately heading toward acceptance. But anyone who has experienced a loss firsthand understands that it isn’t so simple. Grief can be isolating, confusing and unyielding.

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Shelf Help is a new wellness column where we interview researchers, thinkers and writers about their latest books — all with the aim of learning how to live a more complete life.

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In 2022, a new addition to the DSM-5 (“Diagnostic and Statistical Manual of Mental Disorders”) caught Delistraty’s eye: prolonged grief disorder. It’s a rare condition in which grief becomes so severe that it interferes with daily life. The classification opens the door to medical solutions: pharmaceuticals are in early testing stages, and a slew of new digital, psychedelic and other treatments are emerging.

Delistraty’s new book, “The Grief Cure: Looking for the End of Loss,” (Harper) follows his inquisitive sampling of available and future therapies, all while wondering whether grief is a problem that needs to be solved.

Your understanding of grief initially centered on a concept known as the five stages: denial, anger, bargaining, depression and acceptance. How did that shift?

Portrait of Cody Delistraty standing in front of a bookcase

Cody Delistraty (Grace Ann Leadbeater)

When Elisabeth Kübler-Ross came up with the five stages, she was talking to patients who were coming to terms with their own deaths, not with their own grief, which is similar but also very different. There was a study that tracked grievers from various demographics and found that most people actually experience a progression, but my issue with the typical interpretation of the five stages is that it’s presented as the right way to grieve, that there’s a method you can master and that the end game is acceptance.

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America has a culture of individuality and mastery — we want to achieve, we want to overcome, we want to bootstrap our way to success. But in grief, we only set ourselves back trying to do this. After a loss is the time to pause and reflect, and even if you do go through these stages to some degree, trying to rush through them or extract value in order to get to acceptance and move on is a fundamentally wrong way of looking at it.

“America has a culture of individuality and mastery — we want to achieve, we want to overcome, we want to bootstrap our way to success. But in grief, we only set ourselves back trying to do this.”

— Cody Delistraty, author of “The Grief Cure.”

Your book confronts the isolation of grieving and how it’s so often considered unseemly or inappropriate when done publicly. Grief is culturally framed as an individual journey, and yet it’s a universal fact of life. What do you think accounts for this disconnect?

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This paradigm shift from public to private grieving is a relatively recent phenomenon. Americans, especially, are weary of talking or asking about loss. This is a symptom of “happiness culture,” where grief is considered a burden and you don’t want to seem unhappy or bring others down. The disintegration of local communities exacerbates this. And then this false idea that closure marks a victory over grief. Keeping grief private implies that you did your job. There’s morally valuable willpower. You did it. You got over it.

I think self-care has been the problematic marketing breakthrough of the 21st century, in which the more challenging aspects of being a human, like disappointment, sadness and grief, get pushed out of the frame. They’re not within our consumption narrative, and they’re not within the way we want to present to others.

What surprised me while researching is that it seems like people are actually bubbling with the desire to talk about these things. When I was researching for the book, I got sick of holing up in hotels, so I went to a bar and ended up talking with someone who told me about her recent divorce, which she called the greatest loss of her life. She hadn’t really talked to anybody about it, and it was so nice to connect over loss. When people are open, it can snowball into greater openness.

Our society can place varying value on different types of loss, resulting in some to fall through the cracks, like that woman with her divorce. But grief exists on a spectrum. In the book, you discuss ambiguous loss. Can you tell me more?

Book jacket for "The Grief Cure" by Cody Delistraty

(Courtesy of Harper Collins)

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The term ambiguous loss was coined by Pauline Boss at the University of Minnesota, who worked with the families of soldiers who went missing in Vietnam. Boss defined it as “a relational disorder caused by the lack of facts surrounding the loss of a loved one,” but today, it encompasses a wide variety of loss.

Climate grief is a big and very modern one. There was a European study that found a third of respondents are extremely worried about climate change. That’s a huge instance of ambiguous grief because there’s disappearance of species and landscapes, there’s an increase in climate refugees, but you can’t really point to a body in a casket and say this is what I’m grieving.

Relationships are another big example. In the book, I went to breakup boot camp to explore losing a loved one outside of death. Friend breakups can be devastating. I really push against the idea of hierarchies and grief. There isn’t a fundamental ranking within grief, and it is subjective to the relationship you had to that person or thing.

Your experiences brought you to the cutting edge of grief research. What do you make of the future of grief treatments?

When I was writing the AI [artificial intelligence] chapter of re-creating technologically deceased loved ones, it was super cutting-edge and wild. Then, of course, it all hit the news cycle pretty intensely with Chat-GPT. Optogenetics for memory deletion could be something we’re faced with in another decade or two. There will be medical technologies where we can take a lot of the pain and burden out of loss. My book questions whether that’s really for the best. We should be thinking about this now before the time comes.

