In his decades as a surgeon, this was something Dr. Allan Goldstein had never done before. He was about to separate two sisters, conjoined twins, in a Boston operating room. The family had travelled from overseas for the surgery. The girls were joined together just below the ribs. They were 22 months old. In most surgeries, doctors go into an operating room expecting that if all goes well the patient will emerge in better shape than when they have entered. But things were different this time. Dr. Goldstein knew that even if all went well, there was a high probability that one of those girls was going to die. It was an ethical conundrum the likes of which he had never experienced, and it was an enormously complex surgical challenge as well.

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