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CNN SPECIAL REPORTS

The Miracle of Medicine and Science Saves Jadon and Anias. Aired 10-11p ET

Aired June 23, 2017 - 22:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


[22:00:15] ANNOUNCER: The following is a CNN special report.

SANJAY GUPTA, CHIEF MEDICAL CORRESPONDENT, CNN: The rarest of rare.

UNIDENTIFIED FEMALE: Hi, pumpkin.

GUPTA: Two boys held together, sharing a brain. Their parents facing an impossible decision. Knowing their only hope for a future is to be separated.

JAMES GOODRICH, DIRECTOR, MONTEFIORE MEDICAL CENTER: If you don't get them separated by 3, you've kind of lost that window.

GUPTA: A terrifying choice.

UNIDENTIFIED MALE: How long into the surgery will you know if you can actually separate that vein or not?

GUPTA: A dangerous operation.

They have to continuously move Jadon and Anias.

An uncertain future.

UNIDENTIFIED MALE: All right, double skin hooks

NICOLE MCDONALD, MOTHER OF CONJOINED TWINS: Cutting through them could change it.

GUPTA: The moments, the milestones, the setbacks.

UNIDENTIFIED MALE: So I was at a point that I was wondering whether we were going to lose both kids.

GUPTA: Come with us on this extraordinary journey. The exclusive story you've never seen before. Separated: Saving the Twins.

From the first moment, Christian McDonald lays eyes on Nicole at a Nashville bar back in 2011, he knows.

CHRISTIAN MCDONALD, FATHER OF CONJOINED TWINS: She looked amazing sitting over there. Honestly, I think my feet reacted quicker than my mind even did. I was just -- before I knew it, I was on my way over there.

GUPTA: It's truly love at first sight. He is pretty sure how he hopes life will progress from there. Marriage. Kids.

C. MCDONALD: I guess I never had a number, but three. Three was always kind of an ideal number.

GUPTA: By spring 2015, the dream is progressing nicely. Married with one child, Aza, Nicole is pregnant again. But something is different this time around.

N. MCDONALD: We went for a jog when I was four months pregnant, and we got halfway and I said, something's wrong.

GUPTA: What did you think at that time?

C. MCDONALD: I just thought, well, you know, she's pregnant. Maybe she's getting older.

GUPTA: But Nicole is only in her late 20s. Healthy, physically fit, what we doctors call low risk. On May 20th, 2015, she gets her first routine ultrasound. What she hears comes as quite a surprise. Two heart beats.

N. MCDONALD: Within ten seconds, she goes, huh, there's two babies in here. I go, what?

C. MCDONALD: I was shocked. We were calling everybody.

(CROSSTALK)

N. MCDONALD: We were kind of bragging at that point.

C. MCDONALD: We're having twins.

GUPTA: And just an hour later, amidst the celebration comes a call of concern and urgency.

N. MCDONALD: The radiologist wants to redo the ultrasound herself, personally, now.

GUPTA: But Christian has gone back to work. Without her husband by her side, Nicole returns to the hospital and sees for herself what was so alarming.

N. MCDONALD: She said, you know, I don't really know how to say this, except for to just say it, that your twins are conjoined at the head. All I could say was, OK, and try and breathe and not cry. I ran through the waiting room and just sobbed in the car till I couldn't breathe.

GUPTA: Dazed, emotional, Nicole finally heads home. Her grandmother, Ray Taylor is waiting.

RAY TAYLOR, NICOLE MCDONALD'S GRANDMOTHER: We all had a good cry, and then Nikki calmed down. She got very calm. She went into a woman with a plan.

GUPTA: She turns grief into action. It would become a new mantra in her life, learning everything she can about conjoined twins. The reality is sobering. Of the twins conjoined at the head, called craniopagus, 40 percent of them are stillborn. One-third die within 24 hours of being born. Doctors estimate the McDonald's twin's survival rate at just 10 to 20 percent. They ask Christian and Nicole the uneasy question. Do they want to terminate the pregnancy?

N. MCDONALD: No.

C. MCDONALD: Never. Never an option.

N. MCDONALD: No. That's what I said, thank you, but no.

DEBRA SELIP, MEDICAL DIRECTOR, FETAL AND NEONATAL MEDICINE CENTER: She was 100 percent in. Her husband, Christian, was 100 percent in.

