Twenty-three years ago, the world held its breath. It wasn’t for a moon landing or a sports final. People were glued to their TV screens, watching a hospital in Singapore where two sisters were trying to do something no one had ever done before. Honestly, it’s one of those stories that stays with you. If you lived through the news cycle of 2003, you remember the Bijani twins.
Ladan and Laleh Bijani weren’t just "conjoined twins." They were two fiercely independent women who happened to share a skull. They were 29 years old. Most people didn't think they’d even make it that far. Born in Iran in 1974, their lives were a series of bizarre hurdles. They were even "lost" for a few years during the Iranian Revolution because the doctors caring for them had to flee to the U.S. and their parents couldn't find them in the chaos. Eventually, they were found and raised by an adoptive father, Alireza Safaian.
The Impossible Choice
Imagine having a law degree but never being able to work a case alone. Ladan wanted to be a lawyer in her hometown of Shiraz. Laleh wanted to be a journalist in Tehran. Because they were joined at the head, every single second was a compromise. If one wanted to sleep, the other had to lie down too. If one wanted to read, the other had to be there.
They hated it.
They weren't "one person." They were two people trapped in a biological cage. Ladan was talkative; Laleh was the quiet one who loved video games and animals. By 1996, they were desperate. They went to Germany, but the doctors there said, "No way." The risk of death was basically 100% because they shared a massive vein—the superior sagittal sinus—that drained blood from both their brains.
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But then came 2001. A team in Singapore successfully separated Nepalese infants Ganga and Jamuna. This gave the sisters hope. They contacted Dr. Keith Goh. They were told the odds were 50/50.
Most of us wouldn't take a 50/50 chance on a surgery that could end it all. But for Ladan and Laleh Bijani, 50% hope was better than 100% of the life they were living. Ladan famously said that if God wanted them to live as individuals, they would.
52 Hours at Raffles Hospital
The surgery started on July 6, 2003. It was a massive operation. We're talking 28 specialists and 100 medical assistants. The team included Dr. Ben Carson, who was already a legend in neurosurgery at the time.
The plan was complex:
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- Open the skull (which turned out to be much thicker and denser than scans showed).
- Create a bypass for that shared vein using a graft from Ladan’s thigh.
- Pry the brains apart millimeter by millimeter.
- Reconstruct the tissue.
It went south almost immediately. The bone was like rock. It took hours longer than expected just to get through the skull. Then, the doctors realized the brains weren't just touching—they were fused. They had been pressed against each other for three decades.
By the second day, the surgeons were exhausted. They found a "forest" of tiny, undetected blood vessels that weren't on any of the pre-op scans. Dr. Carson later admitted he wanted to stop the surgery when things got messy, but the team felt they had to push through.
The Tragic Final 90 Minutes
On July 8, the news broke that they were finally separated. People were cheering in the hospital lobby. But the joy lasted about an hour.
Ladan died first. Her circulation just collapsed. Her heart couldn't handle the new plumbing. Ninety minutes later, Laleh followed. They had lost too much blood. The surgery that was supposed to give them freedom ended up taking everything.
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People were devastated. In Iran, the grief was national. Thousands of people lined the streets for their funeral in Lohrasb. They were buried in separate coffins, side-by-side.
Why Ladan and Laleh Bijani Still Matter
Looking back, the medical community learned a lot from this "failure," though that feels like a cold word for it. It proved that adult brain plasticity is nothing like an infant's. You can't just reroute 30 years of blood flow and expect the body to say, "Okay, cool."
But more than the science, it was about autonomy. There’s a lot of debate even now: should the doctors have said no? Ethicists like Arthur Caplan have pointed out that since they were competent adults, they had the right to choose. They weren't suicidal; they were desperate for a specific kind of life.
Moving Forward: Lessons from the Bijani Case
If you’re interested in the history of medical ethics or neurosurgery, the Bijani story is the "Patient Zero" for adult craniopagus separation. Here’s what we actually know now:
- Imaging Limitations: Even the best MRI and CT scans in 2003 couldn't see the tiny vessel networks that ultimately caused the fatal hemorrhaging. Modern 3D modeling and VR simulations used in surgeries today were birthed from these kinds of tragedies.
- Psychological Weight: The sisters underwent months of psychiatric evaluation. They knew they might die. Their choice was a conscious rejection of their condition, not a misunderstanding of the risk.
- Legal Impact: The coroner’s verdict was "misadventure." It cleared the medical team of wrongdoing, but it set a very high bar for when doctors should agree to "quality of life" surgeries with such high mortality rates.
If you want to understand the full weight of their legacy, look into the documentary Ladan and Laleh: The Sisters Who Fought for a Dream. It shows the human side of the headlines—two women who just wanted to look at each other's faces without a mirror.
To really honor their story, it's worth reading up on the World Craniofacial Foundation. They do the work of helping families who face these impossible anatomical challenges every day. Understanding the difference between infant and adult separation surgery is key to seeing why this case was so unique and why it likely won't be attempted in the same way again.