Fused Iranian twins eye life apart

Twin Iranian sisters fused at the head yesterday said they were willing to risk death for the chance to live separate lives, even against the advice of specialist doctors.

At a rare and at times emotional news conference in Singapore ahead of their scheduled surgery sometime in July, the 29-year-old sisters Ladan and Laleh Bijani – both law graduates – said physical separation – was a lifelong dream.

Sharing a cream coloured headscarf, they talked of different ambitions and desires. Ladan, the more outspoken of the two, said she wants to be a lawyer and live in her home town in Iran of Shiraz, while Laleh wants to be a journalist in Tehran.

Twins fused at the head occur only once in every two million live births, and successful separation is even rarer. Singapore doctors performed the operation in 2001 on infant girls from Nepal, but experts say an operation on adult twins is unprecedented.

Keith Goh, a neurosurgeon at Singapore's Raffles Hospital who will lead the surgical team, said he tried to talk the twins out of the operation. "We spent the last three months trying to dissuade them," he said. "We spelled out the downside to the surgery in very explicit terms."

German doctors had turned away the Bijanis in 1996, deeming that splitting them could prove fatal. But the sisters continued their search for surgeons willing to separate them, arriving in Singapore last November for medical and psychological tests.

After seven months, doctors said the operation was possible because the women had anatomically separate brains. "We don't have any fear of the surgery because we know that every surgery has a high risk," said Ladan.

Singapore experts in neurosurgery, plastic surgery, radiology and anaesthesia will be joined by specialists from the United States, France, Japan and Switzerland for the operation, expected to begin in early July and last at least three days.

"We would like to see the face of each other without the mirror," said Laleh. One reporter's voice wavered with emotion as she asked the two if they had any last wish.

For as long as she could remember, "when we opened our eyes to see the light, we wanted to be separated," Laden said.

"We want after the surgery different careers. I want to be a lawyer and my sister wants to be a journalist like you. We have a lot of work and dreams to do after surgery," Ladan said.

They said they had endured enough sacrifices and compromises because of two very different personalities.

Goh recounted their tears when they were told of the high risk, but in the end their desire to live separately prevailed.

He said he believed they had experienced deep but often concealed unhappiness as a result of the fusion. "Their resolve to go ahead with it never wavered," he said.

The Bijani twins heard of Goh and his success in April 2001, when he led a team of doctors to disentangle the fused skulls and intertwined brains of 11-month-old Nepali girls Jamuna and Ganga Shrestha in a four-day operation.