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Conjoined twins with fused brains separated; surgeons practiced for months in virtual reality

Arthur and Bernardo finally get to see each other face to face.

Image by sasint/Canva

Surgeons prepared to separate 3-year-old conjoined twins in Brazil using virtual reality.

The things human beings have figured out how to do boggles the mind sometimes, especially in the realm of medicine.

It wasn't terribly long ago that people with a severe injury had to liquor up, bite a stick, have a body part sewn up or sawed off and hope for the best. (Sorry for the visual, but it's true.) The discoveries of antibiotics and anesthesia alone have completely revolutionized human existence, but we've gone well beyond that with what our best surgeons can accomplish.

Surgeries can range from fairly simple to incredibly complex, but few surgeries are more complicated than separating conjoined twins with combined major organs. That's why the recent surgical separation of conjoined twin boys with fused brains in Brazil is so incredible.


The twins, Bernardo and Arthur Lima, are almost 4 years old and have never seen one another's face. They've spent their lives conjoined at the top of their heads, facing opposite directions. Born as craniopagus twins (joined at the cranium), their brains were also fused together, making their separation extremely complex. According to the BBC, they've been cared for at the Instituto Estadual do Cérebro Paulo Niemeyer (Paulo Niemeyer State Brain Institute) in Rio de Janeiro for the past two and a half years.

Surgeon Noor ul Owase Jeelani is the founder of medical charity Gemini Untwined, which funded the surgery. He helped lead the team of nearly 100 medical workers who worked for months to prepare for the boys' separation, which was one of the most complicated of its kind.

Jeelani told the BBC that it was the first time surgeons in separate countries practiced by operating in the same "virtual reality room" together, wearing VR headsets.

"It's just wonderful," he said. "It's really great to see the anatomy and do the surgery before you actually put the children at any risk. You can’t imagine how reassuring this is for the surgeons. To do it in virtual reality was just really man-on-Mars stuff."

Watch Jeelani explain how they prepared for the procedure:

Prior attempts to separate the twins had been unsuccessful, making the surgery even more challenging due to scar tissue. However, after multiple surgeries that took more than 33 hours collectively, the boys were successfully separated in June.

“It was without a doubt the most complex surgery of my career,” said neurosurgeon Gabriel Mufarrej of the Paulo Niemeyer State Brain Institute, according to EuroNews. “At the beginning, nobody thought they would survive. It is already historic that both of them could be saved."

Jeelani told the BBC that the boys' heart rates and blood pressure were "through the roof" for four days after the surgery—until they were reunited and touched hands.

According to Reuters, Bernardo and Arthur are the oldest twins with fused brains to be successfully separated. They will spend the next six months in rehabilitation.

Congratulations to the Lima family and to the global team that combined dedication, perseverance and the miracle of modern technology to create a brighter future for these young boys.


This article originally appeared on 08.04.22

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There's a cool new way to help kids with cancer keep calm during treatment.

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Northwestern Mutual

Pretty much nobody likes getting their blood drawn.

Some of us are better about it than others, but when it comes to needles, it's safe to say very few people jump at the opportunity to get stuck with one — aside from the good-hearted folks who donate.

Unfortunately, part of what cancer patients have to go through for treatment includes tons of needle-y, pokey, proddy procedures that can give even the most stoic patients pain and anxiety. And for pediatric cancer patients, it's even worse.

Image via iStock.

Jenny Hoag, a pediatric psychologist at the Children’s Hospital of Wisconsin, tells the story of one patient, Jamie*, whose experience demonstrates just how distressing regular procedures can be for kids with cancer and other chronic diseases:

"I had worked with him since the beginning of his treatment, and he really, really struggled," she says. "He would get here and immediately feel nauseous and anxious and would almost always vomit, sometimes more than once, before we even did anything."

Hoag's job is to come up with ways to help kids conquer that discomfort and anxiety. But in Jamie's case, he wasn't interested.

Jamie rejected Hoag’s coping mechanisms, but once she suggested virtual reality, his curiosity won out.

Hoag brought in a virtual reality program that makes the wearer feel as though they're underwater, being pushed along calmly while viewing colorful fish, ships, and other distracting scenes.

