Originally posted by Dralix
I am hoping that Sean would like to explain...
I hadn't looked into this story before it closed.
I wanted to know what went wrong, and found many answers.
There has never been a successful separation of adult twins sharing a single skull cavity. Even with resilient newborns, it's dicey, usually estimated at "50/50" survival, not to mention developmental impairment due to brain damage. Giving these older women that "50/50" seems optimistic!
The general assumption was that two separate faces and two distinct personalities must mean two separately functioning brains. The twins believed that, and it's certainly the easiest thing to believe. Prior to this operation, the surgeons convinced themselves that they only needed to help those two separate brains apart.
This was a grand spotlight event, with 128 doctors and assistants eager to lend a hand. I think the sheer numbers of people involved and interested in this operation created a group psychology. It is very difficult to stop the determination of a large group, where a small team that feels independent might pull out of and patch up an effort that clearly isn't working.
"The surgeons encountered unexpected obstacles throughout the procedure. The removal of the strip of bone joining their skulls took longer than expected because the bone was thicker and denser than anticipated."
That doesn't inspire confidence. I think most posters on this forum would have the common sense to find out the thickness and density of something before planning to cut it. A few primitive X-rays would have shown both.
Nothing so critical about sawing bone, though. Go on. The next step was assumed to be the big challenge. Surgeons separated the major shared vein in the twins' brain(s). Seemed to go all right.*
"Thirty-two hours into the procedure, surgeons had stopped the operation and considered calling it off -- leaving the twins joined -- because blood wasn't flowing properly through a finger-thick vein they had stitched to Ladan's brain to compensate for the coming loss of a shared vein that drained blood to their hearts."
"As well, the twins' brains had adhered to each other after 28 years of growing in their conjoined skull." That's one way of saying it, if we insist on the plural.
"One surgeon said the operating team knew Monday night that the final stage would be ''very, very risky.'' He said surgeons asked again what the wishes of the twins were -- and were told that they had wanted to be separated ''under all circumstances.''
Doctors went ahead and completed the operation -- but they weren't able to control the bleeding afterward. Both women died, within 90 minutes of each other. They were still under anesthesia."
The separation of the twins' brains took much longer than expected. The "two" brains just wouldn't come apart. Surgeons had to tease and cut, tease and cut, all the way. I think that after doing that for a while, it became clear these "two" women wouldn't have any meaningful life afterwards, and probably wouldn't survive the operation.
"Separated under all circumstances." Well, I shouldn't have called this "murder". It's not that, exactly.
*Few would think it odd the twins were under general anesthetic during their brain surgery, but this struck me as a serious procedural error. The scalp, face, etc, are easily anesthetized locally, and the brain feels no sensation so requires no anesthetic. The reason for keeping people alert and chatting during brain surgery is that it's a direct and foolproof means of knowing when something is
wrong. For example, an established safeguard before making an incision is to stimulate or suppress the area first and get feedback from the patient. If one or both of those twins had blacked out or started singing backwards, early on, the operation could have been aborted, and they could be saved without further damage.
