Leah Libresco Sargeant. The Dignity of Dependence. University of Notre Dame Press, 2025. $28.00. 200 pp.
There’s a child in my son’s summer school program who sits in a specialized chair. He’s small, perhaps four or five years old, with bright blue eyes. He has a tracheostomy. The tubes connect to a ventilator that sits in a bag behind his chair. Small winter mittens cover both hands, attached to thin elastic bands that are tied to the arms of the chair. This is so that when he hits himself, the mittens soften his blows to his face.
Today, as I was picking my son up from class, this boy’s trach tube popped out. Without a constant watchful presence, a dislodged trach tube is a death sentence for the ventilator-dependent. His nurse calmly reinserted the tubing back into the opening at his throat, so his breathing could resume. The tube that the nurse’s hands reconnected to the machine, and the machine that pumps air into his lungs, and the little mittens, and the chair all talk very loudly, although the boy himself can’t speak. They say: “Help me. I need you.”
I know, because my son has some of those things too, and they speak to me. My son hasn’t spoken to me, and I don’t think he will, but every time I help him breathe or eat or walk or change his diaper, I am talking back to him in a language of our own making, a language without words. His needs call out to me, and I answer back. I talk to his birth defects, his blindness, his brain abnormalities when I touch him and care for him. My touch says “I’m here. You are not alone.”
The needs I see in my son and in his little friends aren’t simple needs. They don’t smell nice, and they make you sweat. They leave you bruised. When I picked my son up the other day from his classroom, all of us—I, the teacher, and my son’s nurse—were covered in his vomit, down to our shoes.
Most people have experienced the helplessness of a newborn baby. This is an acceptable need, one welcomed and expected. Something happy. But babies grow. Dependence, for most parents, is fleeting, or at least circular. Children grow and change. Adults appear more or less self-sufficient. Then, of course, as we age, our helplessness reemerges. As I write this, my newborn son is developing before my eyes. This is the fifth time I’ve welcomed a baby, but the miraculous change of a tiny baby quickly gaining independence is always fresh.
But for some, like the boy with the trach, or my son David, the world is fated to be small. My son knows only what is offered to him. Needs, like the care they demand, are not equitably distributed. Yet David and I are not as far apart as we perhaps appear. It would be a grave mistake to assume that only the recognizable “other” has needs. As Leah Libresco Sergeant argues in her new book, The Dignity of Dependence, “our need is what makes us human.” “Vulnerability,” is a reality that “cannot be solved, it can only be shared.”
But the world is not built for those with needs, and it therefore incentivizes the pantomime of autonomy, Sargeant argues. She demonstrates many ways our culture penalizes dependencies. This can take the form of policies, like no standardized paid maternal leave in the workplace, or in the careful façade society has built around the myth of the autonomous individual. At the core of this pretense is an avoidance of shame—an unwillingness to see ourselves and others for what we really are. And what we really are is quite needy. “Abandoning the false ideal of autonomy is our route back to reality. The shift is painful,” Sargeant writes, because “we have grown accustomed to feeling guilt for being human.”
Need and dependence do not touch all of us in the same ways. Women bear the burden of living in a society shaped for men; the shape of women’s unique bodies, built to care for others, rendered irrelevant, and worse, inconvenient. Sargeant’s meditations on the physicality of motherhood are rich and poignant, noting that “a culture that idolizes autonomy can’t value pregnancy,” seeing “childbearing as an interruption of the human project.”
The powerful are better able to sustain the illusion that autonomy is truly possible. Pretending we don’t have needs is achievable for a while in an economy where care is for sale. But this comes at a cost, always passed down to the most vulnerable. It is “impossible to tell the truth” about who we are without “accounting for mutual dependence.” Building a culture on the basis of a “false anthropology” is doomed to fail. “Building a just society,” Sergeant writes, “requires a moral revolution.” This, she acknowledges, will be costly, and painful, noting that “openness to the reality of pain goes alongside intimate dependence on others.”
Recently, my father-in-law told me that if he ever thought he’d become a burden to someone in his old age, he’d “walk off and never come back.” The great irony of my father-in-law’s statement is that he suffers from dementia, and the burden of that disease touches each member of our family daily. Sargeant argues that “a culture focused on expressive individualism and suspicious of the natural and the needed finds it easy to pathologize the real and idealize the pathological.” The old, the ill, and the weak in this type of world are inherently at risk—problems to be solved—by such means as abortion or euthanasia when possible.
