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Column: He was the oldest man in the U.S., and his loving caretaker was with him to the end

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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.

California is about to be hit by an aging population wave, and Steve Lopez is riding it. His column focuses on the blessings and burdens of advancing age — and how some folks are challenging the stigma associated with older adults.

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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.

Markoff celebrated his 109th birthday in downtown Los Angeles.

(Family photo)

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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.

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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.

Morrie Markoff, 99, and his wife Betty, 97, are photographed in their home on September 19, 2013 in Los Angeles.

Markoff and his wife, Betty, at home in September 2013.

(Los Angeles Times)

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“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.

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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.

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“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.

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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.

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.

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“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

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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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