Like Farah and Saba, Veena and Vani are still joined, but their doctors have made efforts to outsource the operation. Recently they contacted University Medical Center in Salt Lake City, Utah, which has separated at least three sets of headjoined twins, but were turned away.
This open letter to the twins' chief caretaker was published in an Indian online newspaper, the Central Chronicle, on October 25, but the link is no longer active.
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Dr. Yarlagadda Nayudamma is a pediatric surgeon in India who has made his career of separating conjoined twins. Since the early 90s he has separated three sets of orphaned conjoined twins with fantastic results (i.e., no deaths or lasting disabilities). However, he now hopes to separate 18-month-old Veena and Vani Laxmi, who are also orphans. They are quite closely conjoined at the head (not-quite-vertical craniopagus) but have already learned to walk. Because of the closeness of their conjoinment and the probability of shared brain and circulatory tissue, they are unlikely to survive.
This article appeared this morning on NDTV.com, an Indian news site. Several of the quotes attributed to Dr. Nayudamma and written about the surgery are worrisome to me (try to pick out which ones!)
Here is a copy of a letter I sent to Dr. Nayudamma this morning. I have sent a modified version to four Indian online newspapers as well.
Dear Dr. Nayudamma:
I am a researcher and historian from the United States and I have been following the case of Veena and Vani, conjoined twins who are attached at the head. I am writing to express concern for the girls' futures as well as misgivings about the decision to separate them.
You have been been quoted as saying, "The dictum goes that these children will be mentally retarded. It is a fact. If it is a major fusion in the brain matter or the blood vessels, we have to accept some morbidity in the form of mental retardation." You have also said that, in the event of a shared major blood vessel, it may be necessary to allow one of the twins to die on the operating table.
From a medical ethical standpoint, neither of these outcomes is acceptable. Veena and Vani have shown that they are mentally normal and physically capable children. They can already walk and speak and do not show signs of mental retardation. To make them mentally retarded is decidedly unethical. They are orphans and are likely to be raised in a hospital regardless of whether or not they are separated, but if they are not separated, there is a good chance that they may grow up to be self-sufficient and productive adults. If they are separated, they will become seriously disabled and will remain wards of the state for the remainder of their lives.
That you consider it acceptable to allow one of the twins to die is also worrisome. I have studied several cases in which one twin was allowed to die so that the other might live. In every one of these situations, the twin who was chosen to survive has also died, usually after a prolonged struggle for life. It is not fair to inflict this fate on either of the twins.
I urge you to place these twins' futures before the advancement of your own career, and allow them to live out the rest of their days as happy and healthy conjoined twins.
Sincerely,
[my name]
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3 comments:
God bless you.
Your article is very good and I appreciate your article regarding Veena and Vani.
As you have done much work in such cases I would like to know the likely problems faced by such craniopagus twins in their future life. How long they survive and if they die prematurely, the cause death
Thank you
M.Ravindranath.
Hello Sir
I agree to some extent. But worried if they are allowed to survive in the present state. They are loosing the childhood and moreover they have to face lot of problems if they need to walk or sit. today i saw a story board article in a TV show. I suggest operation should take place and they should survive. I pray to god that this should be taken very soon
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