Love Stories from the Front Lines of America's Caregiving Crisis
by Laura MauldinAn urgent and deeply affecting account of America's failure to provide meaningful support to its chronically ill and disabled citizens and our resulting reliance on the unpaid caregiving labor of spouses and intimate partners.
When twenty-seven-year-old Laura Mauldin moved to New York for graduate school, she fell headlong into love. But just months into the relationship, her partner's leukemia returned—and in a country without adequate systems for long-term care, Laura found herself quietly and devastatingly transformed from romantic partner to unpaid, full-time caregiver, fighting to keep the woman she loved alive in a system designed to let them both fall through the cracks.
Now a sociologist and professor of disability studies, Dr. Mauldin turns her private pain into a searing public investigation. To better understand her own experience, she speaks with couples across the country navigating the brutal, lonely fallout of chronic illness and disability. These are heartbreaking stories of love under strain—relationships full of extraordinary intimacy and resilience, but pushed to the edge by an ableist society that would rather look away from its most vulnerable citizens. At the heart of this investigation is a profound series of questions: What if love isn't enough? What if our most cherished romantic ideals—commitment, sacrifice, "in sickness and in health"—have been weaponized to excuse the state from its responsibilities? And what happens to love when we ask it to do the work of an entire broken system?
Urgent, unflinching, and full of grace, In Sickness and In Health is a rallying cry for a radical reimagining of care—not as an individual act of devotion, but as a collective responsibility. In connecting the care crisis to the politics of love and intimacy, Mauldin reframes the conversation, urging us to build a world where no one is left to do the work of love alone.
Across these stories runs a common thread: the intense burden placed on spousal caregivers, who are often expected to become "The One" responsible for every aspect of care while also maintaining financial stability. As Mauldin observes, cultural ideas about spousal caregiving encapsulate "our expectations around love, romance, sex, intimacy, and self-worth," as well as the legal and moral obligations embedded in marriage itself. The book illuminates the quieter costs of caregiving: burnout, declining mental health, shifts in sexual identity, and the constant negotiation of social judgment. One caregiver who began dating decades after his wife became permanently brain-dead was labeled a "bad guy"; after divorcing her, however, he was praised as "a saint" for continuing to care for her...continued
Full Review
(833 words)
(Reviewed by Pei Chen).
Alice Wong, author of Year of the Tiger: An Activist's Life
In Sickness and In Health deftly connects personal stories with public policy, disability history, and data that provide a broader context critical to understanding the systems that devalue disabled people and those that care for them. The future of care involves an understanding of interdependence and collective care. This book gives us a window into what is broken and what is possible. Empathetic, essential, and illuminating.
Sara Nović, New York Times bestselling author of True Biz
In Sickness and in Health is a damning indictment of the American healthcare system, and a heartfelt tribute to the caretakers who fill those gaps, often past their own breaking points. Likely a shock to some readers, while deeply resonant for those who've suffered under this system, Mauldin's writing speaks clearly and empathetically to both audiences.
The website Disability at Home is a digital archive of creativity. Created by sociologist Laura Mauldin, the site documents the inventive ways disabled people and caregivers adapt their homes to make everyday life possible. The project grew out of interviews Mauldin conducted with 44 couples across the United States while researching her book In Sickness and in Health, which explores the emotional and practical realities of caregiving and disability in intimate relationships.
Because Mauldin could not always visit participants' homes—especially during the pandemic—she asked them to send photographs of the solutions they had devised. The result is a collection of "life hacks" that demonstrate how people build accessibility...

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