[22:04:58] GUPTA: Dr. Debra Selip is the director of the Fetal Center at Rush University Medical Center in Chicago, Illinois.

SELIP: They'd do whatever it took to guarantee the best outcomes for their children.

GUPTA: Whatever it takes. Months of near constant monitoring.

SELIP: We anticipated delivering Nicole, best case scenario, 36 weeks.

GUPTA: But the boys have other ideas. September 9th, 2015, 32 weeks along, Nicole's water breaks. Christian is on a work trip. He'll have to meet her at the hospital. Where, coincidentally, dozens of doctors, nurses and technicians are together, rehearsing the delivery for the first time that very morning.

C. MCDONALD: It was a miracle to them, too.

(CROSSTALK)

N. MCDONALD: That everyone looks like, this is crazy.

C. MCDONALD: That they were all there.

N. MCDONALD: We're going to do it because everybody is here.

GUPTA: It's a textbook delivery. Despite being premature, the boys are in remarkably good shape. Nicole and Christian decide to name them Jadon and Anias. Their names mean God heard and God answered. Heard and answered. The daily prayers for their survival.

C. MCDONALD: We felt like God was already with us and really had been with us.

GUPTA: But then Anias begins to struggle. Breathing issues, vision problems, heart failures, even seizures. It takes four rocky months to stabilize the twins. February 2016, they are finally ready to go home.

N. MCDONALD: We're going home. We're going home.

GUPTA: While every new parent has a steep learning curve--

N. MCDONALD: Yes, you shake that, Jadon.

GUPTA: The McDonald's is steeper than most. Just to move the boys takes two. One adult holding each baby in complete unison.

N. MCDONALD: You're out of control.

GUPTA: No crib will fit them, so they sleep in a queen sized bed.

N. MCDONALD: You think you're funny.

GUPTA: Instead of a stroller, the McDonalds use a wagon.

C. MCDONALD: I got it. I got that belly.

GUPTA: As the days, weeks and months pass, they all settle in. Life is joyful.

N. MCDONALD: Give him love.

GUPTA: But in the back of everyone's mind is the realization that the only chance at a real life is separation.

N. MCDONALD: I'm going to get you.

GUPTA: So will the McDonald's prayers be heard and answered?

N. MCDONALD: Get the babies. Get the babies.

[22:10:00] (COMMERCIAL BREAK)

GUPTA: January 2016. The bustling Bronx in New York City. About as far from quiet coal city Illinois as the McDonalds can imagine. They're here on a mission.

C. MCDONALD: We needed someone special. We needed someone very unique to do a surgery like this.

GUPTA: Someone to entrust their children's lives to.

C. MCDONALD: First time you guys meet Goodrich, walk into his office.

N. MCDONALD: Yes.

C. MCDONALD: That's when I knew we had the right guy.

N. MCDONALD: Go in his office.

C. MCDONALD: yes, when you walk in there, you know he's got heads. Not human heads but -- on their dresser, I mean, this guy is into his work.

GOODRICH: These are all basically cranial--

GUPTA: And I understand what the McDonald's are talking about when I meet pediatric neurosurgeon James Goodrich in his office in at Children's Hospital Montefiore.

GOODRICH: You see our (Inaudible) That's a clue.

GUPTA: There are heads everywhere. But his mind is singularly focused on separating Jadon and Anias.

GOODRICH: The goal is ideally to have both children come out without neurological issues, but one has to be realistic. I mean, you cannot separate two brains, particularly if there is fusion, without the potential risk of something happening.

GUPTA: The risk others have taken with Goodrich. He's separated more twins joined at the head than any other surgeon in the world.

GOODRICH: They've since undergone--

GUPTA: Ironically, he stumbled upon the specialty years ago when a charity for families in need asked him to help separate a set of conjoined twins.

GOODRICH: If I had really done my homework and looked at the literature on craniopagus at the time, I never would have accepted it. Because the literature was devastating.

GUPTA: Historically, the operation was so invasive, that the likelihood of both twins surviving was abysmally low. So low, in fact, that doctors used to ask parents to pick which twin to save.

But that's changed now. Instead of doing one marathon separation surgery, Goodrich does several smaller operations, spread out over several months. He slowly separates vessels and tissues.

