Science
Column: He was the oldest man in the U.S., and his loving caretaker was with him to the end
The oldest male in the United States was a man of many appetites, even at 110, and his live-in caretaker did her best to feed them.
Rosario Reyes would make banana pancakes for Morrie Markoff, and he would plead for more syrup. She’d bring him a corned beef sandwich, followed by a piece of lemon meringue pie, and reluctantly give in when he insisted on washing that down with a cup of hot chocolate.
Markoff wanted to read the paper, watch the news and get in some exercise every day, and Reyes helped make it happen. He made clear that on his 111th birthday in January, he fully expected an exotic dancer to perform in the living room of his Bunker Hill apartment, for the third straight year. Reyes already had the balloons in storage.
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In their normal daily routine, they’d listen to classical music together or watch, yet again, two of Markoff’s favorite movies: “Midway” or “Guns of Navarone.” Markoff also liked “The Notebook,” which Reyes hadn’t seen. He bet her that if they watched it together, she would cry. And she did.
He called her by her nickname, Charito. She called him Mr. Morrie.
“It was kind of a remarkable relationship,” said Judith Hansen, Markoff’s daughter, who called Reyes an angel and one of countless unsung heroes in the elder-care ranks. “Dad would not have lived as long as he did without Charito. She’s an incredibly wise woman, and she knew what would keep him going. She knew that he was a man who wanted to accomplish something each day.”
Markoff celebrated his 109th birthday in downtown Los Angeles.
(Family photo)
And he usually did, until his body began giving out in April. Markoff was briefly hospitalized a few weeks ago and died at home June 3, with Charito holding Mr. Morrie’s hands in hers.
“He died in peace,” she said.
I was lucky to have met Markoff when he responded to a 2012 column I wrote about having been resuscitated after going into cardiac arrest following knee replacement surgery. He’d been a goner, too, Markoff said, just shy of his 99th birthday, and we ought to have a cup of coffee and “hang around” together as full-fledged members of the Back From the Dead Club.
Markoff grew up in a New York City tenement, dropped out of school after eighth grade, went to a trade school, married his beloved Betty in 1938 and moved west, where he sometimes drove her crazy with his manic energy and argumentative nature. As he aged and mellowed, Markoff swooned over his beloved “Betsy,” as he called her, and after she died in 2019, he couldn’t stop singing a song he wrote about pining to be with her again.
I had the pleasure of being at Markoff’s 100th birthday party (there was cake, but no exotic dancers), Betty’s 100th and their 75th wedding anniversary. He once said to me that he couldn’t recall being bored a day in his life, and that was his gift to all of us: the reminder that if you stay plugged into the world around you and open yourself to new experiences, the aging process can slow to a crawl.
“If I had to put my finger on one thing that helped his longevity, I would say it was his innate curiosity about everything,” said his son, Steven, who, like his sister, is in his 80s.
That and, of course, the luck of good genes.
Markoff and his wife, Betty, at home in September 2013.
(Los Angeles Times)
“You could bring him a sow bug,” Steven said, “and he would say, ‘Look, it rolled into a little ball. How did it do that?’ Or he would say, ‘I just met the most interesting person in the world on a bus.’”
In fact, Morrie and Betty loved exploring Los Angeles by bus, and one day they met Tracy Huston, the owner of a Chinatown gallery. Markoff, who was trained as a machinist but held a variety of jobs, mentioned that while servicing and repairing gadgets and appliances, he’d noticed that a toilet tank float looked like the skirt of a ballerina. So he began welding scrap metal parts together, fashioning dozens of sculptures, including a ballerina.
Huston was intrigued, and in 2014, I attended Markoff’s first-ever art exhibit, in her gallery. It was yet another high point in a life that had just hit the century mark, and one of my most prized possessions — a gift from Markoff — is his sculpture of his daughter reading a book.
I once visited the Markoffs with the late Times photographer Gary Friedman, who adored them. When Markoff mentioned that he’d taken thousands of black-and-white photographs on his world travels, Friedman was astonished by the quality of the work in Markoff’s neatly archived albums and told him they ought to be in a museum.
