BookBrowse Reviews In Sickness and in Health by Laura Mauldin

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Blending memoir and sociology, Laura Mauldin exposes the hidden labor of spousal caregiving, revealing how love is stretched to its limits by a fragmented, underfunded American care system.

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Sociologist and disability scholar Laura Mauldin writes from deeply personal experience in In Sickness and in Health, a work that argues for a more collective approach to caring for the chronically ill and disabled rather than relying on the unpaid labor often justified as "love." For many years, Mauldin served as caregiver to her partner, J, during her battle with leukemia. As Mauldin describes it, she became "The One": romantic partner, home nurse, patient advocate, personal driver, and more. She bathed and toileted J, navigated insurance and hospital bureaucracies, managed medications and appointments, and handled household administration. A social scientist with no clinical training, she even learned to administer IV infusions for J's treatment. She did these things partly because their romance felt like "an antidote" to J's disease—"if my love for her was bottomless, a renewable resource, then my capacity to care for her should be too"—and partly because there was simply no one else to do them.

In this book, Mauldin reveals how convoluted and patchwork the American caregiving system is—an infrastructure many people first encounter during the worst moments of their lives. She notes that 29 percent of American adults are categorized as disabled; disability, she writes, is "utterly ordinary, everyday," and "if we live long enough, we will age into disability at some point or another." Yet family caregivers provide roughly 80 percent of the ongoing care needed by loved ones, largely because few can afford to pay out of pocket for professional help. Mauldin does not argue that family members should not care for one another—"family members provide 'exquisite' care," she quotes one of her interviewees as saying, while "institutions sometimes provide anything but"—but rather that many are forced into unsustainable caregiving roles at immense personal cost because we live in an ableist society that offers few alternatives.

Mauldin spoke with 44 caregivers for the stories of In Sickness and in Health, which unfolds in four sections, each centered on a vignette illustrating how families are pushed deeper into a caregiving crisis. In "Without a Net," a wife cares for her husband after a stroke leaves him barely able to move, much less work. The couple confront the complexities of applying for Social Security Disability Insurance (SSDI), a system designed to gatekeep against fraudulent claims and one that often takes months or years to process—an impossible timeline for families facing mounting medical bills and the loss of income. By the end of 2023, Mauldin notes, the average SSDI decision time had reached 228 days, and during that fiscal year, roughly 30,000 applicants died awaiting a determination.

In "Division of Labor," Marty—rules-oriented, numbers-driven, and squeamish about bodily fluids—becomes a wound-care nurse for his husband, who lives with a rare cyclical disease. After enduring traumatic care at an overburdened hospital, the couple loses faith in the medical system meant to help them. Navigating the costs of medications, hospital stays, and specialized supplies requires near-professional expertise; even Marty, an accountant armed with spreadsheets, struggles to keep up, leaving the pair wondering how others manage.

"No Good Moves" follows Ben, a young husband caring for his wife with multiple sclerosis while serving as the family's sole breadwinner. Pushed to the brink and considering divorce, he ultimately cannot leave, knowing she depends entirely on him. Although the couple qualifies for Medi-Cal coverage for in-home care, the chronic shortage of reliable caregivers—driven in part by the field's low wages—means Ben still performs most caregiving tasks himself, a burden that has repeatedly cost him employment.

In "Can't Contain," a nurse who left her career to care full-time for her husband with Parkinson's reaches a breaking point. After years of sacrifice and isolation, she begins an affair simply to feel seen and less 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.

Mauldin is uniquely positioned to draw out such intimate reflections. Because she has lived these experiences herself, she builds remarkable trust with her interviewees, who share the private griefs, contradictions, and compromises of caregiving. Woven throughout the book—and framing its opening and closing—is Mauldin's own story with J.

Tender and quietly devastating, In Sickness and in Health invites readers to reconsider the place of caregiving within a capitalist, ableist society. Whether for a spouse, parent, or child, the labor of caregiving remains both indispensable and profoundly undervalued—and Mauldin's book makes clear how urgently a more collective system of care is needed.

This review first ran in the March 25, 2026 issue of BookBrowse Recommends.