GOODRICH: The concept is that if you're trying to cut off of these veins at one time, the kid can take a huge hit. And that's a kid you're going to lose. Or if the kid does survives, it's going to be devastating.

GUPTA: He first tried the technique in 2004 with 2-year-old twins Clarence and Carl Aguirre. And it worked. Both boys survived.

GOODRICH: Since doing it now, we've had no deaths, no mortalities.

UNIDENTIFIED MALE: What has happened here--

GUPTA: No mortalities in nearly a dozen operations.

N. MCDONALD: Sweet boy.

GUPTA: A result he hopes for with Jadon and Anias. And there is no time to lose.

GOODRICH: If you don't get them separated by 3, you've kind of lost that window.

GUPTA: The McDonalds know the clock is ticking.

C. MCDONALD: Are you little munchkins.

GUPTA: But just looking at their twins, they appear to be thriving just the way they are. Laughing, singing, even fighting over toys, just like all siblings do.

N. MCDONALD: I know. Anias is playing with it.

GUPTA: For Nicole, they're perfect.

N. MCDONALD: They looked at me like their mother. They reached for my face. And they did everything a baby that age would do. Except they were stuck. They were individually perfect, and I knew that cutting through them could change it.

[22:15:03] GUPTA: Nicole is terrified to change who her boys are, but she knows they still need this operation to survive. So just one month after that meeting in the Bronx, March 2016, the McDonalds leave their home in Illinois on a donated private plane for New York City.

Was there a special medical setup of some sort?

N. MCDONALD: On the plane? No.

GUPTA: They think there is no need. The boys are stable when they take off. Then one hour into the flight, Anias mysteriously stops breathing.

N. MCDONALD: His lips were turning a little bit blue. He wasn't responding to me. Nothing. I pinched him. I just did everything I could.

GUPTA: Nothing works. Nicole panics.

N. MCDONALD: This is a good amount of time. I rolled him on his side and he went--

GUPTA: Anias starts breathing and stabilizes for the rest of the trip.

N. MCDONALD: It was influenza B.

GUPTA: That's what it was for Anias.

The flu, but so severe, it takes two months for Anias to recover. And only then can the painful journey toward separation begin. Over the next five months, four operations. Starting first in the front of the head, then the side, and then the back.

During each operation, doctors carefully clip blood vessels and separate shared tissue. Then the hardest and most painful surgery. Tissue expanders like balloons are inserted and slowly filled with water to create the excess skin that will be necessary after the final separation.

OREN TEPPER, DIRECTOR OF AESTHETIC SURGERY, MONTEFIORE MEDICAL CENTER: Our hope is we have a pretty good foundation for a skull reconstruction. And plenty of scalp to close over that.

GUPTA: Cranial facial surgeon, Dr. Oren Tepper has been tasked with reconstructing each of the boys heads once they are separated.

TEPPER: I think this is about as risky as it gets. The complexity of it, we've planned every step.

GUPTA: And every step so far is successful. And by October, everyone, especially these little boys, is ready.

N. MCDONALD: These are our babies. This is Jadon. And this is Anias.

GUPTA: It's two days before the final separation.

N. MCDONALD: Jadon is really kind of in pain all the time. You wouldn't know it.

GUPTA: She's right. You wouldn't know it. While they bear the scars of the earlier operations, these 13-month-old boys seem like happy, even carefree little kids. But it all weighs heavily on their parents.

N. MCDONALD: It's been hard. Every day is a decision. It was a leap of faith. We had to move our whole family out here.

C. MCDONALD: Yes.

GUPTA: Remarkable faith. Despite remarkable uncertainty.

N. MCDONALD: It doesn't matter what the statistics say. The surgery is going to happen. The outcomes are going to be whatever God allows them to be.

C. MCDONALD: Are you being funny, Anias? Are you ready to be your own boy tomorrow?

GUPTA: And so the night before the operation, all Christian and Nicole can do is what they have done every night since the twins were born. A bottle. A cuddle. And a little prayer before bed.

N. MCDONALD: I love you. God loves you more.

GUPTA: Will those prayers be answered?

N. MCDONALD: And everything. Everything is going to be OK.

GUPTA: We are going directly inside the operating room when we come back.

