The Incomplete Twin

Enrique Garcia, 35, a farm laborer in Reynosa, Mexico, had reason for anxiety when his wife Lorenza went into labor one blustery night nine months ago. The couple's first child had been stillborn, and both badly wanted a baby. But Garcia's nervousness turned to horror when he saw the boy that was to bear his name. Attached to the lower abdomen of the otherwise healthy, pretty infant was a football-shaped protuberance that carried a partially developed extra pair of legs.

The deformity, which apparently occurred when the egg that had begun to split into twins failed to divide fully, sent a thrill of terror through the Garcias' neighborhood. Superstitious peasants, who believed the child was cursed, threw rocks at the small house. A traveling circus, seeking to capitalize on the family's obvious misery, offered to buy the deformed child for its freak show. Fearful that Enrique might be abducted and sold, the family took refuge in the nearby home of a doctor.

Unique Care. In May the Garcias took young Enrique across the border to a clinic in Brownsville, Texas. Though doctors there could do nothing themselves, they did call in Dr. Michael Donovan of the Shriners Hospital for Crippled Children, a Houston institution specializing in corrective surgery. Said Donovan: "I know of no other case like this, and, God knows, I never expect to see another." But he was willing to try an operation.

First Donovan and his six associates spent nearly three weeks X-raying Enrique and subjecting him to a battery of tissue and blood tests in order to determine the deformity's extent. X-ray examinations showed that the incomplete twin consisted of a second pelvis fused to the front of Enrique's own pelvis, plus a partial extra bladder. The pictures also disclosed that the growth was not connected to Enrique's spine or nervous system; indeed, Enrique had never been known to move or show feeling in the appendage, though it made up one-quarter of his weight. But doctors still had no way of knowing until the operation itself how much of Enrique's circulatory system was connected to his deformity.

Though the doctors realized that it was feasible to remove the extra pelvis and legs, they feared that the excision could imperil the child's urological functions or damage his circulation if major arteries were involved. They also worried that removal of so large a growth might leave insufficient skin flaps for suturing.

Silver Clips. Donovan's team cut around the appendage, taking out the arteries that supplied blood to the incomplete twin. After that, they found to their relief that the removal would not impair the patient's circulation. They next separated and took out the duplicate bladder. Then, after marking the limits of Enrique's own pelvis with silver clips, they cut away the extra pelvis and hip joints and removed the growth. The procedure left ample skin flaps for suturing.

Enrique, whose normal legs had been forced into a spread position by the deformity, must still spend several weeks in traction to correct this condition. But the doctors believe that further corrective surgery will be unnecessary. According to Donovan, Enrique's incomplete twin would have grown in proportion to the youngster's normal growth. Instead, he says, "We will send him home normal in every way, with only two scars to show for what might have been."

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