What’s the best gift I can give my daughter at 16? The same gift my mother gave me | Ranjana Srivastava

“Hold your mum’s hand and call an ambulance.”

“Should I give her extra morphine?”

“Good idea.”

Then I say something I rarely say when I don’t know the full situation.

“Your mum will be OK.”

At 16, the roof shouldn’t cave in like this on your life, but it sometimes does for this courageous carer of a terminally ill mother, and I am sympathetic.

Thankfully, a short hospital stay restores my patient, thus inserting a good chapter in a bad story.

That evening I am dictating letters and mulling daughters as caregivers when a question slices my tension.

“How much can I spend on your card?”

On the eve of turning 16, my daughter is out with friends, an idea I vaguely remember endorsing.

“I’m happy to pay for dinner,” she says, flaunting her newfound “bank” from a minimum-wage job.

“You don’t have to,” I offer.

“OK, then!”

Now, I am tempted to play dumb. What dinner, what card? Instead, I text a smiley face and “spend what you need”, pairing trust with responsibility.

On the surface, there are no similarities between my daughter and 16-year-old me. If I factor in my mother, who turned 16 in the 1960s, the experiences are foreign.

My Indian mother staged a hunger strike to attend university. Her father vociferously objected to her all-male class, then commissioned a rickshaw replete with opaque curtain to ferry her and decreed that she sit in a corner, away from prying eyes. By 19 my mother had ticked three boxes: degree, marriage and child, thus putting paid to any career ambitions.

In turn, my mother empowered me by laying stones on her heart and sending me to another continent to become a doctor before moving to Australia to care for my children so I could chase even more of my dreams. Recently, my daughter emailed me an impressive application to study abroad with a request to “sign here”. No hunger strike or empowerment needed.

It’s never dull being the mother of a modern young woman but, as a doctor, I can’t help noticing things that raise questions about the pace of progress.

My daughter was born to the joke that finally, someone could take us to our old-age appointments. But now I see the irony. The (albeit young) daughter of my patient cast in a caregiving role is not an exception. As an oncologist, I care for elderly cancer patients who are often cognitively impaired: almost always the caring duties are shouldered by their daughter. Tasks reliably left to daughters include driving, cooking, cleaning, shopping, entertaining and future planning. Most calls to book, cancel or reschedule appointments are made by a daughter (and occasionally, a daughter-in-law). And beyond these “obvious” tasks, I witness an unshakeable cognitive load of caregiving that is rarely acknowledged and never remunerated. I meet devoted sons, too, but in my experience, they manage to confine their role and delegate responsibility, unlike their sisters.

The 2023 Nobel laureate Claudia Goldin disproved the conventional wisdom that women earn less because they choose lower-paying careers. The gender wage gap (an average of 12% in the OECD) is created by the motherhood penalty and women’s desire for flexibility, which is utilised for all manner of caregiving. To watch gender economics in play, come to my waiting room.

So, sure, I want my daughter to retain her wonderful caring attributes – but I wonder at what cost.

For all of medicine’s impressive gains, the gender pain gap is a pox on our house. When I yelped with postpartum pain, my doctor joked, “Relax, it’s not like I am putting the baby back!”

Half of women are impacted by issues related to their periods, pregnancy, birth and postnatal care. Thirty per cent report conditions such as chronic pain, menopause and endometriosis impacting their ability to work. A dismaying third of women feel disrespected and disregarded by their doctor, leading a prominent obstetrician to observe, “It’s not that women are afraid or shy of speaking – it’s that we have not been listening.” Note she said we, not they. The medical profession, in equal numbers male and female, is not listening to women.

When my daughter encounters health problems, will her articulate voice be suppressed by her doctors? Will she be told that her pain is imagined or that her symptoms are all in the mind? Scratching this inequity means rethinking “women’s issues” as societal issues but I worry about disappointing another generation of girls.

At 16 my daughter has the emotional intelligence that I lacked at her age. Sensing a heavy day of work, she will serve dinner and gently ask after my patients. When she is exhausted, she pre-empts her terseness with an apology. She is the most likely to defuse tension, share credit and give praise. And when I neglect my parents, she provides a fine cover. Since her brothers may be reading this, I must confess they are very good too, but we all agree that her conscientiousness is of a different calibre. I would say that this is the kind of difference between the contributions of sons and daughters that I see at work, although I am happy to be told otherwise.

Heading into the second act of my life, I want to grow old delighting in my daughter’s finest qualities. But I also hope that when life tugs her in many different directions, she will resolutely be her own best advocate.

It is said that a mother who radiates self-acceptance vaccinates her daughter against low self-esteem. It has taken me decades to realise that this is how my mother shaped me into the person I am today.

My daughter is 16 and I don’t know what to get her. Perhaps the best birthday gift is to stop worrying about how she will turn out and take quiet stock of myself.