My second year of residency has altered my job from delivering healthy, term babies, to preterm babies that will either not survive or babies that have died. It's a new interpersonal skill, to give parents this life-changing news, and to support them through the process. It's a new technical skill- the delivery of either a term fetus who has died and thus lacks the muscle tone to complete normal delivery, or the delivery of a baby so small that goal is delivery within an unruptured amniotic sac. It's also a new intrapersonal skill for me to do this during the day (or night), and then proceed with my own life without carrying with me too much sadness or emotional fatigue.
A resident a year ahead of me (and thus much wiser) keeps a small memorial for these children. She told me that it helps her to cope with the job, and also is a memory of babies that parents do not acknowledge. It seems right to her that someone would remember and honor these children. I decided this was right for me too, and thought hard about the way I would like to do this. I was really anxious about this task of second year, and this seemed to soothe some of the anxiety and give me more control over managing my job and emotions.
My last night in Hawaii while on vacation early in my second year, my husband and I walked along the beach at sunset. I had bought a little jar earlier that day from a craft fair, with a sea turtle design on it, but I wasn't sure what I was going to put in it. Walking along the shoreline, I picked up a small shell, and then a piece of sea glass, a small piece of driftwood. It started to come together for me, and I picked up more and more special shells, gifts from the sea. My husband helped me find them, and held them in his pockets for me. I wondered how many I should get. Is twenty enough? I wish there wasn't going to be even that many. I pick up one and look at it, a micro-conch shell with tiny pink swirls. What baby will you be for? What will be my thoughts and experience that makes me drop you into my little jar?
The jar sits on my nightstand, the sea turtle on the front of it. About six shells so far have been dropped inside. So far I can name each child the shell goes with, but I know this won't be forever. Over time, the jar will fill, and I'll forget the details, but it'll serve it's purpose- a reminder and memorial of the work I do this year, and for many years to come. And hopefully provide some closure, where I can place a shell and walk away.