It’s rare. Like, one in 2.5 million births rare. When we talk about craniopagus twins, or twins conjoined at the head, most people immediately think of a medical "anomaly" or a tragic headline. But if you spend any time looking at the actual lives of people like Tatiana and Krista Hogan or the late Lori and George Schappell, you realize the medical side is actually the least interesting part of the story.
The brain is the most complex thing in the known universe. Now imagine two of them, fused.
Most of these twins—about 40 percent—are stillborn. Another third die within twenty-four hours. So when you meet twins who have reached adulthood, you aren't just looking at a medical rarity; you're looking at a biological miracle that defies almost everything we think we know about individual consciousness.
The Reality of Sharing a Brain
Let's get into the weeds of how this actually works. It isn't just skin and bone holding them together. In many cases of craniopagus twins, there is a "thalamic bridge."
The thalamus is basically the brain’s switchboard. It handles sensory input. In the case of the Hogan twins from Canada, their thalami are linked. This means one twin can feel what the other is feeling. If you put a pacifier in Krista's mouth, Tatiana feels the sensation. They’ve even described being able to see through each other's eyes. It’s wild to think about. We usually view the "self" as a closed loop, but for these sisters, the loop is open.
They’re two distinct people. They have different personalities, different favorite foods, and they definitely argue. But they share a sensory experience that no other human being on Earth can truly understand.
Why Separation Isn't Always the Goal
Whenever a new case of twins conjoined at the head makes the news, the first question everyone asks is: "When are they getting the surgery?"
Honestly, it’s a complicated question.
For many, separation is the only way to have a "normal" life, but the risks are staggering. We're talking about shared venous sinuses—the big "drains" for blood in the brain. If you have two brains but only one main drainage system, you can’t just cut it down the middle. One twin usually ends up with the plumbing, and the other... well, the other often doesn't survive or ends up with massive neurological damage.
Take the case of Ladan and Laleh Bijani. They were Iranian twins, both law graduates, who chose to undergo separation surgery in 2003 at the age of 29. They knew the risks. They were tired of seeing each other only in a mirror. Tragically, both died on the operating table due to massive blood loss. It was a wake-up call for the medical community about the limits of neurosurgery.
Then you have the success stories.
Dr. James Goodrich, who passed away in 2020, was the gold standard for this. He pioneered a "staged" approach. Instead of one 50-hour marathon surgery, he’d do several smaller ones over months. This gave the brains time to re-route their own blood vessels. He famously separated Jadon and Anias McDonald in 2016. It worked. But even with "success," the recovery is years of intense physical therapy. It's never a "quick fix."
The Incredible Longevity of Lori and George Schappell
You might have heard that Lori and George Schappell passed away recently, in April 2024. They were 62. At the time, they were the oldest living twins conjoined at the head.
They were fascinating. George (who originally went by Dori) came out as a transgender man in 2007. They lived in a two-bedroom apartment in Pennsylvania. They rotated who got to "pick" what they did each day. They even had different hobbies; George was a country singer who traveled to perform, and Lori worked in a hospital laundry.
They were adamantly against separation.
"Why would you want to fix what isn't broken?" George famously said in a documentary. They viewed their condition as a physical challenge, sure, but not a disability that defined their worth. They proved that you could live a long, fulfilling, and mostly private life while being physically joined to another human being.
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Modern Tech: VR and 3D Printing
Surgery in 2026 isn't what it was twenty years ago. We are now seeing surgeons use Virtual Reality (VR) to practice the separation months before the first incision.
In 2022, a pair of Brazilian twins, Bernardo and Arthur Lima, were separated with the help of Gemini-level technology. Doctors in London and Rio de Janeiro wore VR headsets and worked in the same "virtual surgery room" together. They used 3D-printed models of the boys' fused brains to find paths through the blood vessels that were previously invisible on standard MRIs.
It’s basically "measure ten thousand times, cut once."
- Mapping: Using 4D flow MRI to see exactly how blood moves.
- Simulation: Running "what if" scenarios on digital twins.
- Precision: Using robotic arms to handle microscopic vessel suturing.
The Ethics of the "Normal"
We have to talk about the "social" side of this. There is a lot of pressure on parents to "fix" conjoined twins.
Bioethicists like Alice Dreger have argued for years that we are too obsessed with making people "individual" at any cost. Sometimes, the surgery is life-saving—if one twin’s heart is failing the other, you have to act. But if they are healthy? The decision becomes a massive ethical weight.
Some twins who grow up conjoined describe a level of intimacy that "singletons" (that's us) can't comprehend. They are never lonely. They have a constant partner. To them, the idea of being "cut apart" can be as terrifying as the idea of being "stuck together" is to us.
Living with the Public Eye
The hardest part for these families isn't usually the medical appointments. It’s the grocery store.
People stare. People take photos without asking. Families of craniopagus twins often have to become experts in "boundary setting." The Hogan family in British Columbia has been very open about their lives, but they’ve also had to shield the girls from the darker side of internet fame.
It’s a balancing act: educating the world so the girls are treated with respect, while also trying to let them just be kids who like Powerpuff Girls and iPad games.
What You Should Actually Know
If you’re researching this because you’re interested in neurology, or maybe you’re just curious about the human condition, here are the real takeaways.
First, "conjoined" does not mean "the same." These are separate souls with separate minds. Second, the medical field is moving away from the "heroic" one-off surgery toward a more cautious, tech-heavy approach that prioritizes quality of life over just "separating them for the sake of it."
What most people get wrong is the pity. When you see twins conjoined at the head, don't lead with "how sad." Lead with "how incredible." Their brains have adapted in ways that science is still trying to map. They are a testament to the sheer plasticity and resilience of the human neurological system.
Actionable Insights for the Curious
- Support the right organizations: If you want to help families dealing with rare congenital conditions, look into the National Organization for Rare Disorders (NORD). They provide actual resources for the massive costs of specialized care.
- Watch the right documentaries: "Inseparable" (the story of the Hogans) is a great look at the reality of their lives without the "freak show" vibe of older media.
- Check your language: Avoid terms like "freaks" or even "tragedy." Use person-first language. They are people first, twins second, and conjoined third.
- Stay updated on Neuro-Mapping: Follow the work of pediatric neurosurgeons like those at Great Ormond Street Hospital. They are the ones currently pushing the boundaries of what is possible with 3D brain modeling.
Life is messy and rarely fits into the neat boxes we want it to. Craniopagus twins are a living reminder that the human experience is way broader than we usually admit. Whether they are separated or stay together, their lives are defined by a connection that is, quite literally, deeper than anything most of us will ever know.