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Twin Tragedy

Aired July 08, 2003 - 13:09   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


MILES O'BRIEN, CNN ANCHOR: In Singapore, the Bijani twins life and death gamble to lead separate lives. We're very sorry to tell you failed. Shortly after doctors parted the twins, who had been conjoined at the head, Laden, died, and then 90 minutes later, ladened died.
(BEGIN VIDEO CLIP)

DR. LOO CHOON YONG, RAFFLES HOSPITAL CHAIRMAN: When we undertook this challenge, we knew the risks were great. We knew that of one of the scenarios was that we may lose both of them. Ladan and Laleh knew it, too. We were hoping and trying to do better than it was obvious (ph), but, alas, we didn't make it.

(END VIDEO CLIP)

O'BRIEN: All right. And joining us now is Dr. Sanjay Gupta, our medical correspondent and neurosurgeon himself.

I have to say, Sanjay, this one caught me by surprise. It really hit me this morning when I heard the news. I think a lot of us really had been charmed by these women.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: I think a lot of people had that same reaction. I did as well when I got the call this morning. A lot of people got to know these women, and as lot of people liked them. They were certainly very outgoing women, educated, 29 years old, Iranian, making medical history. So many elements to the story help no question about it. I'll tell you, Miles, I think the surgeons were discouraged, obviously, but probably not surprised by this ultimate outcome.

O'BRIEN: Well, it's interesting, because we can talk a little about risks and our perception of risks. There are so many things that could have gone wrong. Maybe we should give people a sense of it.

GUPTA: First of all, there's no precedent for something like this. This was the first time this was done in an adult, that is separation of conjoined twins. It's hard to say. Some of this was brand new territory. In fact, all of it was. A couple of critical parts of the operation. One part, there's a major vein in the back of the brain where there should have been two. There's one, where there should have been two. They actually had to create that. There was a good chance, Miles, at some point, even the operation part of it went well, the technical part of it went well, and that causes, if you can imagine, the brain actually filling up with blood. All of a sudden, all these surfaces that had just recently been operated on, cut, start to bleed. Add on that now, the fact that they were probably on blood thinners to prevent these clots from occurring. And you can imagine somebody who is being operated and on blood tin thinners, the problem is obvious.

O'BRIEN: Boy, talk about the surgical tightrope, you want the blood thinners in to guard against clotting. If something goes wrong, it's very difficult to stop the bleeding.

GUPTA: That's exactly right.

O'BRIEN: It's not a good place for a surgeon to be. Let's talk a little bit about the risks here. We invest so much in the miracles of modern medicine, and you have to -- I'm sure there will be a lot of ethical discussion about this in your community as time goes on as to whether they really understood the risks.

GUPTA: I think that's a fair question, and it's going to start right away, I think. One thing that's important to point out, in this operation, there were decisions made all along the way. Certainly, all of us have become familiar with it over the last couple of days, but for the doctors, months and month of planning. For the Bijani twins, obviously, years of planning.

One of the things that struck me, Miles, was well was the intra- operative decisions. Imagine this, you're actually -- surgeons are doing the operation. All of a sudden, they realize things are not going as well as we hoped. We should maybe stop in order to preserve life. If we continue, we are not sure how things are going to proceed. The doctors talked about that at the press conference earlier today.

(BEGIN VIDEO CLIP)

YONG: The team wanted to know once again, what are the wishes of Ladan and Laleh? And we were told that Ladan and Laleh's wishes were to be separated under all circumstances.

(END VIDEO CLIP)

GUPTA: All circumstances, including even death, and to answer your question directly, Miles, which I think is a good question. I asked Dr. Carson that same question. What compels him as a neurosurgeon to take such a huge risk, possibly even losing a life of two patients in an elective way, and this is what he had to say.

(BEGIN VIDEO CLIP)

DR. BENJAMIN CARSON, U.S. SURGEON: Recognizing the incredible desire they have for this and how miserable their lives are, and that they would rather face death than to continue in that manner, recognizing that we do at least have a 50 percent chance of success, putting all that together and recognizing that they will continue to seek to be separated even if we don't do it.

(END VIDEO CLIP)

GUPTA: Dr. Carson saying saying they would find somebody to do this operation, even if it wasn't this team.

O'BRIEN: All right. Just quickly, because we are pretty much out of time -- is it your gut feeling they had an informed consent to all this?

GUPTA: I think so. I mean, they went out and sought the neurosurgeons. They knew that they could potentially die, and since it's unprecedented, I think it's difficult to say for sure all of the elements, but I think they had an informed consent.

