Already Toast: Caregiving and Burnout in America Audiobook

The story of one woman’s struggle to care for her seriously ill husband—and a revealing look at the role unpaid family caregivers play in a society that fails to provide them with structural support.

Already Toast shows how all-consuming caregiving can be, how difficult it is to find support, and how the social and literary narratives that have long locked women into providing emotional labor also keep them in unpaid caregiving roles. When Kate Washington and her husband, Brad, learned that he had cancer, they were a young couple: professionals with ascending careers, parents to two small children. Brad’s diagnosis stripped those identities away: he became a patient and she his caregiver.

Brad’s cancer quickly turned aggressive, necessitating a stem-cell transplant that triggered a massive infection, robbing him of his eyesight and nearly of his life. Kate acted as his full-time aide to keep him alive, coordinating his treatments, making doctors’ appointments, calling insurance companies, filling dozens of prescriptions, cleaning commodes, administering IV drugs. She became so burned out that, when she took an online quiz on caregiver self-care, her result cheerily declared: “You’re already toast!”

Through it all, she felt profoundly alone, but, as she later learned, she was in fact one of millions: an invisible army of family caregivers working every day in America, their unpaid labor keeping our troubled healthcare system afloat. Because our culture both romanticizes and erases the realities of care work, few caregivers have shared their stories publicly.

As the baby-boom generation ages, the number of family caregivers will continue to grow. Readable, relatable, timely, and often raw, Already Toast—with its clear call for paying and supporting family caregivers—is a crucial intervention in that conversation, bringing together personal experience with deep research to give voice to those tasked with the overlooked, vital work of caring for the seriously ill.

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"Already Toast is a must-read for those concerned about the coming crisis of care and those currently facing the challenges of the caregiver life. Kate Washington describes caring for her husband suffering from cancer while raising two small children and, in doing so, is not afraid to ask tough questions about how we think about care—an activity both highly valued and taken for granted. A moving, lucidly written true story, Already Toast offers a glimpse into the lives of millions of Americans who give selflessly by providing care to sick, disabled, and/or elderly loved ones, but who pay a steep price in their emotional and physical health and financial stability. Washington argues eloquently that we urgently need to change how we view this practice if we wish to build a compassionate, truly caring society."

— Chris Gabbard, author of A Life Beyond Reason