Markoff frequently talked to me about his years-in-the-making memoir, and the working title was his answer to a question he fielded often: “What is the secret to a long life?” Markoff was 103 when he sold copies of “Keep Breathing” from his very own booth at the L.A. Times Festival of Books.
When I wrote about attending his 109th birthday party last year, I noted that Markoff’s live-in care was a luxury many people won’t be able to afford, given longer lifespans. He’d saved and invested well, Steven told me at the time, but the cost of 24-hour care can easily run $10,000-$15,000 monthly, and the shortage of home healthcare workers is a massive unaddressed challenge.
“The real lesson learned from this is how unprepared our government is to deal with end of life for people,” Steven told me the other day. “It seems to me a tragedy, with all the money that’s spent in other ways.”
When Markoff was nearing the end, Judith got the idea that with so many millions of people experiencing dementia in old age, her father’s extraordinary brain might be useful to researchers. She went to the National Institutes of Health website and was linked to Tish Hevel of the nonprofit Brain Donor Project, who gladly accepted the donation.
“Lots of studies are being done on super-agers, and he may be the super-est of super-agers,” Hevel told me. “Some people in brain banking think this could be the oldest cognitively intact brain that is now preserved.”
Hevel said 16,000 brains are in the bank, helping researchers study mental illness, Parkinson’s disease, cognitive loss and other neurological disorders. Having a healthy brain like Markoff’s can be invaluable, Hevel said, for comparative analysis.
“I think Dad would be tickled to death to know that someone was interested enough to analyze his brain,” said Steven, who had lunch with his father weekly and was struck by how sharp he remained until several weeks ago, when he began to fade and the family decided to begin hospice care.
Reyes, who has a daughter in college, met the Markoffs about 20 years ago, when she worked as their housekeeper. It was only in the last few years that the native of Peru became Markoff’s full-time caregiver. When I met with her Saturday morning at Markoff’s apartment, she shared a packet of handwritten notes he’d written to me but hadn’t yet mailed.
“With all the young people being killed in fruitless wars,” he wrote in one, using cursive on lined paper, “the undertakers don’t need me. They are busy enough.”
He was a lifelong progressive, and Reyes said he told her he had lived through many of the world’s miseries, including the Spanish flu and COVID-19 pandemics, two world wars and the death of civil discourse over the last several years.
“This was always his favorite place,” Reyes said, showing me the sunroom from which Markoff would take in the view of downtown L.A. high-rises.
He was like the Energizer bunny, she said, in a hurry to drag out the trash bins or head out for a brisk walk. She said she had to hustle to keep him busy, so each day, on a legal pad, she wrote a list of things for Markoff to do, including read the paper, exercise, play cards, watch the evening news, reach out to family and work on his blog (he billed himself as the world’s oldest blogger).
“Always make a plan,” she recalled him saying on many occasions. “Never stop. Next. Next. Next.”
Markoff celebrated his 108th birthday with his daughter-in-law, Jadwiga.
(Steve Lopez / Los Angeles Times)
She showed me a video she took of Markoff watching news of the solar eclipse in April.
“I’m a lucky man,” he said. “It’s wonderful to sit here in comfort and watch the eclipse happen.”
In Markoff’s final hours, Reyes told him he was going to be with Betty again. It was the saddest moment of her life, she told me, but knowing Markoff wouldn’t want to go on living if he couldn’t keep moving, keep discovering, keep making plans, she told him he would be better off.
His color changed at the moment of his death, Reyes said, and she told him to reach for Betty’s hand.
“He died in peace,” Reyes said. “And he’s where he wants to be.”
steve.lopez@latimes.com
California lawmakers are taking aim at proposed rules to implement a state law aimed at curbing plastic waste, saying the draft regulations proposed by CalRecycle undermine the letter and intent of the legislation.
In a letter to Gov. Gavin Newsom and two of his top administrators, the lawmakers said CalRecycle exceeded its authority by drafting regulations that don’t abide by the terms set out by the law, Senate Bill 54.