As society grows richer, human labor becomes more precious. Sargeant explains that when “workers produce more with the same amount of labor, wages rise,” but when it comes to care work, productivity is ultimately limited, and “the core work of parenting and caregiving, which depends on presence, doesn’t scale.” As caregivers have the increasing ability to command higher wages on the market outside of caregiving, the “better” the product of caregiving must become to justify lost wages. This section of the book is a thought-provoking explanation of two extremes: the rise of intensive parenting and the growing reluctance of young people to form families, with dire costs for an aging world.
Sargeant’s most beautiful writing is reserved for personal reflections on motherhood and family life. She concludes by arguing that “it is the largeness of our love that exposes us to risk. I count my treasure in my exposure to catastrophe. I measure my humanity in how little my life and my loves can be sustained by my own strength.” Here she demonstrates the paradox of coming into one’s own only by losing ourselves. She is confident, self-assured, and full of agency, even while describing immense physical and emotional self-sacrifice. “I grew up prepared to use my strength to advocate for my sisters, but the more I grow, the more I have found I must offer the testimony of my weakness as well.” I recognize this change; I know it too.
Yet if I could offer one critique of Sargeant’s work, it is that she relies too handily on a particular givenness of the world without duly considering underlying metaphysical priors.
What true reality does human need and dependence illuminate? The metaphysical framework that presupposes her central argument and makes us human deserves explicit treatment. “The human project,” Sergeant writes, “is better understood not as self-creation…but as apprehension of the world, with the self being the one to grow and change and harmonize with what is true.” Yet the nature of the true world is not so easily apprehended by fallen man. The truth that Sargeant alludes to is our creatureliness, ever in need of our Creator. As Psalm 100 sings, “It is he that has made us, and not we ourselves; we are his people and the sheep of his pasture.”
The embodied reality of the incarnational Christ is the true template for a life of dependence. This provides a transcendent framework for those living under the burden of providing care. Sergeant meditates on the annihilation of the self that she experienced while giving birth, likening it to an apocalypse. “Apocalyptic annihilation makes me focus on the crucible of caring as transfiguration,” Sergeant writes, acknowledging that this transfiguration reaches “beyond the veil,” and “wants to remain curious about what that might be.” She explains that “the world I had come to feel at home in often turns out to be passing away. I need to be ready to explore and accept the deeper reality that my circumstances and crosses reveal.”
The deeper reality is the Kingdom of God. It is indeed at hand. It is at hand when I touch my son. It is in my hand.
The transfiguration we experience when caring is the tool of a God determined to forge us into the likeness of his Son. Faced with the deepest, unsolvable needs of others, I am tempted to despair, without focus on the face of Christ in my touch. The Son of God needed nothing from us. Yet he became someone who needed shelter, food, care, friendship, family, community. He came to humble himself, even to his death. We depend on Christ even as He depends on the Father.
Presence is what dignifies dependence. Nowhere do we have a better example than in the presence of Christ. He is always with us. We serve a suffering Christ who gives himself over and over as a sacrificial presence in the face of our own pain. Yes, all of our dependencies are “concentric circles of need,” as Sargent argues, but they are anchored by the image of the crucified Christ firmly at the center.
David doesn’t just depend on me to complete tasks that fall outside the realm of his abilities. He requires a witness to his reality—no fix necessary.
“The world is the wrong shape for women,” Sargeant argues in her opening chapter. But the deeper truth is that the world is shaped wrong for us all. The space David’s body is groaning for doesn’t exist this side of heaven. The type of community that could truly meet all of his needs—or all of my needs—simply isn’t there. It’s dependence on a teleological level that reveals our humanness, not just needs in relation to the material. Our need for God is what makes us human, more than our need for others.
I will do what I can for others, knowing it is never enough. Who gives dignity to dependence? Christ alone. What gives dependence true and lasting dignity is only the “right side up” logic, as our priest says of the kingdom of God. We live in the upside down, where weakness is pitiable, discardable, and worthless. But in the kingdom of God, last becomes first. David is ministerial, priestly even, in his dependence. David magnifies the gift of Christ, who came to be poured out among us like a drink offering, so that we can keep pouring, each of us with our little cups, bailing heaving helpings of God’s grace out of our little boats.
Our bodies are to be doled out for each other, consumed by one another, dose by dose, some strange medicine mixed by the hand of God.
“Long after we are dead,” Sargeant muses, “we leave a physical record of how we answered two questions: Who counts as humans? What do we owe those who cannot pay us back?” In the end, we all pass away. But this remains—how we served, and what we gave, because this lives on in the bodies of others, bearing our gifts, on and on, until heaven descends.
