MANCHESTER, N.H. — Vivek Ramaswamy was holding court before a crowd at a New Hampshire fair, the second of five stops on a typically busy day of barnstorming, when he did something rare: He yielded the spotlight.
A nurse had asked Ramaswamy, the entrepreneur-turned-author-turned-presidential candidate, about nurse staffing shortages at hospitals. But before addressing the question himself, he turned to the doctor nodding emphatically at his side — his wife, Apoorva Tewari Ramaswamy — and handed her the microphone.
“Trust me, I’ve been in his ear. He’s heard that from me, too,” Apoorva Ramaswamy said reassuringly, both to the nurse and to hundreds of others listening. “We need so many people who are actually interacting with other humans and seeing what is going on.”
New to the public eye, Apoorva Ramaswamy, 34, holds many titles: Yale-educated surgeon, cancer researcher and professor, mother of two.
Yet since her husband, 38, transitioned from making frequent appearances on Fox News to stumping in early primary states, Apoorva Ramaswamy has balanced weekdays making hospital rounds with weekends on the trail, adapting to an everywhere-all-the-time campaign that puts their family — including their sons Karthik, 3, and Arjun, 1 — front and center. (One of her husband’s “commandments” reads: “The nuclear family is the greatest form of governance known to mankind.”)
The two display contrasting styles in appealing to Republican primary voters: Vivek Ramaswamy, a practiced debater, has an answer for everything, is quick to assert himself and seems alert to potential areas of disagreement, where he can interject to make a point. Apoorva Ramaswamy is a warm and patient listener, leaning in, looking for common ground, and always smiling.
And where Vivek Ramaswamy has made his right-wing ideology, fast-talking combativeness and a tendency to embellish into something of a personal brand, his wife has sought to balance the needs of her husband’s candidacy against her interest in maintaining the life of a respected working professional.
Indeed, her work was central to a rare public disagreement: In July, Vivek Ramaswamy said on a podcast that he regretted receiving the COVID-19 vaccine. “Had I had the facts that I do now, as a young, thankfully healthy male, I would not have chosen to get vaccinated,” he said. In September, Apoorva Ramaswamy said she did not feel the same about her own vaccinations.
“For my young, healthy husband, that’s a different decision than for me when I am taking care of patients who are cancer survivors, and they trust me to be in their airway every day,” she told NBC News. “Giving people that autonomy is the most important part.”
More recently, when asked if she recommended that others receive the vaccination, in accordance with guidance from the Centers for Disease Control and Prevention, she carefully sidestepped the question: “I recommend that people make their decisions based on the risks and benefits that have been published — and the risks and benefits should be investigated in a fair and balanced manner.” She later said that their children were not vaccinated against COVID-19.
In interviews, Apoorva Ramaswamy resorted to a few different moves in defending her husband: downplaying (“He says things in a way that sounds pretty dramatic, but when you actually read his proposals, they’re very reasonable”) or glossing over the details of his proposals and saying she stood behind him (“He has a different communication style than I do, but I agree with him and his principles on pretty much everything”), or ducking questions by saying simply that he was running for president, not she (“I’m not the candidate,” she said, when asked about his call to fire half the federal workforce).
Apoorva Ramaswamy ventured into the fray after the third Republican National Committee debate, in which her husband had mocked Nikki Haley as “Dick Cheney in three-inch heels” and then invoked Haley’s daughter’s use of TikTok to score another point — eliciting an angry “You’re just scum” in response.
Her husband’s performance was roundly derided. But Apoorva Ramaswamy pushed back against suggestions that he was sexist, calling him “the most pro-woman man I’ve ever met.” She also jabbed back at Haley in an interview, saying, “Maybe she needs to expand her vocabulary.”
Candidates have often relied on spouses to sand their edges. Casey DeSantis, the Florida governor’s de facto second in command, has held solo events corralling “Mamas for DeSantis”; Heidi Cruz and Michelle Obama each took career breaks to support their husbands and soften their images.
Unlike them, Apoorva Ramaswamy has tried to do all of that while still working Monday through Friday researching head and neck cancers, visiting with patients or performing surgeries to treat swallowing disorders.
On Saturday in Ankeny, Iowa, at the first campaign event centered on Apoorva Ramaswamy, about 35 people gathered in a cafe to hear her talk about her family and her faith as she balanced Karthik on her lap about half the time. At one point, when asked if her husband had ever frustrated her, she responded: “The same guy who thinks that lots of things are wrong, and he has to fix them? Yes.” The audience laughed.
“She’s someone you could meet in real life and have over to your house,” said Jem Gong-Browne, who said she had not yet decided on a candidate. “I’ve seen a video of him. He comes across as very alpha, and she’s genuine — real.”
Apoorva Ramaswamy moved with her family to the United States from India at 4 — something her husband makes reference to in saying their parents “came here legally,” before calling to overhaul immigration policies. (She became a citizen while in college.)
She graduated from Yale, then met her husband at a party while she was at medical school there and he was at law school.
Apoorva Ramaswamy hadn’t been politically active. Growing up, she said, she had been taught to “keep your head down, control what you can control.” Politics, she said, “was never something we paid attention to.”
That changed after she became a parent, she said: “You realize you might not be interested in the government, but the government is definitely interested in you. And the decisions they make affect our day-to-day lives.” So when her husband raised the idea of a presidential run last November, she came around.
She has supported Republicans — and donated $10,000 to the Ohio Republican Party in 2021 — but said she did not vote in 2020 because she was busy with her medical fellowship and a newborn child.
What she is most passionate about is her work. No matter the presidential race’s outcome, she has every intention of continuing to treat cancer patients, from whom she says she learned a powerful lesson on prioritization.
Cancer survivors, Apoorva Ramaswamy said, “know what’s important, they know what gives them that sense of purpose — spending time with their family, being able to work in their job — and that is so important to me, being able to help them sustain that.”
It’s something her husband repeatedly praises on the stump.
After Apoorva Ramaswamy spoke at the New Hampshire fair, he took back the mic, saying, “I am proud to be a presidential candidate who comes home in the evening and knows that my job during the day wasn’t the more important of the pair.”
This article originally appeared in The New York Times.