Introduction from "An Uncertain Inheritance: Writers on Caring for Family" (Paperback version will be released in December 2008)
Caring for someone through illness is an epic task. It requires such nimble fortitude—the ability to walk a tight rope of emotion as life hurries on indifferently around you—it is hard to believe that the relationship is as commonplace as it is. In the United States, there are more than thirty million informal caregivers—defined, in the study, Economic Value of Informal Caregiving, by Peter S. Arno, as a person who provides unpaid help to a relative or friend because they have an illness or disability that leaves them unable to do things for themselves, or because they are simply getting older.
I was a caregiver myself once. I saw my sister, Maud, through a five-month depression, which occurred after she’d been hospitalized for a manic episode.
It was a devastating experience. And yet, looking back, my story practically sings with triumph when I consider how it might’ve gone, how it so often goes. Maud was not on an irretrievable downward slide—it was possible for her to get better—so, for all of us, there was an end in sight. And a happy one, as it turned out: Once Maud got back on her feet, she returned to her life with tenacity and success. My family, meanwhile, was given the pleasure and satisfaction of believing that our hard work had paid off, that we had helped Maud.
Seeing a family member through a health crisis is a demand that nearly everyone must face—even if it’s only to make arrangements for someone else to do it. And yet caregiving, as a rite of passage, is only just beginning to enter our cultural and literary consciousness. (In part, this may be because, in describing the act of tending to the ill, language can veer into clinical descriptions—terms like ‘toileting’ and ‘assisted living’ come to mind.) There are excellent narratives in which caring for family is the theme—Ted Hughes’ collection of poems, Birthday Letters; The Story of My Father by Sue Miller; Lorrie Moore’s short story, “The People Like That Are the Only People Here;” Philip Roth’s Patrimony and The Year of Magical Thinking by Joan Didion, to name some of the very best. But, together, these have not created a literary genre all its own, sparking a national discussion about the broader dilemma, as with, for example, motherhood or depression.
Perhaps, as with death—so often a part of the caregiving experience—it is not something many of us want to look at directly. We’d prefer to take furtive glances, quietly fending it off until suddenly called upon by someone in our own family. And who can blame not wanting to spend more time in sorrow’s grip? But seeing an intimate through illness is a meaningful pilgrimage, one that calls on us to know how much we can and will sacrifice for those we love.
And it is becoming increasingly necessary: The average life span is growing longer—it has extended by about four years for both sexes since 1980—and, with the first wave of Baby Boomers already in their sixties, the need for care at the end of life is more dire. (Not to mention that, since many are choosing to become parents later, there are now approximately sixteen million Americans catering simultaneously to the needs of elderly parents and young children—the so-called “sandwich generation.”) Only three years from now, in 2010, it is expected that the number of people aged 85 or older in the U.S. will rise by more than two million. Meanwhile, already an estimated 80 percent of all home care for the elderly—from giving baths to monitoring ventilators—is provided by family.
This collection illustrates an experience that is in flux: Caregiving is a growing aspect of our society but we haven’t yet paid adequate attention to it. By bringing many writers to bear on this subject, the hope is that everyone will find a story with relevance and value. These are predominantly stories of ailing mothers and fathers—reflecting the fact that nearly three-quarters of caregivers look after an elderly parent—but other writers explore their bonds with afflicted husbands, wives, siblings, and children.
The opening essay, Helen Schulman’s My Father, The Garbage Head, is a beautifully rendered criticism of the tendency to idealize the caregiver, to blithely and grandly suggest that the person who chooses to care for another will be rewarded for their efforts. Schulman also rails against her own mortal limits. “My love wasn’t going to ease his pain, and it certainly wasn’t going to save him,” she writes about her father. “How could this be? I wondered. How could this endless reservoir of affection and attachment and respect that I felt for this man prove so powerless?”