Dr. Mitchell Feldman (far right) shares a moment with his mother and father.
Years of professional experience and confidence in one's expertise can't always prepare us for life's most personal challenges—particularly when the roles we've spent our careers fulfilling become our own reality.
MJ White had spent decades working in health care, including 20 years as a critical care nurse. She knew how to recognize problems and navigate complicated medical situations. So when her mother began needing more support, White thought she should know what to do.
“I’m a professional in this field,” she remembered thinking. “I should be able to handle this.”
But caring for a patient and caring for a parent, she discovered, are profoundly different things.
For Mitchell Feldman, MD, a UCSF primary care physician and professor of medicine, that realization came as both of his parents began declining at the same time. His father needed increasing physical and cognitive support, while his mother—who was also experiencing changes of her own—was trying to care for him.
Feldman lived nearby, which he describes as both a privilege and, at times, a burden. There was always a reason to stop by, another problem to solve, another decision to make.
Their circumstances were different, but White and Feldman found themselves navigating an experience familiar to millions of family caregivers: the gradual shift from being someone’s child to also becoming one of the people responsible for their care.
And even careers devoted to caring for others couldn't fully prepare them for what it would mean to care for their own parents.
When independence begins to change
For White, one of the first unmistakable signs came when her fiercely independent mother got lost while driving to a familiar destination.
A police officer pulled her over and asked whether everything was all right. White’s mother assured him it was—she was simply late for her hair appointment.
Then the officer asked her to look at her car.
Both tires on the passenger side were flat, and the side of the vehicle was damaged. White’s mother had apparently hit something without realizing it.
“What I’d been fearing is coming to pass,” White remembers thinking.
What followed wasn’t one decision, but many: addressing her mother’s driving, navigating growing cognitive concerns and, later, responding to a multiple myeloma diagnosis and chemotherapy.
White knew how to anticipate problems. That was part of her training. But that instinct sometimes put her in conflict with the very person she was trying to protect.
Her mother saw some of White’s efforts as an intrusion on her independence. Her brothers didn’t always agree about the severity of the situation or what should happen next. White often felt she could see problems coming before everyone else was ready to acknowledge them.
“I see the train on the track, and I see it about to derail,” she said. “I can’t sit and watch the train go off the track.”
Feldman encountered a similar tension.
His parents had remained relatively independent into their late 80s. As his father’s needs increased, his mother initially took on more of his care. But Feldman could see that she was becoming overwhelmed.
Then she, too, began to need help.
“I’m worrying about both of them for different reasons,” Feldman recalled.
During the COVID-19 pandemic, managing care at home became increasingly difficult. Caregivers got sick or couldn’t come to work. His father had medical needs. His mother was anxious about being left alone. There were appointments, hearing aids, phone calls and countless logistical decisions.
“This is becoming a full-time job for me on top of my full-time job,” Feldman remembers thinking.
Eventually, his parents moved together into a senior living community. It didn't end Feldman's involvement in their daily lives, but it brought something important: he knew they were now safe.
The work no one else sees
Caregiving is often described in tasks: arranging appointments, managing medications, coordinating transportation, hiring help, making financial decisions.
But those tasks don’t fully capture its weight.
For both White and Feldman, caregiving occupied an enormous amount of mental space—even while the rest of life continued around it.
At the same time White was coordinating her mother’s care, she was leading a performance improvement group at UCSF and attending graduate school at UCLA.
She kept going. She solved problems. She held things together.
Until, eventually, she couldn’t.
As her mother reached palliative care, White found herself explaining to a social worker everything she was doing to keep her mother’s world functioning.
The social worker asked a simple question: Who takes care of you?
“I take care of myself,” White responded, “because if I don’t, no one else will.”
Hearing herself say it brought a realization.
“I’m not as prepared for this as I thought I was.”
Feldman describes another kind of invisibility.
Unlike an illness or other circumstances that might be apparent to colleagues, caregiving can remain almost entirely hidden. He continued working while carrying a constant awareness of what might be happening with his parents.
“What I wish people would understand is how preoccupying” caregiving can be, he said. “This is always on your mind.”
Sometimes the support he needed wasn’t complicated. A colleague who knew what was happening might simply ask, “How are you doing? How’s your dad?”
Thirty seconds of acknowledgment could matter.
“You can feel very alone,” Feldman said.
Caring for the caregiver
Love, however, doesn’t eliminate exhaustion.
After White’s mother died, the toll of the previous years finally caught up with her.
She left her job and took a year off.
“I was just so burned out,” she said. “I couldn’t work.”
It’s one reason White now tells caregivers something that can feel counterintuitive when someone they love needs them: Take care of yourself, too.
Burnout, she cautions, doesn’t always arrive in the middle of the crisis. Sometimes it comes afterward, when everything becomes quiet enough for the caregiver to finally feel what they have been carrying.
Her advice is to make room for that processing along the way—to eat, exercise, rest, reflect and recognize that caring for yourself is part of remaining able to care for someone else.
Feldman’s experience has also changed the way he sees caregivers around him.
As a leader at UCSF, he now pays particular attention when he knows a colleague is caring for an aging or ill parent. Society has become better, he noted, at recognizing the pressures faced by parents of young children. The responsibilities of people caring for older adults can be far less visible.
Simply noticing matters.
So does finding people who understand.
In the final years of his parents’ lives, Feldman’s family found professional caregivers who developed genuine relationships with them. Several became so close to his mother that Feldman invited them to her funeral. They came back to the family’s home afterward, shared stories about her and received some of her belongings as keepsakes.
What began as caregiving had become connection.
White, too, has found a way to transform what she learned into connection. Today, she shares what she learned with patients, families, friends and others beginning their own caregiving journeys.
“None of it’s intuitive,” she said.
She hopes the lessons she learned can “lighten their load as they go through it.”
That may be one of the most important lessons in both White’s and Feldman’s stories.
There is no single way to be a caregiver. It can mean advocating for a parent who doesn’t believe they need help. It can mean answering the phone in the middle of the night, navigating sibling relationships, making impossible decisions or simply sitting beside someone you love. It can bring frustration, exhaustion, grief and loneliness alongside tenderness, gratitude, humor and profound connection.
And even people who spend their careers caring for others can need someone to ask, How are you doing?
Caregiving may happen quietly, but caregivers do not have to carry it quietly—or alone.
Sometimes care begins with recognizing the weight another person is carrying.
Sometimes it means accepting help.
And sometimes, as Feldman learned, it is simply choosing, again and again, to show up with love.