Lancet Wakely Essay Prize-winning piece on child loss celebrates thoughtful healthcare

Image courtesy of Getty Images

Image courtesy of Getty Images.

"Not a simulation of love, but actual love as it is manifested in institutions”

His peaceful death was the long-anticipated conclusion of a pregnancy fraught with inconclusive scans and tests, and eventually a diagnosis of anhydramnios – the absence of amniotic fluid due to lack of urine production by the kidneys – that put all ambiguity to an end.

Tamarin, a Doctoral Prize Research Fellow in the School of Design and Creative Arts, has been awarded The Lancet’s Wakley Essay Prize for her written piece describing the moments immediately after the peaceful death of her newborn baby son.

I remember very little of the hours that followed. What memories remain are rounded and smooth and still as stones. By now I know them well. They are so worn with recollection that all their shape and roughness is long rubbed off, and only the most dense and silent parts remain, writes Tamarin.

In these moments we are, more than anything else, an aching lack of something to hold, and we will answer that lack indiscriminately. Anything will do. The tiniest interaction, the briefest event, or expression, or decision for better or worse, might become the thing we hold and make our centre of gravity for a lifetime to come. The years ahead of us would turn on these moments. There were people who knew this—and thank goodness, because it meant they knew to put in our way something good. Something good enough. Something that would do. The clipping of hair, the printing of palms, the bathing, and patting dry, and putting into clothes.

It was a good simulation of a centre. Even now, at the distance of calm reflection, I still think it was love. Not a simulation of love, but actual love as it is manifested in institutions.

Titled ‘Something good enough’, Tamarin’s essay acknowledges the excellent care she and her husband received at the hospital both before and after their son’s death, and traces that care back through the efforts of researchers, practitioners, and policymakers who may not witness first-hand how deeply their work is felt by its beneficiaries.

Over time I have come to understand that memories of our son's birth and death were not formed by accident at all, but were crafted, Tamarin reflects. They had been lovingly carved by the efforts of many, many people, some of whom we met in the hospital that day and some we never will, their part having been played long ago or far away.

Tamarin says the essay observes “the acute need for parents bereaved at birth to fill the void left by their deceased baby, and how at their best, research-based interventions can offer ‘something good enough’ to temper this feeling of emptiness”.

She continues: “The essay looks to highlight the long-lasting consequences of healthcare that feels loving, and how small gestures and thoughtful decisions at crucial moments can impact bereaved families for years to come.

“I hope it will speak to the researchers, policymakers, and others who work ‘behind the scenes’ of healthcare, writing funding applications, gathering and analysing data, lobbying for change. This work feels unrewarding at times, but its effects are deeply felt and appreciated by the families whose lives it eventually impacts.”

Tamarin, who is also a Visiting Research Fellow at the Centre for Death and Society at the University of Bath and convenes the Lives in Medicine Research Network at the University of Oxford’s Oxford Centre for Life-Writing, researches meaning-making through stories and narratives.

The essay is part of a wider project to understand and amplify the distinct meanings and cultural resonances of baby loss, which she says "tend not to recognised enough as a society".

Tamarin is currently in the process of writing a memoir of her son’s life and is collaborating with a charity to help develop creative writing resources for parents bereaved at birth.

When asked why she decided to and continues to share her experience of child loss, she said: “We need to listen to families’ experiences of baby loss, not only to help improve care, but because we all stand to learn more about what it means to be human if we take into account the unique lessons baby loss can teach us—about parenthood, love and the limits of the life course.

“When a baby dies it isn’t only tragically sad; it’s important, and as full of meaning as the life of a child who lives. We miss so much if we fail to hear these stories.

“Parents who lose babies very often love talking about them, as it can help us feel we are spending time with them or amplifying their presence and importance in the world. Writing about my son is no different.”

To read ‘Something good enough’ in its entirety, click here.

More information on the 2021 Wakley Prize, which was inspired by George Eliot's Middlemarch and looked for pieces that take place on a human scale in health-care and community settings, plus The Lancet’s remarks on Tamarin’s essay, can be found here