Separation Anxieties by Steven P. Arthur

We were inseparable. At least that’s what the doctors in three different children’s hospitals, across the nation, said. My sister and I were born by cesarean section on August 13, 1973, literally joined at the hip: conjoined twins.

She was the healthier of the two of us. At six pounds eight ounces she was nearly twice my weight of just under five pounds. Mom told us it was touch and go for me at first. I was cyanotic and lethargic due to poorly developed lungs. But with the care of neonatal specialists I fought through and celebrated my first birthday—or rather we celebrated our first birthdays—in the pediatric wing of St. Jude’s hospital.

Despite the rough beginning, and the fact my sister and I shared a liver and some vital blood vessels, the doctors gave my sister and I a clean bill of health. Being conjoined was potentially lethal, but our position, facing each other, caused more problems and fights than anything else. Mom used to joke that my sister and I loved each other and hugged so much it fused us in the womb. After a year and a half, we went home.

The first few years went mostly as expected for two infants. Long nights and short tempers. Dirty diapers, special diets, and more dirty diapers. But during a checkup with our pediatrician, routine blood work discovered our shared liver was overworked. The doctors were concerned.

They had initially thought we could wait for medical advancements before considering surgical separation.

We were both toddlers technically, and with the help of strenuous physical therapy regimens we were semi-mobile. Only a year behind what was considered normal locomotion for children our age. My sister did most of the work. I was half her size and she more often carried me like a purse than let me walk.

The pediatricians tried everything to postpone the inevitable surgery. At our underdeveloped age the risks were outstanding. The plan was to let us get a little older. Find a suitable donor for me and do a marathon twenty-two-hour surgery.

Just short of our fifth birthday, those plans failed. One morning when neither of us could be roused, we were rushed to the hospital. Our liver was failing. The doctors were forced to ask my parents to choose which one of their babies would get the larger portion of the liver and
the best chance of survival.

They opted to leave the small part of our liver to me, and I was given a twenty percent chance of survival.

The separation was a success, to a point. I vividly remember waking up in pain and feeling empty; my sister was gone. With only a fraction of the liver I was doing considerably well. The doctors speculated that because I was half the size I normally would be at that age, my body didn’t tax my liver.

My sister didn’t fare so well. She never woke up from the anesthesia. Her organs began to fail, and she was put on long-term life support. Eventually the decision was made to let her go.

Death from a broken heart? I’m not so poetic to think so. But I believe that we had kept each other alive until then. Being that close. Sharing the same blood and organs is an intimacy that cannot be replicated or explained. When we were separated, she gave me the gift of life at the cost of her own and I can still feel her here with me.

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