THE GOD-FEARING SURGEON
WHO SEPARATED THE TWlNS

I

Before they were separated, Alta (upright)
entertains Clara. Because of the way they
were joined, one usually had to sit up for
the other to sleep.

In the doorway of his Dominican Republic
  store, Salvador Rodriguez, the father,
beams, flanked by two of his three sons.

F or Mrs. Farida Rodriguez, beaming
broadly in the embrace of a Philadel-
phia pediatric surgeon, it was a
mother's moment of relief and joy. At
home. 1,500 miles away in the Domin-
ican Republic, the tather, Salvador
Rodriguez, was the happiest man in the
tiny village of Las Auyamas. He had
stayed home to look after their sons
and the family store. For them the new5
was good: for the world, historic. In a
rare and difficult operation the "Sia-
mese twin" daughters of the Rodrl-
guezes, joined at the waist and pelvis
had been successfully separated,

When they were born 14 months ago,
Clara and Altagracia Rodriguez
seemed doomed to spend life sharing
the same grotesque body-if, indeed,
they would live at all. Hospital atten-
dants in the town where they were born
did not offer much hope. Yet as they
neared their first birthday, it was clear
that both girls were remarkably
healthy. That they frequently played to-
gether, happily rocking back and forth
on their shared torso, made their plight
all the more poignant.

This summer, word of their condition
reached Mrs. Dianna Zimnoch of War-
rington, Pa., a member of a Community
in Christ church. She and her congre-
gation arranged to have Mrs. Rodri-
guez and the twins flown from the
Caribbean to the Children's Hospital of
Philadelphia, where, under the direc-
tion of Dr. C. Everett Koop. over 10
hours of surgery made each little girl

a reasonably normal human being.
It was the seventh time such siml-
larly joined twins had been separated,
only three of the previous operations
had been wholly successful. While
word of Koop's surgical triumph circled
the earth, the news was somewhat
slower in getting to the Rodriguez fam-
After the operation, surgeon Koop and the
   girls' mother share a proud moment.

4


ily. A radio station in Santo Domingo
contacted a telephone company office
in San Jose de Ocoa, a mountain town
90 miles to the southwest, and from
there a jeep was dispatched to remote,
primitive Las Auyamas. To the joyfully
bewildered Rodriguez, Koop and his
fellow physicians were "gods," per-
forming a miracle the family could
scarcely hope for. But Koop, who de-
scribes himself as "a pretty deeply
committed Christian, a Bible-believing
conservative evangelical." was quick
to put the accomplishment into per-
spective. "Obviously," he said, "we

cannot do what God has done. But we
have done what we can do."

A graduate of Dartmouth College
and the Cornell Medical College, Koop.
57, can hardly remember a day when
he did not want to practice medicine.
Growing up in Brooklyn, of Dutch
and German parentage, he recalls. *`I
never went the fireman or policeman
route. I always wanted to be a doctor.
since the age of 5. In fact, I always
wanted to be a surgeon. The idea of
being able to use my hands to make
people well fascinated me."

Twenty-seven years a surgeon.

nearly all of them as surgeon-in-chief
of Children's Hospital, Koop ap-
proached the operation with a certain
optimistic realism. "What we had
here," he explains, "was a decision
whether to allow these little girls to live
as a monster-not a very pretty term.
but nevertheless the term we use-or
to give them the hope of living as
separate individuals, each with her own
life."

That choice was not without agony
for the Rodriguez family. "There was
one thing I had to translate to the
doctors 20 times a day," recalls Mrs.

During the operation, Dr. Koop (above,
right center, with glasses) directed the 23.
member surgical team.

In front of a lighted viewing glass, Dr. Koop
and an associate review X rays of the two
girls which were taken prior to surgery.

6

Photographs by Arthur Schatz


Zimnoch. "The parents didn't want the
operation if it meant that one of the
girls had to die so that the other could
live." With Koop's assurances, the par-
ents finally consented.

Although both girls are small for their
age-Alta's postoperative weight was
eight pounds, Clara's 13-they were
proclaimed healthy and are expected
to be able to return to the Dominican
Republic by the middle of this month.
For the moment, however, they
were confined to the infant intensive
care unit, their tiny figures dwarfed by
the wires, tubes and consoles that

monitored their every bodily function.

Occasionally visible when they
moved restlessly were two rows of
small, sterile mother-of-pearl buttons
sewn onto each tiny abdomen. The su-
tures from each side of the incision
were wound around the buttons, thus
lessening any chance of tearing the
skin.

Because they spent the first 13
months of their lives side by side, Clara
and Alta are sharing the same hospital
bed. While still watching their physical
signs, the doctors are in fact as con-
cerned about their psychological

adjustment to the enormous shock of
being separate from one another. As
Koop looked in on the two, Clara
reached out and touched her sister's
hand (see following pages). "We will,
of course, keep them together as much
as possible," he said in his best lec-
ture hall manner. "You see, they have
always held hands while they slept."
He paused and the bearded surgeon's
voice softened. "Isn't it wonderful?"

CONTINUED

Intently watching a monitor of her heart
rate, Dr. Koop examines Clara, the larger
of the two newly separated girls.


On the evening of her
first night as a separate
  little girl, Clara (left)
  reaches out to touch
the hand of her sister
Altagracia as the two
    drift off to sleep.