“While we support many changes in the current draft regulations, we have identified several provisions that are inconsistent with the governing statute … and where CalRecycle has exceeded its authority under the law,” the lawmakers wrote in the letter to Newsom, California Environmental Protection agency chief Yana Garcia, and Zoe Heller, director of the state’s Department of Resources Recycling and Recovery, or CalRecycle.
The letter, which was written by Sen. Catherine Blakespear (D-Encinitas) and Sen. Benjamin Allen (D-Santa Monica), was signed by 21 other lawmakers, including Sen. John Laird (D-Santa Cruz) and Assemblymembers Al Muratsuchi (D-Rolling Hills Estates) and Monique Limón (D-Goleta).
CalRecycle submitted informal draft regulations two weeks ago that are designed to implement the law, which was authored by Allen, and signed into law by Newsom in 2022.
The lawmakers’ concerns are directed at the draft regulations’ potential approval of polluting recycling technologies — which the language of the law expressly prohibits — as well as the document’s expansive exemption for products and packaging that fall under the purview of the U.S. Department of Agriculture and the Food and Drug Administration.
The inclusion of such blanket exemptions is “not only contrary to the statute but also risks significantly increasing the program’s costs,” the lawmakers wrote. They said the new regulations allow “producers to unilaterally determine which products are subject to the law, without a requirement or process to back up such a claim.”
Daniel Villaseñor, a spokesman for the governor, said in an email that Newsom “was clear when he asked CalRecycle to restart these regulations that they should work to minimize costs for small businesses and families, and these rules are a step in the right direction …”
At a workshop held at the agency’s headquarters in Sacramento this week, CalRecycle staff responded to similar criticisms, and underscored that these are informal draft regulations, which means they can be changed.
“I know from comments we’ve already been receiving that some of the provisions, as we have written them … don’t quite come across in the way that we intended,” said Karen Kayfetz, chief of CalRecycle’s Product Stewardship branch, adding that she was hopeful “a robust conversation” could help highlight areas where interpretations of the regulations’ language differs from the agency’s intent.
“It was not our intent, of course, to ever go outside of the statute, and so to the extent that it may be interpreted in the language that we’ve provided, that there are provisions that extend beyond … it’s our wish to narrow that back down,” she said.
These new draft regulations are the expedited result of the agency’s attempt to satisfy Newsom’s concerns about the law, which he said could increase costs to California households if not properly implemented.
Newsom rejected the agency’s first attempt at drafting regulations — the result of nearly three years of negotiations by scores of stakeholders, including plastic producers, package developers, agricultural interests, environmental groups, municipalities, recycling companies and waste haulers — and ordered the waste agency to start the process over.
Critics say the new draft regulations cater to industry and could result in even higher costs to both California households, which have seen large increases in their residential waste hauling fees, as well as to the state’s various jurisdictions, which are taxed with cleaning up plastic waste and debris clogging the state’s rivers, highways, beaches and parks.
The law is molded on a series of legislative efforts described as Extended Producer Responsibility laws, which are designed to shift the cost of waste removal and disposal from the state’s jurisdictions and taxpayers to the industries that produce the waste — theoretically incentivizing a circular economy, in which product and packaging producers develop materials that can be reused, recycled or composted.
As promised, federal health officials have dropped longstanding recommendations that healthy children and healthy pregnant women should get the COVID-19 vaccines.
“The COVID-19 vaccine schedule is very clear. The vaccine is not recommended for pregnant women. The vaccine is not recommended for healthy children,” the U.S. Department of Health and Human Services said in a post on X on Friday.
In formal documents, health officials offer “no guidance” on whether pregnant women should get the vaccine, and ask that parents talk with a healthcare provider before getting the vaccine for their children.
The decision was done in a way that is still expected to require insurers to pay for COVID-19 vaccines for children should their parents still want the shots for them.
The new vaccine guidelines were posted to the website of the U.S. Centers for Disease Control and Prevention late Thursday.
The insurance question
It wasn’t immediately clear whether insurers will still be required under federal law to pay for vaccinations for pregnant women.
