Reviewed by A.C. Riffer
Because disability is neither rare nor distant, there is a need for conversations around caregiving. Laura Mauldin’s In Sickness and In Health is a deeply grounded and unflinching account of love, care, and the structures that fail to sustain either. Drawing on both personal experience and sociological research, Mauldin traces what happens when intimate relationships are asked to bear the full weight of chronic illness in the absence of meaningful social support. The result is a book that is as emotionally resonant as it is politically urgent.
What distinguishes Mauldin’s work is its refusal to offer easy answers. The narratives she gathers, and situates within broader systems of care, do not resolve into neat conclusions. Instead, they linger in the difficult, often unarticulated realities of caregiving: exhaustion, guilt, love, resentment, and the quiet persistence required to navigate them all at once. This commitment to realism gives the book its weight. It does not turn away from what is unsustainable, even when that unsustainability is normalized.
At the same time, the book is suffused with a profound sense of care, not only between partners and other interpersonal alliances, but in Mauldin’s own approach to the people whose stories she tells. There is a clear and consistent attention to connection, to community, and to the ways people continue to show up for one another even when systems do not. In this way, In Sickness and In Health resists reducing disability or caregiving to tragedy. Instead, Mauldin reveals the intimacy and meaning that coexist alongside structural neglect.
Across these accounts, strain is not framed as a lack of devotion, but as the inevitable result of a system that asks too much of too few. The story makes evident what the book argues throughout: that love, no matter how deep, cannot substitute for structural care. And love is there; seen in the spreadsheets tracking coverage and medication or knowledge of optimal pillow placement or in ingenuity of adaptability.
As Mauldin makes clear, many people will age into disability over the course of their lives, often without the resources or frameworks needed to navigate it. Caregiving, too, is shown not as an exceptional circumstance, but as an increasingly common and deeply unsupported role. The cultural narrative that individuals, or couples, should be able to manage these realities on their own emerges as both pervasive and profoundly damaging.
By placing these experiences within the context of a broader caregiving crisis, Mauldin exposes the gap between the ideal of love as self-sufficient and the reality that care requires collective infrastructure. The expectation that partners absorb the full burden of care is revealed as untenable, producing not only material strain but also shame, an internalized sense of failure when the impossible cannot be sustained.
In Sickness and In Health ultimately calls for a reimagining of care as a shared social responsibility. It asks readers to reconsider the boundaries between private love and public obligation, and to confront what is lost when care is treated as an individual problem or concern rather than a collective one. In doing so, Mauldin offers not only a critique, but a quiet, steadfast argument for a more expansive, humane understanding of interdependence.
Title: In Sickness and in Health: Love Stories from the Front Lines of America’s Caregiving Crisis
Author: Laura Mauldin
Publisher: HarperCollins
Date: 2026
Read A. C. Riffer’s reviews of Unfurl: Survivals, Sorrows, and Dreaming; Disabling Intelligences: Legacies of Eugenics and How We are Wrong about AI; Respecting Disability: Attitudes, Ideals, and Relationships, and It Wasn’t Meant to Be Perfect: A Memoir in this issue of Wordgathering.
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About the Reviewer
A. C. Riffer is a hopeless romantic and enigmatically so. In their spare time, they somehow managed to earn a doctorate in Social Work from the University of Illinois Chicago, where their research explored censorship and culture.