[22:20:00] (COMMERCIAL BREAK)

GUPTA: As the sun rises, Jadon and Anias McDonald wake up.

GOODRICH: Good morning, gentlemen.

GUPTA: To the biggest day of their young lives. It's separation day.

GOODRICH: Ready to rock and roll?

N. MCDONALD: Ready to rock.

GUPTA: Ready to go from one to two. But huge hurdles remain.

N. MCDONALD: How long into the surgery will you know if you can actually separate that vein or not?

GOODRICH: Hopefully by afternoon.

GUPTA: Christian is talking about a crucial shared vein that drains blood from both boys' brains. It is delicate. Goodrich won't know until he gets close if he can separate it. Goodrich and his team of 30 plus doctors and nurses have been prepping for months. And now, they're putting the final touches on operating room number 10.

I've never seen this sort of setup before. So, literally two operating tables. And two sort of setups for both boys here.

GOODRICH: The advantage to this is once you separate them, you just rotate the tables 90 degrees opposite.

GUPTA: Screens with brain images will guide the team, as well as anatomically exact models of the twins.

Is there a way to contextualize how much this makes your life easier?

GOODRICH: Huge. There is no guesswork anymore. You really physically have it right there.

TEPPER: It's a complete game changer.

GUPTA: It's pretty amazing. I mean, literally, cut here.

TEPPER: The idea here is we know exactly where we need to be.

GUPTA: Yet despite the technology, Goodrich and Tepper know this is not foolproof. These boys are 14 months old and growing fast. Every day, their brains become more fused, and they sprout new blood vessels. Facts that keep everyone the most experienced doctor up at night.

Do you get nervous a couple days out?

GOODRICH: I think any big case you do. There's not a day that you don't think about it.

GUPTA: And this day, October 13th, is no different. At 7.15 in the morning, the journey to the operating room begins with big brother Aza for the ride.

N. MCDONALD: There you go, baby. Down the elevator.

GUPTA: The twins are taking it all in.

GOODRICH: OK. N. MCDONALD: OK.

C. MCDONALD: That's right.

GUPTA: Soon, they make it to the doors of the surgical suite.

UNIDENTIFIED FEMALE: You can go into there.

N. MCDONALD: Big kiss for a speedy operation.

GUPTA: Time to say good-bye. No one, especially Aza wants to let go.

[22:25:00] It could be the last time they see Jadon and Anias together.

As their parents head for the waiting room, Jadon and Anias are carefully placed and positioned on the operating table.

UNIDENTIFIED FEMALE: One, two, go.

GUPTA: Like everything that will happen during this operation, it's rehearsed, practiced and carefully choreographed. It has to be.

GOODRICH: You have two children that are conjoined. And the complexity of what they share for the anesthesiologists passing over drugs, for IC intensivist trying to give one kid a drug, the other kid picks it up. It is an enormous ordeal.

UNIDENTIFIED FEMALE: Give me a little more.

GUPTA: The clock officially starts at 9.45 a.m. Plastic surgeon Dr. Oren Tepper makes the first incision.

UNIDENTIFIED MALE: All right, double skin hooks.

GUPTA: Cutting through the scalp to the conjoined skull. And then removing the bone--

TEPPER: Get some bone wax ready.

GUPTA: -- that he'll save and use later to rebuild each boy's head.

TEPPER: All right, sir.

GUPTA: At 10.15 a.m., Dr. Goodrich takes over and begins the process of exposing the delicate brain tissue. He starts with the parts of the brain he worked on before, opening them up to get access deeper into the shared tissue.

In order to do this operation, they've got to continuously move Jadon and Anias. So this is the position that they're in beforehand. And they essentially flipped like this, and then like this. So now they're going to focus on this part of the bone and this part of the brain. Just seven hours after the first incision.

N. MCDONALD: Hi. GUPTA: We check in with the family. It's 5 p.m.

N. MCDONALD: Really? What's weighed in my stomach is for the phone call. OK. We're into the -- I call it the land of the unknown. We're really into that area that we just don't know, are we going to be separated today or are we not?

GUPTA: Around 10 p.m., 12 hours since the operation started, doctors hit that land of the unknown.

GOODRICH: I was at a point that I was wondering whether we were going to lose both kids.

GUPTA: Goodrich has to stop.

