New life, apart: Conjoined twins separate and undergo surgery as individuals

Dr. Goodrich and Nicole McDonald with the twins before surgery. (CNN)
Dr. Goodrich and Nicole McDonald with the twins before surgery. (CNN)

New York (CNN) Twin baby boys conjoined at the head were successfully separated early Friday at the Children’s Hospital at Montefiore Medical Center in the Bronx.

Jadon and Anias McDonald, 13-month-old twins, were still undergoing surgery at 6 a.m. to reconstruct their skulls and make them whole.
The surgery was led by Dr. James Goodrich, considered the leading expert on what’s known as craniopagus surgery. The separation part of the surgery took nearly 16.5 hours.
It marked the seventh separation surgery performed by Goodrich — and just the 59th craniopagus separation surgery in the world since 1952.
Their parents, Nicole and Christian McDonald, had to make an agonizing decision, opting for the procedure even though it carried major risks, including the possibility of death or long-term brain damage for one or both boys.
Goodrich informed the family of the separation around 3 a.m.
“Well, we did it,” Goodrich said.
On her Facebook page, Nicole wrote: “TWO SEPARATE BABIES!!!…and yet I ache with the uncertainty of the future. I didn’t cry until the surgeons left the room. I was barely able to even utter the words ‘thank you’ because of the pit that still sits heavy in my stomach. We are standing on the brink of a vast unknown. The next few months will be critical in terms of recovery and we will not know for sure how Anias and Jadon are recovering for many weeks.”

‘I feel good’

Dr. Goodrich stands in Operating Room Number 10. It’s a drab off-white, and empty of people. Two operating tables sit in the middle of the room, abutted together. A 3D replica of the boys’ heads sits between them.
It’s 6:52 a.m.
The doctor began his day by skipping breakfast and enjoying a single cappuccino.
It’s been 12 years since he last separated twins conjoined at the head at Montefiore. That was his first ever craniopagus surgery, and he’s learned much since then, performing five other separation surgeries around the world, including Syrian twins in Saudi Arabia earlier this year.
Prior to the mid-1980s, it was accepted medical practice to sacrifice one child on the operating table to save the life of the other. Many times both babies died. If one child made it through surgery, he or she often suffered debilitating brain damage.
Goodrich has pioneered the field. He established the practice of performing the separation of craniopagus twins in several shorter stages, instead of one single operation lasting more than 50 hours. The McDonalds have had three previous operations, each resulting in progressively more separated brains. Today is the fourth and final stage. None of Goodrich’s conjoined twins have died during the operation. His mantra: “Take it easy and slowly and carefully.”
His surgical cap embodies that philosophy: It’s decorated with turtles.
“Don’t change what works,” he says. “Ready to go.”
Within minutes, he and Dr. Oren Tepper — the plastic surgeon charged with reconstructing the boys’ skulls and stitching their heads back together — go to the 10th floor to a corner room where Jadon and Anias are resting with their family.
The doctors exchange pleasantries with Mom, Dad and other family members who crowd the room. Asked how he’s feeling, Goodrich breaks out into a James Brown-like jig. “I feel good,” he croons.
At 7:12 a.m., the boys are wheeled out of the room. Their older brother, Aza, lies with the twins on the stretcher as they’re taken down an elevator and through a phalanx of hallways toward the third floor operating room.
“Open door,” Aza says.
It’s time to say goodbye. Against his will, Aza is taken off the stretcher. “Babies, babies,” he says, reaching toward his brothers.
Mom and Dad kiss their boys bye. “We’ll see our two boys later,” Christian tells Nicole.
Nicole scoops up Aza and cradles him. The three walk away. The twins go straight into the OR.
It’s 7:18 a.m.

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