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TAKEAWAYS

from “The Grief Cure”

Psilocybin is a huge scientific breakthrough for grief. I talked to one of the most renowned psilocybin researchers, Robin Carhart-Harris, who told me about this guy, Kirk Rutter, whose mother had died, he’d been in this terrible car accident and then he went through a romantic breakup all in the span of about a year. Carhart-Harris’ team gave him just two pills of synthesized psilocybin, donned him with an eye mask and calm music, and he had this incredible perspective shift. He cycled through memories of his mom and realized he didn’t have to maintain the most painful parts, but he could still hold onto her and respect her memory. That treatment made him look at grief differently.

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What is your best advice for somebody really stuck in their grief?

There’s no right way of doing it, but don’t rush it. As awful as this time is, there’s so much to be gleaned from really looking inward, reflecting on yourself and your feelings, and thinking about the person you’ve lost. I rushed after my mom died, trying to push past the pain, and here I am, a decade later, writing a book about it. These things really do take time.

I also recommend telling your people what you need from them. The vast majority of people want to talk about these things, they want to be helpful, but especially in the U.S., we are very bad at knowing what that looks like. To the degree that you can, communicate your needs. I think you’d be surprised by the degree to which people will be there for you.

Should someone in grief be aiming for closure?

I think closure is a mythical idea. Nancy Berns, a professor at Drake University, has done a lot of great work on closure and how it’s a social construct. We too often skip over the grappling-with and reflecting-on of grief in order to get to this mythical place of closure when really the truest value is being able to hold that loss in one part of your life while holding a future-looking part in another.

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We see this push for closure reified across American culture. One of the biggest shocks for me was bereavement leave, where the median is only five days according to a 2024 study, and this only applies to a close family death. There’s no U.S. federal law requiring leave. This bolsters the idea that closure is part and parcel of productivity, of getting back to normal, of getting back to work.

Our rituals around grief are one-off. We go to a funeral, and that’s it. You get support for an hour, and then it’s over. We’d do well to really reflect on more personal, creative rituals that have more intimate meaning and can be continued over a longer period. This shift would help people with the understanding of time lines around grief. It all takes so much longer than we think. You miss so much when you rush through to tick the box of closure, and frankly, when you do so, you’re really not grieving at all.

a figure sit in the threshold of a door opening to a void

(Maggie Chiang / For The Times)

Endicott is a writer and multi-disciplinary artist based in Denver. Her work has appeared in a number of publications including the New York Times, Scientific American, the Guardian, Elle, Electric Lit and Bomb Magazine. You can find her on Instagram @weirdbirds.

Shelf Help is a new wellness column where we interview researchers, thinkers and writers about their latest books — all with the aim of learning how to live a more complete life. Want to pitch us? Email alyssa.bereznak@latimes.com.

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What’s in a Name? For These Snails, Legal Protection

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What’s in a Name? For These Snails, Legal Protection

The sun had barely risen over the Pacific Ocean when a small motorboat carrying a team of Indigenous artisans and Mexican biologists dropped anchor in a rocky cove near Bahías de Huatulco.

Mauro Habacuc Avendaño Luis, one of the craftsmen, was the first to wade to shore. With an agility belying his age, he struck out over the boulders exposed by low tide. Crouching on a slippery ledge pounded by surf, he reached inside a crevice between two rocks. There, lodged among the urchins, was a snail with a knobby gray shell the size of a walnut. The sight might not dazzle tourists who travel here to see humpback whales, but for Mr. Avendaño, 85, these drab little mollusks represent a way of life.

Marine snails in the genus Plicopurpura are sacred to the Mixtec people of Pinotepa de Don Luis, a small town in southwestern Oaxaca. Men like Mr. Avendaño have been sustainably “milking” them for radiant purple dye for at least 1,500 years. The color suffuses Mixtec textiles and spiritual beliefs. Called tixinda, it symbolizes fertility and death, as well as mythic ties between lunar cycles, women and the sea.

The future of these traditions — and the fate of the snails — are uncertain. The mollusks are subject to intense poaching pressure despite federal protections intended to protect them. Fishermen break them (and the other mollusks they eat) open and sell the meat to local restaurants. Tourists who comb the beaches pluck snails off the rocks and toss them aside.

A severe earthquake in 2020 thrust formerly submerged parts of their habitat above sea level, fatally tossing other mollusks in the snail’s food web to the air, and making once inaccessible places more available to poachers.

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Decades ago, dense clusters of snails the size of doorknobs were easy to find, according to Mr. Avendaño. “Full of snails,” he said, sweeping a calloused, violet-stained hand across the coves. Now, most of the snails he finds are small, just over an inch, and yield only a few milliliters of dye.

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Video: This Parrot Has No Beak, But Is at the Top of the Pecking Order

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Video: This Parrot Has No Beak, But Is at the Top of the Pecking Order

new video loaded: This Parrot Has No Beak, But Is at the Top of the Pecking Order

Bruce, a disabled kea parrot, is missing his top beak. The bird uses tools to keep himself healthy and developed a jousting technique that has made him the alpha male of his group.