GOODRICH: No, no. Don't do that. The reason why, you -- you'll tear these guys.

GUPTA: The dream of separating these boys is about to end.

UNIDENTIFIED MALE: You want to go through that doughnut.

GUPTA: The boys share more brain tissue than expected, 6 to 7 centimeters, not 2. And that crucial shared vein which drains blood from each brain is more complex than Goodrich expected. If he injuries it or just kinks it, the blood won't drain and both boys' brains would begin to swell. That could be devastating.

GOODRICH: This is the venous complex.

GUPTA: But then at 1.30 a.m., Goodrich and his team see a way through the land of the unknown.

GOODRICH: You should be 1 centimeter away from it.

UNIDENTIFIED MALE: You can see it right there.

GUPTA: And in the midst of the quiet chaos, all of a sudden.

GOODRICH: Through. Congratulations.

(APPLAUSE)

GUPTA: Two-eleven a.m., almost 17 hours after they began, Jadon and Anias McDonald are separated. Now, each boy's head can be rebuilt and closed up. Jadon is finished first.

How did it go, do you think?

GOODRICH: Much better once we got it figured out.

GUPTA: Goodrich tells me it was one of the toughest and longest separations he's ever done.

GOODRICH: If I hadn't been able to do that, we would have had to stop. GUPTA: You need to stop.

GOODRICH: Yes. And I don't know what I would do the second time around. So good thing we got it done the first time.

GUPTA: But not all done. Remember Anias? He's not out of the woods. He's still in surgery. His fight when we come back.

[22:30:00] (COMMERCIAL BREAK)

[22:30:00] UNIDENTIFIED MALE: Got a sense of humor?

GUPTA: In an elevator surrounded by doctors and nurses, Jadon McDonald is out of surgery and headed to intensive care.

N. MCDONALD: Every ding of the elevator, my heart was like just pounding out of my chest.

GUPTA: His parents are waiting. The last time they saw Jadon, he was attached to his brother.

N. MCDONALD: And then it was just Jadon. It was something I can't even explain. Because I've waited for that moment, and seeing them, for such a long time. I felt like all my dreams have come true, but at the same time, my heart was aching for my other baby that was downstairs.

GUPTA: Anias is still in operating room number 10. Reconstructing his head is turning out to be more complicated than his brothers. The gurney that was supposed to take him to the NICU hours ago still lays empty.

N. MCDONALD: He's the one that needs so much more help.

C. MCDONALD: He's always got the short end of the stick, every single time. And I mean every single time.

GUPTA: And this time is no different.

UNIDENTIFIED FEMALE: A-line is gone.

UNIDENTIFIED MALE: I know. Better?

UNIDENTIFIED FEMALE: No.

GUPTA: Throughout the marathon operations, doctors continuously struggled to stabilize Anias.

UNIDENTIFIED MALE: I feel like Anias is a little unstable.

GUPTA: His blood pressure, his heart rate plummeted over and over.

UNIDENTIFIED FEMALE: Yes, much better.

[22:35:02] And to separate the boys, Dr. Goodrich dissected more of Anias' tissue, in particular, the area that controls motor function. JAMES GOODRICH, DIRECTOR, MONTEFIORE MEDICAL CENTER: It's coming down

and then going this direction.

GUPTA: The concern, he might not be able to move his arms or his legs. But his parents faith is still undeniable. Unshakable.

C. MCDONALD: I knew god got him this far. Why is he going to let him go now?

GUPTA: Finally, around 1 p.m., 27 hours after the operation began.

N. MCDONALD: Want to kiss him?

GUPTA: It ends. Anias is finally reunited with his parents.

C. MCDONALD: He looks beautiful. So handsome, Anias.

GUPTA: And soon, back with his brother in the same room. But for the first time in their lives, on separate beds. The operation is complete, but it's the first 72 hours that are still the most critical.

N. MCDONALD: Jadon had extremely high fevers. Incredibly uncomfortable. Lots of pain. He wasn't using his left side at all.

GOODRICH: We know that postoperatively, both children would have some type of weakness. We did not know how severe and, of course, we didn't know how long it will last.

GUPTA: Almost immediately, Anias starts having seizures. One lasts 45 minutes. Doctors manage the seizures with medication, and Nicole while she manages them like only a mom can. Lying beside Anias, reading him books, singing him songs. Each time she does, his heart rate slows. His blood pressure lowers. And he calms down.