"Once the headset was on, he was already smiling, which I almost never saw," Hoag says. Jamie sat through the whole 20-minute program, enjoying every moment. "He took it off and said, 'I really want to do that again.'"

Image via Northwestern Mutual.

Using the immersive program, Hoag was able to help Jamie endure his procedures with a lot less stress, anxiety, and pain. But it didn’t stop there. Once Jamie saw that Hoag was right about the benefits of VR, he was suddenly much more willing to try her other coping suggestions.

While once he had been anxious and withdrawn, now his virtual reality experience was encouraging Jamie to branch out into actual reality too.

Now, Hoag is working with Northwestern Mutual and KindVR to study just how much virtual reality could benefit kids at Children’s Hospital of Wisconsin and beyond.

In her work thus far, Hoag has mainly looked to solve individual cases of anxiety instead of searching for options that could be applied to help kids all over the country. "But obviously," she says, "having an empirically supported treatment is the best way to treat kids."

Dr. Hoag has been letting her patients try VR informally, and is getting ready to conduct a clinical study on its benefits. Image via Northwestern Mutual.

That’s why she’s preparing to apply the solution she saw work so well with Jamie to a clinical study that could result in VR programs being implemented in children’s hospitals nationwide.

Not only could VR provide a more effective way to treat patient discomfort, it could also increase the number of children that could benefit from the hospital's psychological intervention program. With VR, many hospital staff — not just psychologists — can help patients use the equipment.

Right now, only cases that are extreme enough merit a visit from a psychologist. But if Hoag’s research proves that VR treatment is effective, hospitals could drastically increase the amount of kids receiving anxiety treatment without having to hire more staff.

Image via iStock.

For kids enduring a chronic illness, the calming effects of VR could be life-changing.

Drawing blood might not seem traumatic, but after months of frequent treatments, it can be.

"The average adolescent is having an IV maybe never, or if anything, maybe once or twice through the course of their childhood," Hoag says. "These patients are coming in sometimes multiple times a week and having this done. So the anticipation of knowing you have to have a needle is really stressful for kids, and by the time they even get to the hospital, they're pretty worked up about it."

Image via iStock.

For many, the excitement of getting to use a piece of virtual reality software can help temper those feelings of nervousness or nausea, which can improve a child's life overall by a lot.

In the end, that's what Hoag is hoping to do: make the lives of kids with cancer just a little bit easier.

Image via iStock.

"Going through cancer treatment is probably the hardest thing that these kids will ever do — not just as children, in adolescence, but in their entire lives," Hoag says. That's the motivation behind her research and the efforts that Northwestern Mutual has made to sponsor similar quality of life projects to help kids with cancer.

"If there are things that we can offer that improve their quality of life or improve their experience while undergoing cancer treatment, that's absolutely something that we want to do."

Image to via Northwestern Mutual.

Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company, Milwaukee, Wisconsin, and its subsidiaries. Learn more at northwesternmutual.com.

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This virtual woman is very sick. Talking to her could make doctors more empathetic.

Giving a patient bad news can be uncomfortable, but med student Katie Goldrath had no choice.

Nobody likes to deliver bad news, but this was important. The patient, a young woman named Robin, had come in because she kept getting nosebleeds — and Goldrath had just learned the reason behind it was leukemia.

Goldrath knew Robin needed to get into treatment as soon as possible. She also knew if their conversation went poorly, Robin might get angry or even storm out, delaying her treatment ... and possibly endangering her life.

Luckily, if things spiraled out of control, Goldrath could always hit the redo button. That's because Robin wasn't a real person. Robin was part of a computer program called MPathic-VR, designed to help young doctors learn to communicate with their patients.

Robin. Image courtesy of Dr. Fred Kron/Medical Cyberworlds, Inc.

Goldrath's experience talking to Robin was part of a study to test out the program's potential.

A doctor’s words can change a person's life, but knowing what to say, and how to say it, isn't easy. It's a serious skill that has to be learned and mastered. Better communication can make patients feel better, both emotionally and physically. Poor communication, on the other hand, can lead to malpractice suits, patients not listening to their doctors, and sicker people.

Medical students like Goldrath usually go through special training to learn these skills. Common methods include multimedia trainings or holding mock conversations with students or actors standing in for the patient. But these can have downsides. The mock conversations can be expensive and hit or miss depending on how good the "patient’s" acting skills are. The "patient" might also not be able to give very detailed feedback.

