Clarence and Carl Aguirre (born April 21, 2002) are former
conjoined twins
Conjoined twins – sometimes popularly referred to as Siamese twins – are twins joined ''in utero''. A very rare phenomenon, the occurrence is estimated to range from 1 in 49,000 births to 1 in 189,000 births, with a somewhat higher incidence ...
born in
Manila
Manila ( , ; fil, Maynila, ), officially the City of Manila ( fil, Lungsod ng Maynila, ), is the capital of the Philippines, and its second-most populous city. It is highly urbanized and, as of 2019, was the world's most densely populate ...
.
[ They were conjoined at the top of the head and shared 8 centimeters of brain.] More than 1—2 centimeters will affect brain functionality in one or both of twins.[ Without separation, they were expected to live around 6—8 months.][
]
Biography
Arlene Aguirre, a Silaynon nurse working in Manila
Manila ( , ; fil, Maynila, ), officially the City of Manila ( fil, Lungsod ng Maynila, ), is the capital of the Philippines, and its second-most populous city. It is highly urbanized and, as of 2019, was the world's most densely populate ...
, discovered at her four-month ultrasound that her sons were conjoined twins
Conjoined twins – sometimes popularly referred to as Siamese twins – are twins joined ''in utero''. A very rare phenomenon, the occurrence is estimated to range from 1 in 49,000 births to 1 in 189,000 births, with a somewhat higher incidence ...
. As a Catholic, she refused to have an abortion, and gave birth to Carl and Clarence on April 21, 2002, ten days before her due date, via C-section
Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or ...
.[ The boys were craniopagus and were joined at the top of their heads, meaning they were unable to sit up or see each other.][ The doctors recommended the typical solution of sacrificing one child to save the other, but Arlene refused to choose which boy to save.][ She returned to her parents' home in Hacienda Paz, ]Silay
Silay, officially the City of Silay ( hil, Dakbanwa/Syudad sang Silay; ceb, Dakbayan sa Silay; fil, Lungsod ng Silay), is a 3rd class component city in the province of Negros Occidental, Philippines. According to the 2020 census, it has a popu ...
, where her mother Evelina could help raise the boys.[ The boys' father was married and had four other children to support and was only able to provide small sums of money once a month.][
By February 2003, the boys had difficulty eating and were often ill.][ The ]Philippine Airlines
Philippine Airlines (PAL), a trade name of PAL Holdings, Inc. ( PSEPAL (Philippine Air Lines until 1970), is the flag carrier airline of the Philippines. Headquartered at the PNB Financial Center in Pasay, the airline was founded in 1941 and i ...
Foundation and the American nonprofit Children's Chance helped Arlene connect with New York neurosurgeon Dr. James T. Goodrich
James Tait Goodrich (April 16, 1946 – March 30, 2020) was an American neurosurgeon. He was the director of the Division of Pediatric Neurosurgery at Montefiore Health System and Professor of Clinical Neurological Surgery, Pediatrics, Plastic a ...
.[ Goodrich's team spent six months researching, preparing, and communicating with the Aguirres' doctors in the Philippines before they accepted the case.] Arlene, Carl, and Clarence flew to the United States in September 2003 to have the boys separated.[
In September 2003, tissue expanders (pouches filled with saline) were implanted under the boys' scalps to create more skin to cover the twins' wounds after separation.] The surgeries began in October[ at the ]Children's Hospital at Montefiore
The Children's Hospital at Montefiore (CHAM) is a nationally ranked pediatric acute care children's teaching hospital located in the Bronx, New York. The hospital has 193 pediatric beds and is affiliated with the Albert Einstein College of Medici ...
in The Bronx, New York
The Bronx () is a borough of New York City, coextensive with Bronx County, in the state of New York. It is south of Westchester County; north and east of the New York City borough of Manhattan, across the Harlem River; and north of the New York ...
.[ The hospital covered their multi-million dollar medical expenses and continued to support them after their surgery.]
On August 4, 2004, the final surgery was completed and, at two years old, Clarence and Carl became the first craniopagus twins
Craniopagus twins are conjoined twins that are fused at the cranium. The union may occur on any portion of the cranium, but does not primarily involve either the face or the foramen magnum; their brains are usually separate, but they may share ...
to be separated using a staged method. Goodrich, plastic surgeon David A. Staffenberg, and their team performed four surgeries over ten months.[ During the surgery, Goodrich discovered two inches of shared brain were not detected in MRIs or during the first three surgeries. They were continuous rather than fused, making it more complicated to operate on, as severing a shared brain incorrectly would cause medical distress.][ He was able to find a narrow strip and the boys were successfully separated.
Most of the post-operative rehabilitation took place at ]Blythedale Children's Hospital
Blythedale Children's Hospital is a specialty children's hospital in Valhalla, New York, United States. It is the only independent children's hospital in New York State
New York, officially the State of New York, is a state in the Northeas ...
in Valhalla, New York
Valhalla is a hamlet and census-designated place (CDP) within the town of Mount Pleasant, in Westchester County, New York, United States, in the New York City metropolitan area. Its population was 3,162 at the 2010 U.S. Census. The name was in ...
. Both wore helmets to protect their brains; when they are fully grown, their skulls will be patched,[ though no approximate date has been made publicly available.
Within just over a year, Clarence was able to walk short distances and Carl could walk using a walker; both boys were also learning to speak. By September 2014, the twins were still attending physical therapy at Blythedale. In the month following the surgery, Carl developed a seizure disorder, but by 2014, they were down to two a day rather than a dozen.][ However, he has had some degeneration in his right ]parietal lobe
The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus.
The parietal lobe integrates sensory informa ...
, has limited use of his left side,[ and uses either a wheelchair or leg braces to move around.]
As of October 2021, Arlene and her sons live in Scarsdale, New York
Scarsdale is a town and village in Westchester County, New York, United States. The Town of Scarsdale is coextensive with the Village of Scarsdale, but the community has opted to operate solely with a village government, one of several village ...
in a home that has been funded by a variety of charities, as Arlene has been unable to work on a medical visa.[
]
References
{{DEFAULTSORT:Aguirre, Carl and Clarence
2002 births
Living people
Conjoined twins
People from Silay
People from Scarsdale, New York
Filipino twins