Conjoined twins face financial obstacle
Children's Medical Center seeks to offset $2 million cost
04/02/2003
By LAURA BEIL / The Dallas Morning News
Doctors think they can overcome the medical obstacles that keep conjoined Egyptian twins Ahmed and Mohamed Ibrahim from living separate lives, but the 22-month-old boys now face a different barrier.
Before plans for surgery can proceed, Children's Medical Center of Dallas has asked for $125,000 to offset some of the separation surgery's anticipated $2 million cost. Hospital officials say they want to help the boys but cannot accept them as charity.
Although the twins' case is extraordinary, said John Dragovits, the hospital's chief operating officer, he is afraid to endanger the hospital's main mission. Children's provides nearly $40 million in free care each year, but only for North Texas patients, he said.
"We get approached daily from international patients around the world," he said.
Ahmed and Mohamed were born in Egypt and were cared for in hospitals there until they arrived in Dallas last summer. They are the rarest type of conjoined twins, fused at the crowns of their heads.
When a surgical team from Medical City Dallas Hospital brought the twins here in June, doctors thought that separation, if possible, would be performed at Medical City. But after months of discussion, the neurosurgeons who must painstakingly untangle blood vessels in the boys' brains decided they would prefer to operate at Children's.
Complex surgery
Among the reasons: The surgery will be some of the most complex the neurosurgeons have ever performed, and Children's has technology that is crucial for success, Dr. Kenneth Salyer said.
Dr. Salyer, a craniofacial specialist, is the leader of the boys' surgical team. The separation is not the only procedure the boys need, but the other operations will take place at Medical City. None of the doctors will be paid.
The World Craniofacial Foundation, which is sponsoring Ahmed and Mohamed, cannot pay for surgery, director Sue Blackwood said. When the foundation brings in a child, Medical City donates medical care, and the foundation provides food, lodging and daily needs as it has been doing for the twins, their father and two nurses. It is not unusual for the foundation's families to spend as much as a year in Dallas.
If she started paying hospital bills, Ms. Blackwood said, "One surgery could completely wipe out all the funds of the foundation."
The twins' need has become urgent. The older the boys become, the more their neurological tissue loses the ability to bounce back from the operation, doctors say.
The twins' father, Ibrahim Mohamed Ibrahim, is proud and anxious as he watches them become less like babies and more like little boys. Their growth also makes their lives increasingly hard. Usually happy tykes, the brothers have started squabbling more in clashes of wills. Also, the heavier they get, the more difficult it becomes to carry them. One of the twins' nurses has begun to struggle with back problems.
Mr. Ibrahim said his boys' future rests with the hearts of American strangers. Before coming to Dallas, Mr. Ibrahim worked as a school janitor. After months in Texas with his sons, he fears he has no job left to return to.
He wants his boys separated, he said through a translator, "so they can have a chance to live like any other human beings." However, should the money not come, he will nonetheless feel blessed to raise such unique children.
"I will take them home. I will take care of them," Mr. Ibrahim said. "My family will love them as always." Even if his sons cannot be parted, "We will continue to be happy for having them. ... I will feel honored that God has given me something that even medicine and science could not deal with."
Those who know the boys have vowed to raise the money. Dr. Waleed El-Feky, a Dallas neurologist, has agreed to help lead the campaign for Ahmed and Mohamed. While he can improve lives daily as a physician, Dr. El-Feky said, "I don't think I'll be able to help kids like this again."
No regrets
If the Craniofacial Foundation ultimately must send the twins home without surgery, Ms. Blackwood said no one would regret the time and effort spent trying to help them. During their 10 months in Dallas, the twins have left their Texas hosts charmed.
"They have touched our lives more than we could ever touch theirs," she said.