Meanwhile, four days after the operation, Jadon wakes up. He is ready for something his parents had only dreamed of. He can be picked up and cuddled for the first time. It's as if Nicole sees him for the first time.

N. MCDONALD: As a mother, you know when you hold your child, you know every bit of their face. Well, his face also encompassed Anias'. It was my first moment of relearning his face.

When he looked up at me for the first time in that way, I got to see that he was reassured and he was comforted in my arms, which is something I was scared of. I was scared he didn't want to be held because they'd never been held. He melted in, and it was wonderful.

I just couldn't stop talking to him and telling him how beautiful he was and how strong he was and how proud of him I am. I just love him. I just said, I love you, I love you, I love you.

GUPTA: It's such a powerful moment. A moment she also yearns to have with Anias. But she can't. Not yet.

N. MCDONALD: Tomorrow is a big day. I think we're going to get that tube out of your mouth.

GUPTA: Now one week post-surgery, his seizures have stopped but there is something else. A serious infection around the brain.

TEPPER: What we had to do is scale back some of the bony reconstruction to be able to fight the reconstruction.

GUPTA: Dr. Tepper is forced to remove infected skin and bone. Anias is left without skull around most of his brain.

N. MCDONALD: For Anias, there is never a break.

GUPTA: No break in the pain that he suffers. And no break for a mother torn between two very needy and separate babies.

N. MCDONALD: You get this guilt, like, oh, which baby do I go to, and how do I do it? It is an odd change.

Jadon, hi.

GUPTA: And also remember, her 3-year-old, Aza, has not been allowed in intensive care. And Nicole hasn't left since the surgery three weeks ago. Finally, she feels confident enough to leave.

N. MCDONALD: I was like, all right. We're going to go to dinner. We had a great time at dinner.

GUPTA: Until a message from the hospital.

N. MCDONALD: This is like one of my worst moments. I swear.

GUPTA: It is not Anias this time. But Jadon, he's having a massive seizure. They're trying desperately to get it under control.

N. MCDONALD: Your earth shatters. And you feel the worst guilt you've ever felt for leaving them because who was holding his hand? It wasn't me. Was he afraid? Why did I leave my baby?

[22:40:05] GUPTA: Jadon stabilizes. And for the next few weeks, she is by their side non-stop. Until she has no choice. That part of the story when we come back.

(COMMERCIAL BREAK)

GUPTA: Oh, my goodness.

One month post separation.

Hi, buddy.

A month of firsts for Jadon and Anias McDonald.

Last time we were in this room, they were conjoined.

First time in separate beds. First time being held. And first time actually seeing each other. You sticking your tongue out at me?

N. MCDONALD: Yes, that's a new trick.

GUPTA: You're sticking tongue out at me?

N. MCDONALD: He wants you to do it. You're going to smile?

GUPTA: Each day is new. Like today, November 15th. It's the first time Nicole and Christian will see Jadon's head without bandages.

N. MCDONALD: Oh, it's amazing. It is the most amazing thing. I can't even believe it. Look at his little hair on top that's growing in. Hi, baby.

GUPTA: Jadon has come a long way. He's moving, talking. Back, Nicole says, to his pre-surgery self.

[22:45:00] N. MCDONALD: Jadon is now even more rambunctious, and he loves everybody. Like he smiles at everybody. He wants to play with everybody. He's got 900 girlfriends on the tenth floor. He's out of control.

GUPTA: Anias has not come as far.

N. MCDONALD: It's OK. Nobody is here to touch you but me, and in a nice way. No pain.

GUPTA: When you understand what's happened in the last month, you'll understand what's going on here.

N. MCDONALD: Anias is, sadly, still shy and reserved, but now has this fear component because every time people approach him that aren't our family, it's a pain thing.

GUPTA: Anias continues to fight life-threatening infections and return trips to the operating room.

Just last week, he had a skin graft. Healthy tissue was surgically removed from his back and used to replace disease-infected skin on his head. It's all extremely painful. This is the first day Nicole has been here to comfort Anias.

N. MCDONALD: I've actually been gone. My 3-year-old has hand foot mouth.

GUPTA: Hand foot and mouth disease, of course, is very contagious and potentially dangerous for the babies.

