Storm Prey Read Free Page B

vein was a vein shared by the twins. They'd tie it off on Ellen's side, and attempt to splice it into the five vein on Sara's, the better to move blood out of Sara's brain. The vein numbers simply came from imaging charts prepared by the radiologists.
    "So what are you suggesting?" Maret asked. He glanced at Weather: "You are gorgeous this morning."
    "I know," she said, to make him laugh. As did the other women around him, she liked to make him laugh.
    Dansk scowled at them and said, "I'm suggesting that we slice a few wedges out of the base of the mold, so that we can use them as shims if we have to brace one of the kids."
    "Why not have a nurse hold her?" Maret asked.
    "Because we might be talking a couple hours, if worse comes to worse."
    "You know how much that mold cost?" Maret asked.
    "About one nine-thousandth of your annual salary," Dansk said.
    Maret shrugged. "So, we cut a few wedges. Why not? If we need them, we have them, and if we don't, it won't matter."
    "Should have thought of this before now," said Rick Hanson, an orthopedic surgeon who would make the bone cuts through the kids' shared skull. He seemed shaky; he'd invented a half-dozen little saws for this operation and would be the focus of a lot of attention. Because of the way the children's skulls intersected, they formed a complex three-dimensional jigsaw puzzle--basically, an oval ring of bone--of which he'd be removing only a few pieces at a time. Normally the cutting would have been done by the neurosurgeon, with drills and flexible wire saws. Hanson, from Washington University in St. Louis, had developed his own set of electric saws matched to jigs--cutting templates--for complicated bone cuts. Maret had decided that Hanson's technique would be ideal, and would make it possible to prepare perfectly fitted composite plates to cover the holes in the babies' skulls.
    "We're just nervous," Maret said now. "That's normal." Maret was the team leader, the one with all the experience. He'd done two other craniopagus separations, one in France, one in Miami. Of the four children involved, two had survived--one from each operation. When he talked about the work, he talked mostly about the children who'd died.

    ANOTHER DOC PUSHED into the room, followed by a second one. They had all kinds--anesthesiologists, radiologists, neurosurgeons, cardiologists, plastic and orthopedic surgeons, and a medical professor who specialized in anatomical structures of the skull, as it pertained to craniofacial reconstruction. They had twenty nurses and surgical assistants.
    Weather said to Dansk, the neurosurgeon, "If you want to cut those wedges, you better get it done: they've got to start cleaning the place up."
    Dansk said, "I'm on it," and, "I need a scalpel or something. Anybody got an X-Acto knife?"

    ABOVE THE TABLE, in an observation room behind a canted glass wall, people were beginning to filter into the stadium seating.
    A nurse came into the OR--one of the sterile nurses--and said, "I wanted to see if we could make the move one more time."
    She wanted to practice breaking the tables apart, so that when the final cut was made, and the twins were separated, they could be moved to separate operating areas for the fitting of the new composite skull shells.
    "Why don't we visually check the linkage ..." Maret began.
    It was starting; Weather didn't think it, but she felt it, felt the excitement and the tension starting to build. She worked almost every day, cutting, sewing, cauterizing, diagnosing. This was different.
    She thought, Remember to pee.

    THE RAYNES TWINS were a rare and complicated medical phenomenon. Craniopagus twins comprise only about one percent of conjoined twins. Because of the rarity of the condition, experience with separation surgery was limited. One of the twins, Sara, suffered from defects in the septum of the heart--the wall that divides the right side of the heart from the left side--and the defects were already causing congestion in the