but all the doctors know that if they re going to perform surgery it will most likely be soon. but dr. salyer knows that to accomplish this he needs to reach out and find an elite group of pediatric neurosurgeons. he does find them. but the question is can they help? initially it was quite daunting. it was very difficult to figure out the exact anatomy. dr. dale swift is one of the team that would attempt to come up with a surgical plan for ahmed and mohamed. swift and his colleagues conduct ct scans, mris, arteriograms, and using the data they commission replica models of the twins heads. here in life size is the exact configuration not just of the boys heads but of the increasingly complex web of blood vessels inside. it will show us the arteries or the veins or the scalp or the bone or the dura. you actually took them home?
in may 2006 the twins have a very special visit. how s your english? good. is your english good? yes. dr. salyer s visit to cairo is twofold. he ll tour the facility run by dr. nasser and, of course, check up on mohamed and ahmed. it s been a long time. okay. okay. you went over to egypt to see these boys. right. what was that like? it was a wonderful moment. we had an opportunity to see these boys, and they were happy. it s still soft right here. i mean, it still hasn t filled in like i wanted it to. this is you. that s you. look. see this place right here? it s still a little soft. it has to grow some more. yeah. it was a wonderful reunion and an opportunity to examine their skulls and see that they re healing. next page. i know, next. okay, next. okay, next.
oh, yeah. every night. sat up, looked at them? yeah. till i till i fell asleep. even on vacation he spends hours puzzling over the apparently impossible tangle. but he s conflicted. the boys are healthy, happy, and winning hearts among the medical staff. already the nurses see progress, the boys learning to stand up, take baby steps, and some of their own crafty moves. here we go. they have a life. they seem to be enjoying it. salyer sends the boys to florida for some special therapy, after which there s a trip to disney world, all of which only sharpens swift s worries that such a drastic operation could end all of this, that it risks permanent brain damage and paralysis, even death. this is where the ethical issues become so complex that two ethics committees worked on this. what s best for the boys for their whole life?
and that really makes it very difficult for me. at the same time i have this inner drive and this inner faith of the right thing to do for these kids is separation. does any one of these other people who disagree with you ever look you in the eye and say don t be a hot dog, back off on the ego? it really isn t an ego thing, believe it or not. i don t need to separate a child to satisfy my ego. i m there with a talent that i feel i m supposed to use to help those kids. the specialist surgeons on salyer s team varied wildly in their opinions of how to help the kids, and what the outcome of the surgery might be. and then there s the ethical question of whether to risk
but time and tests revealed an outlook which was even more complicated than anybody had imagined. this is an orchestration of the most complex surgical procedure that occurs on this earth. there s no question about that in my mind. these are the images that confront dr. salyer. a tangled confusion of blood vessels he s never seen before. major veins that originate in one twin, snaking their way deep into the other twin s head. mohamed and ahmed are not only stuck firmly together, they depend on each other for their lives. mohamed, the smaller but more outgoing twin, has more delicate, narrower veins in his head than his brother, and salyer is forced to concede he is the more vulnerable in surgery. surgery they re not even sure is possible. as we ve moved through it,