A program like Robin's simulation might solve some of these common communication problems.

Motion capture was used to help produce Robin's range of facial expressions. Image courtesy of Dr. Fred Kron/Medical Cyberworlds, Inc.

Though talking to a computer might seem weird at first, Robin is designed to react as much like a real human as possible. She has her own expressions, mannerisms, and emotions. The software can also recognize what the student is saying and use a camera to track the student's body language. Even small eye movements don't go unnoticed.

"It was actually pretty incredible to see what it could pick up on," Goldrath said of her conversations with Robin. Did Goldrath lean in and look Robin in the eye, a welcoming, compassionate gesture, or did she act aloof and look away? The computer could record her body language and posture and provide feedback for the next time around.

The program also comes with two other scenarios for doctors to practice with: one that focuses on navigating family drama and another that involves talking one-on-one with a nurse who’s upset she’s been left out of previous conversations.

Doctors care about their patients. This tool can help them ensure their patients know that.

In the end, the study found that, compared to standard multimedia training, MPathic-VR students improved more and felt more positive about the experience. Their results were released in the April issue of Patient Education and Counseling.

While MPathic-VR isn't in any schools yet, Dr. Fred Kron, founder of the company who made the program, says they're starting to look at rolling out the software and want to continue Robin's story.

Everyone wants to be able to express empathy, but it can be hard, especially when delivering upsetting information in a high-stress and fast-paced environment. There's no perfect recipe for how to give bad news, but these kinds of tools might help people who find themselves doing so frequently to find their footing or even just hone that skill with compassion.

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Watch these 90-year-old globe-trotters travel the world through virtual reality.

In their 69 long years of marriage, Laura and Leo Cornfeld have traveled around the world collecting artifacts and memories.

Laura and Leo Cornfeld.

Their travels have brought them to the ruins of Athens, the bustling streets of Bangkok, Paris, Guam, China, Japan, and more. All the while they've accumulated treasured objects — a model boat, a drum filled with seeds, a geisha doll — that serve as reminders of the many adventures they've been on together.

"Travel has been a very sweet spot in our lives," explains Leo Cornfeld in a new video by Upworthy.

The Cornfelds are eager to see more of the world, but have come to terms with the fact that their traveling days are probably over.

"I'd love to go back to Japan," says Leo. "And I'd love to visit Guam again." Unfortunately, at 90 years old, Laura and Leo's mobility is limited. It can be difficult for them to just go to get groceries, let alone take a weeklong excursion to southeast Asia.

So the Cornfelds spend a lot of time in their home in Rye, New York, keeping each other company. Their artifacts and memories are all that's left of nearly 70 years of adventure.

Enter Nathan Windsor and a virtual reality headset.

Windsor has worked with seniors doing music therapy for the last 12 years. Recently, he's started incorporating virtual reality into his work.

He offered the Cornfelds a unique opportunity to see the world without ever leaving their house. Thanks to modern technology and a little bit of movie magic, Laura and Leo were able to travel together again — virtually.

With nothing but some VR goggles and headphones, Windsor set up an experience that transported the couple right back to some of their favorite spots in the world.

It was like they were really there, on the beaches of Guam...

Or gliding across the ocean in Havana...

Virtual reality is one-of-a-kind technology that has the power to truly transport people to places beyond their reach.

While it's currently being incorporated into video games and movies, many people are recognizing its potential to dig a little deeper than entertainment in order to have an effect on people's lives.

"You're getting to relive memory," Windsor explains in the video. "You're getting to relive a moment in time that you had in your life that you could no longer access because you can't get there physically."

People in the medical community are already looking for ways to use VR's unique capabilities to address mental health. "My mission is to drag psychology kicking and screaming into the 21st century," Skip Rizzo, a psychologist who experiments with virtual reality to treat PTSD in combat veterans, told ABC news.

For the Cornfelds, the VR vacation was a ticket to their most cherished memories and a reminder of how lucky they were to experience them together.

"At my age, I have no regrets," says Laura. "It's been a good life and we've been very fortunate."

"We traveled the globe," Leo adds. "Two kids who hardly had any experiences in life; we've been around the world."

Watch Laura and Leo experience traveling through virtual reality:

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