Across the different hospitals and services where I have trained, I have noticed something I did not expect to notice. When we ask who knows the patient’s medications, who can explain what happened during the last hospitalization, or who we should call in an emergency, the answer is very often a woman. A mother. A wife. A sister. A daughter.
A specific memory I have: a seventy-year-old man with diabetes and end-stage renal disease who would call his ninety-year-old mother, living in an assisted living facility, to help him remember his medications. Three sons sitting together in a waiting room while their mother was critically ill in the ICU would call their sister, who lived 900 miles away, because she was the only person who could explain their mother’s medical history in detail to the attending when asked for more information.
A young patient with recurrent admissions for diabetic ketoacidosis would call his mother during rounds each day. His mother herself had lost her vision because of complications from uncontrolled diabetes, yet she remained one of the people he depended on most for his own care.
I also met a hospice patient whose sister had been out of touch with him for almost fifteen years, but she flew in immediately the moment she learned he was sick. Every day, she brought him his favorite Starbucks coffee: the same one she remembered he liked all those years ago.
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And then a frail old woman who made me stop and think about caregiving in a completely different way. She had advanced breast cancer with metastases and needed supplemental oxygen herself. Yet when her husband had an episode of syncope, she was the one who drove him to the hospital. I remember seeing her with her nasal cannula in place, her large oxygen tank beside her, pushing her husband’s wheelchair herself, focused on getting her husband the care he needed. She was the patient too, but at that moment, she was the caregiver.
Maybe I noticed these women because of where I come from. I remember the mood of the house always seemed to revolve around the men in it. Our neighbor had been married off at twelve, to lessen the “burden” on her family. Decades later, she is the one caring for her aging parents, the same parents who once wanted to marry her away as that burden. I have grown up seeing women become caregivers almost by default.
And these women I was seeing now made me think about that role differently. They were working full time. They were raising children, managing their own homes, and also taking care of elderly parents, the same parents who once invested more in their sons. Yet when their families needed someone to remember a medication, explain a complicated medical history, or sit beside a hospital bed, they were there.
There was rarely a discussion about who should do it. They simply did.
The more patients I saw, the more I started noticing this invisible work. Someone knew which medication had been stopped. Someone remembered the name of the previous hospital. Someone knew when the symptoms had started. Someone answered the phone when the patient could not.
And very often, that someone was a woman.
I don’t know how much of this comes from culture, how much comes from family dynamics, or how much is simply the way caregiving has been passed down through generations. I only know that I have started looking for these women, the mother on the phone, the sister who flew in, the wife with her own oxygen tank, still pushing the wheelchair. Nobody asks them to be there. They just are.
Malika Gupta is a physician in India.
