Jewish World Review Dec. 19, 2003 /24 Kislev, 5764

Drs. Michael A. Glueck & Robert J. Cihak

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Consumer Reports

Crossing Fruit Street: Some Movies Like "Stuck on You" Cross the Medical Line | One of the great, slow progresses of our civilization is learning to treat people with disabilities as human beings, not objects of ridicule. Often, Hollywood has been in the forefront. Movies like "A Beautiful Mind," "Scent of a Woman," "Children of a Lesser G-d," "Rain Man" and "Forrest Gump" have enriched our understanding of those with mental illness, visual and hearing impairments, autism and retardation.

We should expect no less in the presentation and personification of those who are born conjoined as Siamese twins. But now Tinseltown is doing something both tasteless and unconscionable. Here I am talking about how Hollywood and Madison Avenue, in their lust for laughs, lucre and larceny, offend our medical senses with movies like "Stuck on You."

This movie is filled with sight gags and one-liners as male twins joined at the waist go about their daily extreme routine. Yes, it is difficult for a guy to have sex with his girlfriend while his brother is standing outside the curtain! One venerable paper desribes the movie as "hilarious." Other reviewers give it "two thumbs up x 2." What are they thinking?

My disappoinment with the movie is that unlike the other movies mentioned above it portrays only the bright side of the diagnostic shadows. The twins are endowed with only the most minimal form of the abnormality easily separable in this day.

They are able to cook on short order; bar hop; chase beautiful women; play baseball, football, ice hockey, golf and tennis; and one becomes a Hollywood actor. Wow! In fairness, there are moments of humor and endearment. But the price of tradeoff is too high!

Notes Lynn Bloomberg, veteran registered nurse and school counselor, from Orange County, Calif.: "This is just not funny stuff. Now when I watch movies, Saturday Night Live or Leno there is rarely anything that is "fall-over-laughing" funny. The jokes are cruel. This generation laughs at things their parents would never consider funny."

Has Hollywood considered that this movie might be offensive to the 48 million Americans who are disabled?

Let's look at the other side of the shadows.

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Siamese twinning is not a humorous issue. Conjoined twins have intrigued society for centuries and are among the rarest of human beings, treated as both gods and monsters over history's timeline. According to a BBC Web site, only a few hundred pairs of conjoined twins are born in the whole world each year they appear once in approximately every 100,000 births but more than half of them are stillborn and one-third live for only a few days. There are few adult pairs living in the world today.

Of those who survive, a very small number will be medically eligible for separation surgery. But as there are few countries that have the hospitals, physicians, nurses and technicians with the skills and experience to perform this delicate surgery, separation is a very unusual event.

Before surgery, endless diagnostic and imaging procedures must be performed. Dozens of specialists and subspecialists are consulted and intricate plans drawn for surgery. There are dress rehearsals, lasting hours, with scores of personnel involved. The cost of separation surgery is in the hundreds of thousands of dollars or more, even though most physicians donate their time.

The agonizing decisions that surgeons and other specialists have to make when faced with Siamese twins have been highlighted by recent cases. Separating these twins is not only technically challenging, it also usually involves life-and-death decisions about whether one twin should be sacrificed in the hope of saving the other. In one recent headlined case the twins shared the same complex venous drainage from separate brains.

The misfortune for conjoined twins who live together is that they ultimately die together, too. When one twin dies, the heart of the other twin keeps pumping until he or she is void of blood.

The venerable Massachusetts General Hospital, a Harvard teaching hospital, the largest hospital in New England and the nation's third oldest, is located on 55 Fruit Street in Boston. The residents work hard and long and the competition is fierce. There are humorous moments in all this seriousness, but when I was there in the '60s and '70s no one thought of crossing the line. You didn't make fun of disabilities any more than you would of cancer!

Have we become so insensitive and anesthetized and lost our sense and sensibilities that we can no longer differentiate between crass humor and compassionate portrayals of the disabled and congenitally deformed?

Others may ridicule for fun and profit, but I hope you do not. As for this writer on this issue I choose not to cross the medical line or push the dignity of Fruit Street and the halls of Harvard and The Massachusetts General Hospital.

The socially redeeming values of this movie could be better met by donating the $20.00 to an organization for the disabled!

And perhaps in sum, conjoined twins are nature's special way (and challenge) of teaching us how to get along and make the most of what we have. For those who are conjoined, and remain so, must always think of the needs of the other person.

Editor's Note: Michael Arnold Glueck wrote this week's column.

Michael Arnold Glueck, M.D., is a multiple award winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute Senior Fellow and a past president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists. Comment by clicking here.


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