An 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.