The Trump administration’s decision came amid criticism from officials at the nation’s leading organizations for pediatricians and obstetricians. Some doctors said there is no new evidence to support removing the recommendation that healthy pregnant women and healthy children should get the COVID vaccine.
“This situation continues to make things unclear and creates confusion for patients, providers and payers,” the American College of Obstetricians and Gynecologists said in a statement Friday.
Earlier in the week, the group’s president, Dr. Steven Fleischman, said the science hasn’t changed, and that the COVID-19 vaccine is safe during pregnancy, and protects both the mom-to-be and their infants after birth.
“It is very clear that COVID-19 infection during pregnancy can be catastrophic,” Fleischman said in a statement.
Dr. Susan Kressly, president of the American Academy of Pediatrics, criticized the recommendation change as being rolled out in a “conflicting, confusing” manner, with “no explanation of the evidence used to reach their conclusions.”
“For many families, the COVID vaccine will remain an important way they protect their child and family from this disease and its complications, including long COVID,” Kressly said in a statement.
Some experts said the Trump administration should have waited to hear recommendations from a committee of doctors and scientists that typically advises the U.S. Centers for Disease Control and Prevention on immunization recommendations, which is set to meet in late June.
California’s view
The California Department of Public Health on Thursday said it supported the longstanding recommendation that “COVID-19 vaccines be available for all persons aged 6 months and older who wish to be vaccinated.”
The changes come as the CDC has faced an exodus of senior leaders and has lacked an acting director. Typically, as was the case during the first Trump administration and in the Biden administration, it is the CDC director who makes final decisions on vaccine recommendations. The CDC director has traditionally accepted the consensus viewpoint of the CDC’s panel of doctors and scientists serving on the Advisory Committee on Immunization Practices.
Even with the longstanding recommendations, vaccination rates were relatively low for children and pregnant women. As of late April, 13% of children, and 14.4% of pregnant women, had received the latest updated COVID-19 vaccine, according to the CDC. About 23% of adults overall received the updated vaccine, as did 27.8% of seniors age 65 and over.
The CDC estimates that since October, there have been 31,000 to 50,000 COVID deaths and between 270,000 and 430,000 COVID hospitalizations.
Here are some key points about the CDC’s decision:
New vaccination guidance for healthy children
Previously, the CDC’s guidance was simple: everyone ages 6 months and up should get an updated COVID vaccination. The most recent version was unveiled in September, and is officially known as the 2024-25 COVID-19 vaccine.
As of Thursday, the CDC, on its pediatric immunization schedule page, says that for healthy children — those age 6 months to 17 years — decisions about COVID vaccination should come from “shared clinical decision-making,” which is “informed by a decision process between the healthcare provider and the patient or parent/guardian.”
“Where the parent presents with a desire for their child to be vaccinated, children 6 months and older may receive COVID-19 vaccination, informed by the clinical judgment of a healthcare provider and personal preference and circumstances,” the CDC says.
The vaccine-skeptic secretary of Health and Human Services, Robert F. Kennedy Jr., contended in a video posted on Tuesday there was a “lack of any clinical data to support the repeat booster strategy in children.”
However, an earlier presentation by CDC staff said that, in general, getting an updated vaccine provides both children and adults additional protection from COVID-related emergency room and urgent care visits.
Dr. Peter Chin-Hong, a UC San Francisco infectious diseases expert, said he would have preferred the CDC retain its broader recommendation that everyone age 6 months and up get the updated vaccine.
“It’s simpler,” Chin-Hong said. He added there’s no new data out there that to him suggests children shouldn’t be getting the updated COVID vaccine.
A guideline that involves “shared decision-making,” Chin-Hong said, “is a very nebulous recommendation, and it doesn’t result in a lot of people getting vaccines.”
Kressly, of the American Academy of Pediatrics, said the shared clinical decision-making model is challenging to implement “because it lacks clear guidance for the conversations between a doctor and a family. Doctors and families need straightforward, evidence-based guidance, not vague, impractical frameworks.”
