Two Brains, One Vein

Each of the twin boys in Chicago's University of Illinois Hospital was as cute as a button. At 15 months they both had handsome, well-formed bodies, twinkling, dark blue eyes and bewitching smiles. They loved to play pat-a-cake, could say "Hi," "Mama," "Dada," and "Nite-nite." They had just learned to say "Frog" too, because mother & father had brought them each a rubber frog. Rodney Dee Brodie was a bit smaller than Roger Lee Brodie, so Rodney got more attention. This made Roger mad, and he showed it by swatting Rodney across the face or grabbing his ear. Rodney hated this, and cried, but Roger laughed even while being scolded.

Except for a minor heart murmur, there was only one thing wrong with the Brodie twins from Moline: they were "Siamese," joined at the tops of their skulls, with their trunks, arms and legs pointing in opposite directions. Their mother, Mrs. Royt Brodie, wife of a farmer who works winters as a meatcutter, had had three normal children before the twins came. (Even then she had a normal pregnancy, and the first baby was born easily, feet first.) She had another baby, a normal girl, last month.

But ever since they were six weeks old, the twins had been in the hospital's Neuropsychiatric Institute while doctors studied the dreadfully complicated question: Should they try to separate the twins, to save them from a hideously unnatural life, knowing the risk that either or both might die in the attempt? The doctors calculated the risk as best they could, then decided that it must be taken to give the twins a chance to grow up as normal boys. The parents agreed.

Last week the surgeons were ready. They had already done a dozen operations and proved that the babies had separate brains and nervous systems, with no connecting arteries. But even with the most elaborate X-ray methods, there was no way for the doctors to know just what they would find when they opened the double skull.

(They had already cut the bony part in two, leaving the twins joined only by flesh and skin.) In medical history they had found no cause for optimism: only two other sets of craniopagus (skull-joined) twins had been operated on, and none of the children lived.

For the climactic operation there was a medical team of 15. Neurosurgeon Oscar Sugar had four surgeons to help him with the heads while two others handled transfusions; there were two anesthetists, two pediatricians and four nurses. For nearly ten hours they worked, cutting a little here, retracting there, stitching and always transfusing. Rodney, the little one, stood the strain better; Roger was in shock three times.

Then the doctors learned the worst: each baby, to have a complete and independent circulatory system, should have had a big vein (unaptly called a sagittal sinus) running fore & aft along the top of his brain to gather blood from smaller vessels and deliver it, through the jugular, back to the heart. The twins had only one. There was no way to divide it, no way to make another. One baby had to get it, and with it, a good chance to survive. The other must almost certainly perish. Little Rodney had the better chance to live, anyway, so the vein was his.

Wearily, the surgeons closed the tops of the little skulls with plastic and aluminum foil, and after more than twelve exhausting, nerve-racking hours, the operation was over. For the first time in their lives, Roger and Rodney lay side by side. Seeing them wheeled from the operating room in separate cribs, Farmer Brodie said in a choking voice: "It sure looks good to see them apart."

Rodney soon began to improve, and the doctors had high hopes that he would live to have a metal brainpan fitted in the top of his skull, and grow up. Roger fought for life, but was still in a coma this week.

In Mississippi, by rare coincidence, another pair of skull-joined twin boys was in the news. One of the four-month-old boys died suddenly; his twin died with in hours before surgeons could free him. In Cleveland's Mount Sinai Hospital, twin girls were born with a band of cartilage joining them at the chest. Dr. Jac Geller cut the babies apart ("Really very simple," he said), and both were soon doing well in incubators. After such a superficial link, they have every chance of growing up to be normal women, and with hardly a scar to show for it.

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