N. MCDONALD: We were quarantined because neither Christian nor I could come here. We didn't want to bring anything here.

GUPTA: So they make the best of being away. Much-needed quality time with Aza. Road tripping to Boston and Connecticut. They try to escape the worry.

Were you able to mentally leave?

N. MCDONALD: No. No, I called a lot.

GUPTA: Probably very good for your mental health.

N. MCDONALD: It was. It was good.

GUPTA: But the boys missed her. Anias is especially happy to see her return.

Another smile. This is not possible.

N. MCDONALD: He smiled right at me. I mean, he smiles right at me, and it wasn't just a half smile. It was like a, mommy! It was so encouraging for me today because we haven't had a break in the pain.

GUPTA: And he's slowly starting to move his arms and legs.

N. MCDONALD: He can't reach out his hands in a cooperated way yet, but he can move his arms and hands in a way that is hopeful to me.

GUPTA: And despite what she thought was a slow progress and setbacks, Dr. Goodrich says her boys recovery is ahead of schedule.

GOODRICH: We're a month. This is one month out. This, to me, is incredibly fast.

GUPTA: Goodrich credits the recovery to the boys brains and bodies, which are resilient but also that their mother is Nicole McDonald. Before the boys were separated, she worked with them daily. She's a pediatric physical therapist.

N. MCDONALD: It's been kind of my mission to prepare them so that when it's done and they're separated, they're not so far behind that they have so much catching up to do.

GUPTA: Preparation that now makes a difference.

GOODRICH: I expected a more prolonged course.

GUPTA: When you say more prolonged, I mean, what's the -- what is a longer--

GOODRICH: Like mom would ask me the length. I'd say three, four, maybe six months.

GUPTA: In fact, Dr. Goodrich anticipates these boys will be ready to leave the hospital after Thanksgiving, just a month and a half after their operation. It's hard to imagine.

N. MCDONALD: OK, OK, OK.

GUPTA: But weeks later, on December 13th, Goodrich is a man of his word.

C. MCDONALD: Dr. Gupta. GUPTA: Give you a hug.

C. MCDONALD: Good to see you.

GUPTA: No more tubes or monitors.

They've changed so much since I last saw them.

No more infections or seizures. Jadon and Anias are eating, rolling around.

N. MCDONALD: Yes, look at that.

GUPTA: So cute.

N. MCDONALD: Yes.

GUPTA: While they're no longer connected at the head, these two boys share an unshakable bond.

C. MCDONALD: I love this.

N. MCDONALD: I know. People think I pose them.

(CROSSTALK)

C. MCDONALD: They always touch.

N. MCDONALD: I don't pose them. They do that.

C. MCDONALD: They lock arms, and they're always holding hands.

N. MCDONALD: They love each other.

C. MCDONALD: They have a great bond.

N. MCDONALD: Take all these cords off. You don't need these.

GUPTA: It's time for them to leave the hospital and head to rehab. It's the next step in their recovery.

C. MCDONALD: You know this guy?

GUPTA: But first, good-byes for the people who made their dreams come true.

You going to be OK saying good-bye to all these folks?

N. MCDONALD: That's not good-bye. It's just see you later.

GUPTA: As they prepare to leave, there are lots of see you later's and lots of thank you's.

N. MCDONALD: It's a huge testament to you that we don't want to live here. We love you and we'll miss you immensely.

GUPTA: It seems fitting that they leave the hospital as they came.

N. MCDONALD: Look at that right arm.

GUPTA: In a red wagon that the family has used to move the boys around. Before they were separated, it was the only thing long enough to hold them.

UNIDENTIFIED MALE: High-five.

GUPTA: But now, it's wide enough to hold them as they're laying side by side. With big brother Aza leading the way.

UNIDENTIFIED FEMALE: Bye.

[22:50:03] GUPTA: After 174 days of ups and downs tears and fears it's time for the next step. When we come back.

(COMMERCIAL BREAK)

GUPTA: The sun is shining bright on this cold December day, 2016 in Valhalla, New York.

N. MCDONALD: Are you ready to see your new home?

GUPTA: Just two months after a 24-hour operation to separate them, Jadon and Anias McDonald are arriving at Blythedale Children's Hospital. For now it's their new home, where they will learn to eat and play, sit up, become little boys, independent at last.