Some experts had been worried that the CDC would make a decision that would’ve ended the federal requirement that insurers cover the cost of COVID-19 vaccines for children. The out-of-pocket cost for a COVID-19 vaccine can reach around $200.
New vaccine guidance for pregnant women
In its adult immunization schedule for people who have medical conditions, the CDC now says it has “no guidance” on whether pregnant women should get the COVID-19 vaccine.
In his 58-second video on Tuesday, Kennedy did not explain why he thought pregnant women should not be recommended to get vaccinated against COVID-19.
Chin-Hong, of UCSF, called the decision to drop the vaccination recommendation for pregnant women “100%” wrong.
Pregnancy brings with it a relatively compromised immune system. Pregnant women have “a high chance of getting infections, and they get more serious disease — including COVID,” Chin-Hong said.
A pregnant woman getting vaccinated also protects the newborn. “You really need the antibodies in the pregnant person to go across the placenta to protect the newborn,” Chin-Hong said.
It’s especially important, Chin-Hong and others say, because infants under 6 months of age can’t be vaccinated against COVID-19, and they have as high a risk of severe complications as do seniors age 65 and over.
Not the worst-case scenario for vaccine proponents
Earlier in the week, some experts worried the new rules would allow insurers to stop covering the cost of the COVID vaccine for healthy children.
Their worries were sparked by the video message on Tuesday, in which Kennedy said that “the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule.”
By late Thursday, the CDC came out with its formal decision — the agency dropped the recommendation for healthy children, but still left the shot on the pediatric immunization schedule.
Leaving the COVID-19 vaccine on the immunization schedule “means the vaccine will be covered by insurance” for healthy children, the American Academy of Pediatrics said in a statement.
How pharmacies and insurers are responding
There are some questions that don’t have immediate answers. Will some vaccine providers start requiring doctor’s notes in order for healthy children and healthy pregnant women to get vaccinated? Will it be harder for children and pregnant women to get vaccinated at a pharmacy?
In a statement, CVS Pharmacy said it “follows federal guidance and state law regarding vaccine administration and are monitoring any changes that the government may make regarding vaccine eligibility.” The insurer Aetna, which is owned by CVS, is also monitoring any changes federal officials make to COVID-19 vaccine eligibility “and will evaluate whether coverage adjustments are needed.”
Blue Shield of California said it will not change its practices on covering COVID-19 vaccines.
“Despite the recent federal policy change on COVID-19 vaccinations for healthy children and pregnant women, Blue Shield of California will continue to cover COVID-19 vaccines for all eligible members,” the insurer said in a statement. “The decision on whether to receive a COVID-19 vaccine is between our member and their provider. Blue Shield does not require prior authorization for COVID-19 vaccines.”
Under California law, health plans regulated by the state Department of Managed Health Care must cover COVID-19 vaccines without requiring prior authorization, the agency said Friday. “If consumers access these services from a provider in their health plan’s network, they will not need to pay anything for these services,” the statement said.
Sacramento — Want to know what constitutes an acceptable form of recycling in California under CalRecycle’s new draft guidelines for the state’s landmark plastic waste law?
It’ll cost you roughly $187, and even then you may not find your answer.
The issue arose this week when CalRecycle held a Sacramento workshop on its proposed regulations to implement Senate Bill 54, the 2022 law designed to reduce California’s single-use plastic waste.
In the regulations’ latest iteration, the agency declared that it will only consider recycling technologies that follow standards issued by the International Organization for Standardization, or ISO, the Geneva-based group that sets standards for a variety of industries, including healthcare and transportation.
According to the draft regulations: “A facility’s use of a technology that is not a mechanical recycling technology … shall not be considered recycling unless the facility operates in a manner consistent with ISO 59014:2024.”
To access ISO 59014:2024, one must purchase the report for about $187.
That’s not fair, said Nick Lapis, director of advocacy for Californians Against Waste. “Copies of those ISO standards should be publicly available,” he said.
Lapis and others also noted that the law, as written, expressly prohibits chemical and nonmechanical forms of recycling.