By Meg Felling and Carl Zimmer

April 20, 2026

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Contributor: Focus on the real causes of the shortage in hormone treatments

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Contributor: Focus on the real causes of the shortage in hormone treatments

For months now, menopausal women across the U.S. have been unable to fill prescriptions for the estradiol patch, a long-established and safe hormone treatment. The news media has whipped up a frenzy over this scarcity, warning of a long-lasting nationwide shortage. The problem is real — but the explanations in the media coverage miss the mark. Real solutions depend on an accurate understanding of the causes.

Reporters, pharmaceutical companies and even some doctors have blamed women for causing the shortage, saying they were inspired by a “menopause moment” that has driven unprecedented demand. Such framing does a dangerous disservice to essential health advocacy.

In this narrative, there has been unprecedented demand, and it is explained in part by the Food and Drug Administration’s recent removal of the “black-box warning” from estradiol patches’ packaging. That inaccurate (and, quite frankly, terrifying) label had been required since a 2002 announcement overstated the link between certain menopause hormone treatments and breast cancer. Right-sizing and rewording the warning was long overdue. But the trouble with this narrative is that even after the black-box warning was removed, there has not been unprecedented demand.

Around 40% of menopausal women were prescribed hormone treatments in some form before the 2002 announcement. Use plummeted in its aftermath, dipping to less than 5% in 2020 and just 1.8% in 2024. According to the most recent data, the number has now settled back at the 5% mark. Unprecedented? Hardly. Modest at best.

Nor is estradiol a new or complex drug; the patch formulation has existed for decades, and generic versions are widely manufactured. There is no exotic ingredient, no rare supply chain dependency, no fluke that explains why women are suddenly being told their pharmacy is out of stock month after month.

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The story is far more an indictment of the broken insurance industry: market concentration, perverse incentives and the consequences of allowing insurance companies to own the pharmacy benefit managers that effectively control drug access for the majority of users. Three companies — CVS Caremark, Express Scripts and OptumRx — manage 79% of all prescription drug claims in the United States. Those companies are wholly owned subsidiaries of three insurance behemoths: CVS Health, Cigna and UnitedHealth Group, respectively. This means that the same corporation that sells you your insurance plan also decides which drugs get covered, at what price, and whether your pharmacy can stock them. This is called vertical integration. In another era, we might have called it a cartel. The resulting problems are not unique to hormone treatments; they have affected widely used medications including blood thinners, inhalers and antibiotics. When a low-cost generic such as estradiol — a medication with no blockbuster profit margins and no patent protection — runs into friction in this system, the friction is not random. It is structural. Every decision in that chain is filtered through the same corporate profit motive. And when the drug in question is an off-patent estradiol patch that has negligible profit margins because of generic competition but requires logistical investment to keep consistently in stock? The math on “how much does this company care about ensuring access” is not complicated.

Unfortunately, there is little financial incentive to ensure smooth, consistent access. There is, however, significant financial incentive to steer patients toward branded alternatives, or simply to let supply tighten — because the companies aren’t losing much profit if sales of that product dwindle. This is not a conspiracy theory: The Federal Trade Commission noted this dynamic in a report that documented how pharmacy benefit managers’ practices inflate costs, reduce competition and harm patient access, particularly for independent pharmacies and for generic drugs.

Any claim that the estradiol patch shortage is meaningfully caused by more women now demanding hormone treatments is a distraction. It is also misogyny, pure and simple, to imply that the solution to the shortage is for women’s health advocates to dial it down and for women to temper their expectations. The scarcity of estradiol patches is the outcome of a broken system refusing to provide adequate supply.

Meanwhile, there are a few strategies to cope.

  • Ask your prescriber about alternatives. Estradiol is available in multiple formulations, including gel, spray, cream, oral tablet, vaginal ring and weekly transdermal patch, which is a different product from the twice-weekly patch and may be more consistently available depending on manufacturer and region.
  • Consider an online pharmacy. Many are doing a good job locating and filling these prescriptions from outside the pharmacy benefit manager system.
  • Call ahead. Patch shortages are inconsistent across regions and distributors. A call to pharmacies in your area, or a broader geographic radius if you’re able, can locate stock that your regular pharmacy doesn’t have.
  • Consider a compounding pharmacy. These sources can sometimes meet needs when commercially manufactured products are inaccessible. The hormones used are the same FDA-regulated bulk ingredients.

Beyond those Band-Aid solutions, more Americans need to fight for systemic change. The FTC report exists because Congress asked for it and committed to legislation that will address at least some of the problems. The FDA took action to change the labeling on estrogen in the face of citizen and medical experts’ pressure; it should do more now to demand transparency from patch manufacturers.

Most importantly, it is on all of us to call out the cracks in the current system. Instead of repeating “there’s a patch shortage” or a “surge in demand,” say that a shockingly small minority of menopausal women still even get hormonal treatments prescribed at all, and three drug companies control the vast majority of claims in this country. Those are the real problems that need real solutions.

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Jennifer Weiss-Wolf, the executive director of the Birnbaum Women’s Leadership Center at New York University School of Law, is the author of the forthcoming book When in Menopause: A User’s Manual & Citizen’s Guide. Suzanne Gilberg, an obstetrician and gynecologist in Los Angeles, is the author of “Menopause Bootcamp.”

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