Town's hopes follow twins to Baltimore

Operation: The people of Lemgo, Germany, will closely follow the procedure starting today to separate conjoined girls at Hopkins.

September 11, 2004|By Todd Richissin | Todd Richissin,SUN FOREIGN STAFF

LEMGO, Germany - The note from the parents, writing from Baltimore to friends and family and members of their faith in this small town in the northwest of Germany, sounded like words from a couple prepared for whatever might come.

"Now there are two days to go and then we must give the children to the doctors," wrote the parents, Peter and Nelly Block, on Wednesday. "The Lord's will shall happen."

The children are Lea and Tabea Block, 13-month-old girls who are joined at the top of their skulls. Doctors at Johns Hopkins Hospital will try to separate the girls beginning today in an operation that could last 24 to 48 hours.

It could begin and then be stopped, maybe for a week, maybe longer, should the health of the girls warrant it. While such operations have been successful, they have also failed. There are many unknowns.

Last year a team of Johns Hopkins doctors operated on 29-year-old Iranian twins joined at the head. But the operation ran into unexpected complications, and the twins died from massive bleeding.

In this picturesque town of triangular houses, of wedding-cake building fronts and sidewalk cafes, there is at least one certainty involving the girls: Nearly everyone here will be watching television, listening to the radio, reading newspapers to see what will become of these babies, who have been shown on TV and in the papers discovering their toes, laughing at their parents, drifting off to sleep.

"I'm sad because I have to work and will not be able to watch television, but I will not be listening to that," said Inga Reineking, 25, referring to the Cyndi Lauper song playing on the radio in her hair salon. Instead, she said, the radio will be tuned to "a news station."

Lemgo is a town of 40,000, but it would be difficult to find a place with so many people that seems so small. There appear to be as many bicycles as cars, more walkways than roads, more trees than houses. And it is nearly impossible to find anybody here who has not heard of the girls, of their parents, anybody who has not contributed pocket change or more to help with the costs of the operation.

"Everybody is interested, and everybody is hoping so much for good things," said Thomas Hoffarth, 44, who sells clothing at the outdoor public market that dominates the center of town. "People care because this is so unusual to have twins like this, but I think that really people care because, after all, these are babies."

The technical term for the conjoined heads is craniopagus, which occurs in about one of every 2 million births. So far as doctors can tell, the girls' brains are separate, but there is a substantial risk in separating them, not least because they share a blood vessel between the brains.

The medical team of about 50 members will be led by Dr. Benjamin Carson, director of pediatric neurosurgery at the Johns Hopkins Children's Center. Carson will be attempting his fifth such operation. Two of them have been successful.

"Operations of this kind are not only very rare but always highly complicated as well," Carson told Stern, a German magazine to which the girls' parents have granted rights to their story. In exchange, the magazine has helped with fund raising.

Before June, Lea and Tabea looked almost like two normal babies placed head to head, in a straight line. Pictures in Stern show them smiling.

Their appearance changed drastically in June, though, when they underwent an operation to stretch the skin of their skulls, to create enough to use once they are separated.

"They have been on our televisions and in our newspapers for many months, and I think people have bonded with them in their way," said Regina Pramann, 50, who was on a pedestrian walkway with her daughter Paula, 7. "This is a small town, and people really know each other and tend to care. And then it's such a thing to have twins like this in a town so small."

The family's community, in some ways, is even smaller.

The Blocks are Mennonites, their ancestors among those driven from Russia and among those who have become part of communities of "true believers," whose doctrine is similar to that of the Amish, including a reluctance to assimilate themselves into more general society.

Peter Block works for his father's heating company. Nelly Block teaches students from first to fourth grades.

The letter they wrote to their friends and members of their faith came in an e-mail to their pastor, Nikolai Reimer, who has been updating the congregation by reading notes from the Blocks at least once a week.

The notes are filled with technical information about the operation - each girl will have three tubes inserted into her, for blood, medicine and to replace fluids, they wrote - but mostly the notes are about prayer.

"Thank you that there are so many people who prayed with us and thank the Lord for hearing us," the parents wrote. "We need God's power and assistance and the children need the Lord's blessing."

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