Officials at CalRecycle, also known as the California Department of Resources Recycling and Recovery, didn’t respond to the criticism or to questions from The Times.
ISO 59014:2024 turns out to be a 38-page report titled “Environmental management and circular economy — Sustainability and traceability of the recovery of secondary materials — Principles, requirements and guidance.”
A copy of the report reviewed by The Times offered no specifics on recycling technologies, or information about the operation of a recycling plant.
The word “recycling” is only used five times in the “Annex,” a 13-page supplementary section of the report. And there it is mentioned only in the context of establishing definitions or examples of “organizations engaged in the recovery of secondary materials” or “collection system types.”
For instance, “Commercial waste and recycling companies” are listed as examples of a type of organization that collects waste. Other waste collectors, according to the report, include municipalities, retailers and reuse organizations such as nonprofit reuse operators.
“The draft calls on aligning facilities with this ISO standard,” said Monica Wilson, senior director of global programs at the Global Alliance for Incinerator Alternatives. “That ISO standard is not about recycling. It’s not about chemical recycling, it’s just not an appropriate comparison for us to be referring to.”
Lapis also found the report hard to decipher.
“Maybe I should go back and look at it again, but it’d be helpful if you’re citing ISO standards … that you identify what parts” are being cited, he said.
Karen Kayfetz, chief of CalRecycle’s Product Stewardship branch, didn’t respond to questions or concerns about the inclusion of a report that is not freely available to the public to review.
During this week’s workshop, she said the agency’s use of the ISO standard “is not meant … to be a measure of whether you are recycling, but rather just one of multiple criteria that an entity needs to be measured against.”
She said the SB 54 statute requires that CalRecycle exclude recycling technologies that produce significant amounts of hazardous waste and tasks the agency with considering environmental and public health impacts of these technologies.
“The ISO standard for the operation of facilities does address some of the best practices that would help to ameliorate and measure those impacts. … It is meant to be one of multiple criteria that can be utilized as a measure and to help set a floor but not a ceiling,” she said.
Anna Ferrera, a spokeswoman for the Wine Institute, which represents more than 1,000 wineries and affiliates across the state, was among those with no complaints about the proposed new regulations.
“We believe it incorporates common-sense changes that would reduce costs and ensure that products are appropriately recycled,” Ferrera said.
Tina Andolina, the chief of staff for state Sen. Ben Allen (D-Santa Monica), SB 54’s author, said the inclusion of the report and other items in the draft regulations suggests that CalRecycle is considering how to manage these polluting technologies — instead of forbidding them, as the law requires.
“The regulations unlawfully shift the standard from the production of hazardous waste as required by the statute to its management,” she said, reading from a letter Allen had written to the staff.
Anja Brandon, director of plastic policy at the Ocean Conservancy, added that along with not being freely available, the ISO standard “does not satisfy SB 54’s requirements to exclude the most hazardous technologies and to minimize the generation of hazardous waste and environmental, environmental justice and public health impacts.”
SB 54, which was signed by Gov. Gavin Newsom in 2022, requires that by 2032, 100% of single-use packaging and plastic food ware produced or sold in the state must be recyclable or compostable, that 65% of it can be recycled, and that the total volume is reduced by 25%.
The law was written to address the mounting issue of plastic pollution in the environment and the growing number of studies showing the ubiquity of microplastic pollution in the human body — such as in the brain, blood, heart tissue, testicles, lungs and various other organs.
Last March, after nearly three years of negotiations among various corporate, environmental, waste, recycling and health stakeholders, CalRecycle drafted a set of finalized regulations designed to implement the single-use plastic producer responsibility program under SB 54.
But as the deadline for implementation approached, industries that would be affected by the regulations including plastic producers and packaging companies — represented by the California Chamber of Commerce and the Circular Action Alliance — began lobbying the governor, complaining that the regulations were poorly developed and might ultimately increase costs for California taxpayers.
Newsom allowed the regulations to expire and told CalRecycle that it needed to start the process over.
These new draft regulations are the agency’s latest attempt at issuing guidelines by which the law can be implemented.
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