N. MCDONALD: We know the boys will flourish here and it's an exciting step.

GUPTA: Hello, hello.

N. MCDONALD: Hi.

GUPTA: When I first visit, it's breakfast time.

She's the feeding therapist. So she's watching and making sure how much he's eating and how he's doing.

C. MCDONALD: Is he a b minus right now or a d?

GUPTA: Within weeks the boys are thriving.

I really notice their growth each time. I don't know if you get to notice it because you see it every day.

[22:55:03] N. MCDONALD: I can feel it. I can feel it.

GUPTA: Also you can't miss these, customized helmets to protect their delicate heads.

C. MCDONALD: This is the wild things.

N. MCDONALD: Where the wild things are. C. MCDONALD: The story book where the wild things are.

GUPTA: Yes, the wild things are.

C. MCDONALD: Because these are little wild things and then Anias' helmet is under construction.

GUPTA: OK.

N. MCDONALD: Because he still got some work to do.

GUPTA: A lot of work. In the world of conjoined twins, there are always struggles which begin soon after arriving here.

N. MCDONALD: I walk in the door, go up to Anias' bed, the top of his head is as red as my dress. He's hot and sweaty and just looking kind of out of it.

GUPTA: Looks like another infection.

N. MCDONALD: He starts having a seizure. Switching on his right side, right face and then his fevers just kept going.

TEPPER: We get a phone call there may be an issue. We take very seriously. I certainly get very concerned that this may be something more serious.

GUPTA: Anias' rushed 16 miles back to the Montefiore Medical Center. Dr. Tepper is waiting.

TEPPER: The plates that we use to hold the bone together can sometimes create this inflammatory reaction that the body tries to reject the foreign body.

GUPTA: It's serious but not entirely unexpected. With 10 days of wound cleaning and antibiotics he turns a corner.

N. MCDONALD: What's wrong, Jadon?

GUPTA: But then the roller coaster ride continues. Jadon gets an infection as well. It's his first.

N. MCDONALD: I was devastated by it because Jadon's supposed to be the tough one.

TEPPER: Each hurdle brings that same devastation.

GUPTA: But Dr. Tepper knows Jadon is a fighter, just like his brother.

TEPPER: Which I think really exceeded all of my expectations. They've really made a tremendous progress.

GUPTA: As the saying often goes what doesn't kill you makes you stronger. Jadon and Anias, rolling over, reaching for toys, talking nonstop. UNIDENTIFIED FEMALE: Hey, baby.

GUPTA: And unbelievably by June something none of us expected to see so soon. Walking. And Jadon is not alone. Anias is close behind.

N. MCDONALD: You big boy. It's amazing, right. Anias, Anias I just saw him do that for the first time. You wouldn't believe what they can do.

GUPTA: Remember these boys were just separated in October of 2016. When they were just over a year old. But doctors say the day of their operation was a new birthday, a rebirth and now they're learning everything they had never had a chance to do.

N. MCDONALD: They're right on schedule. Actually having you here helps me to see and remember how far they've come because not everybody has seen them from the surgery and, you know, and you've been here and to be able to talk to you and say look at what they can do.

GUPTA: They are--

(CROSSTALK)

N. MCDONALD: Look what they can do.

GUPTA: They really seem to be doing well. I mean, they're thriving.

N. MCDONALD: Yes.

GUPTA: I mean, just the sitting up, the attentiveness, the focus. I know it's been a long road. But these boys have worked hard against all odds to chart their own future.

N. MCDONALD: They have a life a good one and they live it to the full. They love life.

GUPTA: Because as two separate boys, the future is without limits.

Jadon and Anias, their separation is the likes of which I've never seen before. It's the best of us, the best medicine has to offer. Dedicated, diligent, and compassionate doctors, nurses, therapists, using the most remarkable technologies and techniques to separate and save these twins. To give them a chance, to give them a future.

C. MCDONALD: They're just doing so much compared to where they came from. So imagine what the next two years they'll do.

N. MCDONALD: There's no boundaries for those babies. Those babies are going to do everything. Those babies will walk and they will talk and they will play and they will grow and they will learn. There's nothing that's going to hold them back. And they are going to have a happy life.

[23:00:00] (COMMERCIAL BREAK)