VERNON, B.C. — There is a passage in a novel about two adult conjoined twins that describes the pain and wrenching loss felt by twins divided by a scalpel.
In Lori Lansens's book, The Girls, Minnie and Marie of Wales were born conjoined at the chest and they shared one heart, which began to deteriorate just before their second birthday. Doctors decided to sacrifice the smaller sister, Marie, to save Minnie. She would receive the girls' shared heart.
When Minnie woke up from surgery, her heart was working fine. But when she saw that her sister was no longer there, she closed her eyes and died, too.
Felicia Simms, a real-life mother of conjoined baby girls, cried when she read the passage.
Christopher reaches out to his sisters, conjoined twins Tatiana, shown, and Krista, as their mother Felicia Simms looks on last month in Vernon, B.C. (John Lehmann/The Globe and Mail)
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"It was so sad," Ms. Simms said, placing her hand over her heart.
The prospect of losing one or both of her girls through surgery haunts Ms. Simms, a 21-year-old from Vernon, B.C. Ever since she gave birth to the twins six months ago, the question has loomed like a mighty weight. It's all anyone wants to talk about when they first meet her: Can Tatiana and Krista be separated? Others are less diplomatic: Can they ever be cured?
Ms. Simms replies truthfully that doctors still don't know. Soon they will.
Yesterday, doctors at B.C. Children's Hospital in Vancouver performed a cerebral angiography, in which blue dye was injected into the twins' veins, illuminating the vast network of blood vessels the girls share beneath their skulls. This test will reveal whether separation surgery is possible.
Doctors are particularly interested in a bridge of tissue that connects the girls' brain stems. If it's discovered that life-sustaining brain signals travel this route, separation might be ruled out. But if this bridge is just tissue, surgeons could attempt to separate them.
Ms. Simms will then face the decision of her life. Despite all the help she feels she receives from her parents, her siblings and her partner, Brendan Hogan, everyone understands that this decision is hers alone.
It's made even more daunting because she has options. Surgery would be elective, not life-saving.
Unlike some conjoined twins, neither girl is in imminent danger of dying without surgery.
Ms. Simms's stepfather, Doug McKay, compares the decision to parachuting.
"You can stand there or jump out of the airplane. There's no halfway in between."
Ms. Simms's mother, Louise McKay, said that her daughter's biggest fear -- and one that Ms. Simms won't discuss -- is that Tatiana, the weaker twin, won't make it through a lengthy operation.
"It's scary," Ms. McKay said. "When you look at them, you just know it's going to be Tatiana who isn't going to make it."
Ms. Simms's stepfather nods. "I just look at either of them and know there ain't no way I could lose either." Of his stepdaughter, he said, "I don't envy her."
Conjoined adults
One reason conjoined twins are so fascinating is that they're so rare: It's believed there are only about a dozen adult pairs in the world.
The sight of two distinct humans sharing one body challenges our notions of independence and selfhood. And it's for this reason, perhaps, that they instill fear and discomfort.
How can two people ever hope to live fulfilling lives if they are joined? How can they marry, have sex, hold separate jobs? What happens if one wants to go for a walk and the other wants to watch television?
Before modern medicine allowed twins to be physically separated, conjoined twins had no choice but to learn to live with another person.
Chang and Eng Bunker, from the former Asian country of Siam (now Thailand), were among the first conjoined twins to financially profit from their condition.
They came to the United States as teenagers in 1829, when an American businessman paid their mother a stipend to feature the boys -- who were joined at the chest by a 15-centimetre band of flesh -- in exhibitions. Later they appeared in P.T. Barnum's travelling circus.
The Bunkers enjoyed the travel and, by all accounts, didn't mind life as circus attractions. By their mid-30s, they had bought a farm in North Carolina.
They married two sisters and fathered 21 children between them.
