At A Glance
Author	Dave
Contact	[email protected]
IAM	kromedome
When	N/A

I woke up this morning to learn that the Iranian conjoined twins, Laleh and Ladan Bijani, had died on the operating table during a high-risk operation to separate their fused craniums. It was the first time such a procedure was ever tried on adult conjoined twins. The Bijanis were 29 years old, and had lived their entire lives joined at the head. They were intelligent women, law school graduates, who decided that they could no longer live their lives together. The sisters each had different dreams and goals that could never be realized unless they separated. They understood that the risks involved in separation were high and that the chances that they would both survive was low. The odds were against them from the start, but they decided that their lifelong dream of living separate lives was worth risking death for. I think that is incredibly brave, and I hope that they will be remembered for having the courage to make that choice.

Because of the dangers and the poor odds, it was difficult for the Bijanis to find doctors willing to perform the operation. The Bijani separation creates a huge ethical dilemma for the medical community. Should a Doctor perform a very high risk procedure on a patient who is not in mortal danger from their condition? The Twins could have lived a relatively normal livespan (if not a normal life) if they had stayed conjoined. How do you justify a procedure that has only three possible outcomes, complete success, the death of one sister, or the death of both? What if you begin the surgery, and then are forced to choose between saving one or the other?

Bijani sisters finally found a team of Doctors who felt that the choice should lie with the well-informed patient. They worked hard to try and achieve the Bijanis dream. Unfortunately, they found that the sisters' brains were more enmeshed than they had previously thought. The surgery took far longer than expected. The sisters died of blood loss on the operating table, not long after being separated. First Ladan, and then Laleh 90 minutes later.

I'm not sure why their story has been on my mind all day. Aside from the courage and tragedy that drew me in, there are parts of it that relate directly to the Body Modification community. I'm not trying to equate the separation of conjoined twins to tongue splitting, implants, or even SRS... but there are parallels (some vague, some less so). Why do people have risky procedures done to fairly healthy bodies? Why split a working tongue, implant a useless and potentially dangerous object under the skin, or remove, alter, or reroute healthy genitalia? There is obviously no single answer, but I think for many people it has to do with a need to make our bodies reflect who we are inside. For some that becomes imperative. With doctors refusing to perform many of these procedures, and politicians making it illegal for non-medical licensed practitioners to do so, the choice is being taken out of the hands of the informed "patient". If risks are involved (and we are kiddin g ourselves if we deny that there are), we should be be allowed to decide for ourselves how far we are willing to go for what we need. The government should not be deciding for us.

I have no problem with doctors who refuse to do these procedures for us. Sure, I'd feel better if they would. I tend toward a (perhaps misplaced) trust of doctors, and if I could find one with experience in performing subdermal implants for purely cosmetic purposes, I'd probably be closer to getting one by now. I also understand why "non-essential" procedures that alter the body in ways that bring it further from and not closer to the societal ideal make little sense to most MDs. They make little sense to most of our society, so why should most doctors be different? It is difficult for them to see that what many people consider mutilation can actually be an important step toward making someone else healthy and whole. Doctors should have every right to refuse procedures that go against their conscience. The government however, should not be making that decision for us. Not for the doctors, and not for us. If I can't find a surgeon willing to split my tongue, that is very unfortunate but understandable. If the state tells me that I can't have it done AT ALL, then something is very wrong.

The Bijani Sisters lived their life as far as they could as conjoined twins. When they could go no further, they searched until they found people who were willing to try to make their dreams of a new life come true. It is a tragedy that they weren't able to realize those dreams in this life. It is a testament to their strength that they had the courage to try. I just hope that wherever the Bijani Sisters are now, that they somehow have won the freedom that that they gambled their lives for.