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.

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?

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.

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.

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?

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?

(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.

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.

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.

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.

(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.

Los Angeles County is moving forward with a pilot program to relieve medical debt for struggling residents, setting aside $5 million for a planned agreement with a national nonprofit that buys and erases such debts.

County supervisors voted Tuesday to allocate money for a county agreement with Undue Medical Debt to carry out the new program. The effort is expected to launch later this year, focusing on debt stemming from hospital care and targeting L.A. County’s “lowest income residents.”

“No one should be driven into poverty because they got sick,” Supervisor Janice Hahn, who put forward the proposal with Supervisor Holly Mitchell, said in a statement.

“But medical debt remains a huge problem in this country, and it can be devastating for families and their financial well-being. Luckily for us, we have an opportunity to make a difference.”

Hospitals stuck with unpaid bills can bundle and sell the debt at a discount to collection agencies that try to recoup the owed money for profit. Undue Medical Debt instead buys the discounted debt and forgives it. The nonprofit said it can erase an average of $100 in debt for every dollar that is donated.

“Five million dollars can really go a long way,” said its vice president of communications and marketing Daniel Lempert. County officials estimated that amount could eliminate $500 million of debt for 150,000 residents.

Across the country, Undue Medical Debt has partnered with local governments such as Cook County, Ill. and Toledo, Ohio. to fund such efforts. Lempert said that under such agreements, the nonprofit typically reaches out to local hospitals and other health care providers to identify and purchase medical debt affecting financially strapped patients, then gets reimbursed by the local government for the cost of debts affecting their residents.

Under its guidelines for financial hardship, Undue Medical Debt works to relieve debt for people from households making no more than four times the federal poverty level — a calculation equating to $124,800 this year for a family of four — or whose medical debt amounts to 5% or more of their income.

L.A. County is still working out who will be eligible under its pilot program, but its broad goal is to reach “our lowest-income residents and the working poor who have catastrophic amounts of medical debt,” said Dr. Naman Shah, director of the division of medical and dental affairs at L.A. County Public Health.

The L.A. County pilot program will focus specifically on medical debts for hospital care, Shah said. Local residents cannot apply directly for their medical debt to be wiped out, but will be informed if Undue Medical Debt has eliminated some or all of their unpaid debt.

“You’ll get a letter out of the blue saying, ‘X, Y or Z debts have been relieved. You no longer owe them. Keep this as a receipt,’” Lempert said.

In Los Angeles County, public health officials have estimated that medical debt totaled more than $2.9 billion in 2022, burdening 1 in 10 adults in the county — a higher percentage than suffered from asthma, according to the public health department. More than half of those who said they were burdened by medical debt had taken on credit card debt to pay medical bills, its analysis found.

The problem has persisted even as more L.A. County residents gained insurance coverage, underscoring the need for a targeted approach, the public health department said.

County officials estimated earlier this year that wiping out nearly $3 billion in medical debt for L.A. County residents through an intermediary would cost $24 million. Other municipalities have turned to funding from the American Rescue Plan Act for such debt relief, but L.A. County had “fully allocated” that money as of January, according to a staff report.

The public health department said it planned to instead use $5 million in one-time county funding for the pilot program, which it said would roll out in stages, starting with “the most vulnerable residents.” Shah said his hope was to raise enough additional money to not have to set priorities about which struggling residents to help.

A study released earlier this year raised questions about the effectiveness of buying up medical debt: A National Bureau of Economic Research working paper that examined medical debt relief for more than 83,000 people from 2018 to 2020 concluded it had no effect, on average, on financial distress or mental health. The research was done in partnership with Undue Medical Debt, then known as RIP Medical Debt.

Despite the “disappointing results,” the researchers wrote, “there is still potential that medical debt relief targeted further upstream or in different populations could yield meaningful benefits.” Stanford University professor of economics Neale Mahoney said the cheapest debts to buy often date back five years or more.

By that point, “a lot of these folks had a lot of other issues, and relieving one of their issues without helping … all of the other financial issues they had wasn’t enough to move the needle,” he said. One solution is to “move more upstream,” and provide debt relief earlier, “before people are too scarred by the debt collection process.”

Mahoney praised the response of the nonprofit, saying it was “taking the study to heart.” Undue Medical Debt president Allison Sesso said in April that it had already made changes since the period covered by the study, including buying medical debt directly from hospitals before it goes to debt buyers or collection agencies.

Sesso also said her group was “collaborating with local governments across the country to concentrate debt erasure to a specific locality to deepen our impact.”

Focusing such efforts in a targeted area ramps up the chances it may be able to wipe out multiple debts for an individual patient, Lempert said.

Shah added that the study did not show what would happen if debt relief happened alongside other prevention efforts. In L.A. County, “there is a larger agenda on medical debt — of which this is just one part.”

Under a broader plan to combat medical debt in L.A. County, the public health department also wants to gather data on how hospitals collect debt and assist strapped patients, create an online portal to apply for financial help, and expand legal aid services, among other proposed steps.

Public health department director Barbara Ferrer told county supervisors Tuesday that their goal is to stop medical debt “at the source,” before it starts piling up for L.A. County residents.

“We don’t want to be coming back to you in five years trying to pay off medical debt again,” Ferrer said.

The people have spoken, and L.A.’s newest Jurassic-era resident has its forever name.

Dinosaur fans who responded to the museum’s request for input overwhelmingly chose to call the Natural History Museum’s new 70-foot-long sauropod “Gnatalie.”

More than 36% of roughly 8,100 participants in a public poll chose that name, which is pronounced “Natalie,” from among five options offered by the museum.

The punny moniker is a reference to the relentless swarm of gnats that plagued paleontologists, students, museum staff and volunteers during the 13-year effort to unearth the dinosaur’s remains from a quarry in southeast Utah. Museum staff nicknamed the dinosaur Gnatalie while they were still digging it up, a process that lasted from 2007 to 2019.

The long-necked, long-tailed skeleton will be the focal point of the NHM Commons, a $75 million welcome center currently under construction on the southwest end of the museum in Exposition Park. Slated to open this fall, the Commons will offer gardens, an outdoor plaza, a 400-seat theater and a glass-walled welcome center that can be toured without a ticket.

“The efforts of hundreds of people contributed to what you see here, ground to mount,” said paleontologist Luis Chiappe, director of the Dinosaur Institute at the Natural History Museum of Los Angeles County.

The specimen appears to be part of a new species, similar to the Diplodocus, which will be scientifically named in the future. Thanks to celadonite minerals that replaced organic matter during the fossilization process, the mounted skeleton has a unique greenish-brown hue.

The skeleton is made up of about 350 fossils from six different animals whose bones washed into a river after death some 150 million years ago and commingled.

“We are delighted to see how many people voted and how much they loved our name for this unusual dinosaur,” said Lori Bettison-Varga, President and Director of the Natural History Museums of Los Angeles County.