O'BRIEN: Yes, it's a sad day. We're sorry that's a story we have to tell today. Dr. Gupta, thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com




9


Aired July 8, 2003 - 13:09   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
MILES O'BRIEN, CNN ANCHOR: In Singapore, the Bijani twins life and death gamble to lead separate lives. We're very sorry to tell you failed. Shortly after doctors parted the twins, who had been conjoined at the head, Laden, died, and then 90 minutes later, ladened died.
(BEGIN VIDEO CLIP)

DR. LOO CHOON YONG, RAFFLES HOSPITAL CHAIRMAN: When we undertook this challenge, we knew the risks were great. We knew that of one of the scenarios was that we may lose both of them. Ladan and Laleh knew it, too. We were hoping and trying to do better than it was obvious (ph), but, alas, we didn't make it.

(END VIDEO CLIP)

O'BRIEN: All right. And joining us now is Dr. Sanjay Gupta, our medical correspondent and neurosurgeon himself.

I have to say, Sanjay, this one caught me by surprise. It really hit me this morning when I heard the news. I think a lot of us really had been charmed by these women.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: I think a lot of people had that same reaction. I did as well when I got the call this morning. A lot of people got to know these women, and as lot of people liked them. They were certainly very outgoing women, educated, 29 years old, Iranian, making medical history. So many elements to the story help no question about it. I'll tell you, Miles, I think the surgeons were discouraged, obviously, but probably not surprised by this ultimate outcome.

O'BRIEN: Well, it's interesting, because we can talk a little about risks and our perception of risks. There are so many things that could have gone wrong. Maybe we should give people a sense of it.

GUPTA: First of all, there's no precedent for something like this. This was the first time this was done in an adult, that is separation of conjoined twins. It's hard to say. Some of this was brand new territory. In fact, all of it was. A couple of critical parts of the operation. One part, there's a major vein in the back of the brain where there should have been two. There's one, where there should have been two. They actually had to create that. There was a good chance, Miles, at some point, even the operation part of it went well, the technical part of it went well, and that causes, if you can imagine, the brain actually filling up with blood. All of a sudden, all these surfaces that had just recently been operated on, cut, start to bleed. Add on that now, the fact that they were probably on blood thinners to prevent these clots from occurring. And you can imagine somebody who is being operated and on blood tin thinners, the problem is obvious.

O'BRIEN: Boy, talk about the surgical tightrope, you want the blood thinners in to guard against clotting. If something goes wrong, it's very difficult to stop the bleeding.

GUPTA: That's exactly right.

O'BRIEN: It's not a good place for a surgeon to be. Let's talk a little bit about the risks here. We invest so much in the miracles of modern medicine, and you have to -- I'm sure there will be a lot of ethical discussion about this in your community as time goes on as to whether they really understood the risks.

GUPTA: I think that's a fair question, and it's going to start right away, I think. One thing that's important to point out, in this operation, there were decisions made all along the way. Certainly, all of us have become familiar with it over the last couple of days, but for the doctors, months and month of planning. For the Bijani twins, obviously, years of planning.

One of the things that struck me, Miles, was well was the intra- operative decisions. Imagine this, you're actually -- surgeons are doing the operation. All of a sudden, they realize things are not going as well as we hoped. We should maybe stop in order to preserve life. If we continue, we are not sure how things are going to proceed. The doctors talked about that at the press conference earlier today.

(BEGIN VIDEO CLIP)

YONG: The team wanted to know once again, what are the wishes of Ladan and Laleh? And we were told that Ladan and Laleh's wishes were to be separated under all circumstances.

(END VIDEO CLIP)

GUPTA: All circumstances, including even death, and to answer your question directly, Miles, which I think is a good question. I asked Dr. Carson that same question. What compels him as a neurosurgeon to take such a huge risk, possibly even losing a life of two patients in an elective way, and this is what he had to say.

(BEGIN VIDEO CLIP)

DR. BENJAMIN CARSON, U.S. SURGEON: Recognizing the incredible desire they have for this and how miserable their lives are, and that they would rather face death than to continue in that manner, recognizing that we do at least have a 50 percent chance of success, putting all that together and recognizing that they will continue to seek to be separated even if we don't do it.

(END VIDEO CLIP)

GUPTA: Dr. Carson saying saying they would find somebody to do this operation, even if it wasn't this team.

O'BRIEN: All right. Just quickly, because we are pretty much out of time -- is it your gut feeling they had an informed consent to all this?

GUPTA: I think so. I mean, they went out and sought the neurosurgeons. They knew that they could potentially die, and since it's unprecedented, I think it's difficult to say for sure all of the elements, but I think they had an informed consent.

O'BRIEN: Yes, it's a sad day. We're sorry that's a story we have to tell today. Dr. Gupta, thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com




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