MANDAN, N.D. — When Jesse Carlsen asked his 11-year-old daughters to pose for a picture at the local humane society, where they had just donated toys for the cats and dogs, Abbigail and Isabelle knelt — an arm’s length apart — and posed with goofy faces.
“Abby, move closer,” the father instructed, “pretend like you like her a bit.”
The moment was a playful reminder of just how far the Carlsen girls have come since they were born on Nov. 29, 2005, as close as close can be — conjoined at the chest and abdomen, with a shared liver and small intestine, and two hearts intertwined.
A decade ago, they were the miracle babies who gained national attention when doctors at the Mayo Clinic in Rochester, Minn., attempted a daring surgery to separate them. Today, they are healthy, bubbly fifth-graders in Mandan who love gymnastics and cats and sleepovers and woke up Christmas morning to find new TV’s under the tree.
It’s a success story that has astonished their family and doctors, even now, and inspired medical advances.
“My heart leaps every time I hear about the Carlsen girls or see a picture of them doing so well,” said Dr. Christopher Moir, who led a team of 17 surgeons to separate the girls on May 12, 2006, “because I know they beat the odds.”
Conjoined twins occur in one of every 200,000 births, but more than 45 percent are stillborn when delivered, and another 35 percent survive only the first day, according to the University of Maryland Medical Center. At the time of the Carlsen separation, 60 percent of all such procedures ended in fatalities.
The girls’ parents, Jesse and Amy Carlsen, alternate between wonder and worry over their family, which moved from Fargo after the girls’ birth to the windswept prairie above Mandan.
The wonder comes from the spunk of two girls born attached and facing each other. They’re alike enough in appearance that they attempted a mom-sanctioned April Fools’ joke last spring, when they switched clothes and went to school as each other. But even as conjoined infants, they were different. Abby was the sensitive snuggler and Belle was the hyper talker — and in some ways, those differences have held up.
The worry comes from what they endured. The surgery left gaps in their chest walls, and both girls needed Gore-Tex implants to cover the openings; Belle in particular needed extra protection for her heart and lungs.
So naturally, any stomachache or tumble causes nervousness in the Carlsen household. When the girls went sledding after a recent snowfall, Jesse winced when Abby crash-landed and clutched her chest.
“Little things scare me,” said Amy, a registered nurse at Sanford Health in Bismarck, “because you just don’t know.”
Time hasn’t eroded the memory of the Carlsens’ first ultrasound in 2005; Amy remembers the technician’s face as she tried to understand the image on the screen. “I just knew something was wrong,” she said.
Separation surgery was possible because the girls had their own hearts and lungs, but the fusion of their liver and intestine made it unlike two prior separations at Mayo.
“You had to create two out of one,” Moir said. “We were getting right down to the limits of what each girl had left for reconstruction.”