Sunday November 5, 2006
Conjoined twins raise more than medical issues
It\’s the age-old dilemma of the part and the whole – but with real human consequences.
Two weeks ago, Vernon resident Felicia Simms gave birth to conjoined twins by Caesarean section. The twins – Tatiana and Krista – were surprisingly healthy. Immediately, they started breathing on their own.
Within 24 hours, doctors declared them out of danger – except, of course, for the fact that they are joined at the head.
No, more than that, joined at the brain. The twins have two of everything, except their brain. Medical staff soon discovered that if both babies were crying and they put a bottle in one mouth, the other baby stopped crying. If they tickled one baby\’s foot, the other baby\’s leg twitched.
Put another way, the twins seem to have two bodies. But apparently only one thought.
So, as a friend pondered, are they two individuals who share the same brain? Or one individual who happens to have a full set of spare limbs and organs?
Two minds or one?
The question has rarely come up before. There have been many conjoined twins – they used to be called Siamese twins – but usually joined at the hip, the back, the abdomen… Many lived full lives. Some even got married and had children.
They shared a body part, but that part was not the brain.
The only recent example was the Iranian twins, Ladan and Laleh Bijani. After 29 years of living with their heads fused together, much like Krista and Tatiana, they decided they no longer wanted to compromise on which twin\’s wishes would prevail.
But note – their ability to disagree reveals that they could operate two distinct mental processes. It\’s not clear yet that Krista and Tatiana can.
When a medical team in Singapore attempted to separate the Bijani twins three years ago, both died on the operating table.
Mother Felicia Simms says that she has no commitment to separating her twins.
Doctors in Vancouver are not sure whether Tatiana and Krista can be separated at all. Technically, it may become possible, as medical science keeps advancing. But should it?
The essence of life
Can a brain be split? And even if it can, how much of each twins\’ personality and mental development gets cut off? Or transferred into a now-separate body?
Because the brain is a special organ. Its functioning shapes personality, ability, emotion, memory…
We cannot live without a heart or a liver, but we can replace them. We can lose a lung, a kidney, a limb, and continue life. But we cannot lose a brain and replace it. Brain death is considered final.
Our forebears believed that life belonged to breath and blood. If you weren\’t breathing, or if your heart stopped pumping blood, you must be dead. (Ancient Greek and Hebrew even used the same word for “breath” and “spirit” – pneuma in Greek, ruah in Hebrew.)
Today, artificial respiration, pulmonary resuscitation, transfusions and transplants have rendered those traditional diagnoses obsolete. Today, only brain death is considered terminal.
The key question seems to be whether Tatiana and Krista have two brains that have fused together inside one skull – in which case they might be separated – or a single integrated set of neurons that connect to two brain stems.
People can lose portions of their brains and still live. In accidents, for example. Seventy years ago, lobotomies enjoyed brief popularity. And in a natural stroke, part of the brain loses its blood supply and atrophies.
Without exception, though, people whose relatives have suffered a stroke tell me, “She\’s not the person she used to be.”
Thus the part affects the whole.
Part and whole
\”Times New Roman\” size=\”3\”> Philosophers have long haggled over the relationship of part and whole.
In logic, invalidating any part of an argument challenges the validity of the whole. That\’s the basis for cross-examination in court, and for political mud-slinging in election campaigns.
In physical terms, removing part of the whole leaves the whole no longer whole. Take a wheel off a bicycle, and it\’s no longer a bicycle, just something that could be a bicycle.
Now translate that into human terms. At the moment, each twin has a whole brain – shared, but whole. Each twin is therefore whole.
But what if societal pressures eventually push them into attempting separation?
If neither has a whole brain, can either be a whole person?
Years ago, in Montreal, Dr. Wilder Penfield\’s experiments in neurosurgery revealed that memories reside in different parts of the brain. When he stimulated specific areas, patients involuntarily experienced long-submerged memories. Indeed, they didn\’t just “remember” a scene, a situation – they re-lived it.
So suppose medical science successfully separated Krista and Tatiana, at some time in the future. And part of the shared brain that contains Tatiana\’s memories goes with Krista\’s reconstructed skull. What would it be like to live with memories that are not your own?
The closest parallel I\’ve heard of was chronicled in Dr. Paul Pearsall\’s book The Heart\’s Code. Pearsall argued that memories are not restricted to the brain – they can also be carried by other body cells.
In his opening chapters, Pearsall told about an eight-year-old girl who received a heart transplant and then started having nightmares about someone attempting to murder her. Investigation revealed that the donor had, in fact, been murdered. And the recipient\’s dreams enabled police to track down the murderer.
Shared perceptions
\”Times New Roman\” size=\”3\”> Identical twins have long been known for having an almost telepathic relationship. Even when raised in separate homes, distant from each other, they often live parallel lives, and sometimes even sense each other\’s tragedies with physical pain or emotional stress.
Could that mysterious connection have something to do with having shared, for a limited period, the same developing bundle of cells?
Tatiana and Krista apparently share the same sensory perceptions. If one is hungry, both feel hunger. If one is hurt, both feel the same pain.
So are they one? Or two?
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Copyright © 2006 by Jim Taylor. Non-profit use in congregations and study groups permitted; all other rights reserved.
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