we're more than 78,000 people looking out for 70 million americans. that's health in numbers. unitedhealthcare. ♪ ♪ when i first saw them, i cried. they looked like little angels sleeping. >> it's a dilemma that few doctors ever face. conjoined twin boys attached at their heads. >> our first goal was to keep them alive. >> but their ultimate goal is to give them healthy, separate lives. one doctor believes there's a way. >> this is an orchestration of the most complex surgical procedure that occurs on this earth. >> incredibly dangerous, too. it will be a tough choice -- let

them live this way or risk their deaths trying to give them a more normal life. >> the ethical issues are complex. first of all, they're children. they cannot make the decision for themselves. >> you know that your chances of saving two kids is not that good. >> chances are not good. but we have to go for that. to me that's the only way. >> a remarkable story. two extraordinary boys. in this hour, "double lives." >> the question you have to ask is what is the value of a single life or in this case of two lives? >> they are two of the most extraordinary children on earth. pure, simple, normal in so many ways.

mohamed, the smaller, vivacious, outgoing, and they say downright mischievous. his bigger brother, ahmed, quieter, reflective, already seems to possess a worldly wisdom. these two boys have spent every moment of their young lives together. and yet they have never once seen each other. and they cannot sit, stand up, or even crawl because they are conjoined twins, joined at the head. the boys' condition can perhaps be remedied with surgery, but surgery so complex and filled with risk, it threatens both boys with permanent brain damage or paralysis or even death. how does this compare with other cases you've done? >> it's right up at the top. without a doubt one of the most challenging decisions that i've ever had to make. >> so what we have to do is close the --

>> dr. kenneth salyer is facing the cruelest choice of his medical career that could well determine whether these unwitting, innocent children live or die. >> it's the decision, do we or don't we? >> the fact that dr. salyer knows the twins at all is an unlikely turn of fate. their story begins 7,000 miles away in a desperately poor remote village lost in the nile valley in southern egypt. the year is 2001. this is where ibrahim and sabah, a 30-year-old unemployed laborer and a homemaker, live hand to mouth. they already had two children when sabah learned she was pregnant with twins. but it's much more complicated than that. >> translator: the doctor told us the twins were joined together and said, i'll be honest with you, this is a very rare case, your wife is in danger if she gives birth.

>> if you had known early in the pregnancy what you were faced with, do you look back now and say we should have ended this pregnancy if we'd known sooner? >> translator: no, no, no. we cannot kill a soul. i would never do it and would never have done it. whatever the price, even if i had to give my own life, i would never have ended the pregnancy. >> but when the babies were born, ibrahim could not comprehend what he was seeing. >> translator: i was in a state of complete and utter shock. i'd never seen anything like it in my whole life. >> still, the couple instantly fell in love with their babies. >> when you saw them for the first time, what was it like? >> translator: when i first saw them, i cried. they looked like little angels sleeping. >> but the parents know they'll need enormous help to care for them. local doctors, woefully lacking knowledge or experience or equipment, think it's best to

transfer the twins, just five days old, 500 miles away to egypt's capital, cairo. >> they were very vulnerable. so our first main goal was to just keep them alive. >> quite possibly the twins would not be alive today if it were not for this man. dr. nasser abdel al has spent a career building the biggest and most modern neonatal surgical unit in the middle east. but this, this case is an incredible first for nasser. as nasser begins to explore how he can ever help these boys, he is stunned when he discovers they are a far more complex case than the conjoined twins from guatemala he'd heard about who are about the same age as mohamed and ahmed. a c.a.t. scan and mri of the egyptian boys reveal they share not only skull and blood vessels, their brains, though individual and distinct, are actually joined together. >> we were terrified and

realized that we are dealing with something unprecedented. >> so nasser calls surgeons overseas for help. but as he waits for a response, a remarkable thing begins to happen. all around the hospital everyone falls in love with the innocent little pair. >> rule number one for any doctor is never to be emotionally attached with your patients. but there's an exception to every rule. and these are the exceptions. >> and they develop different personalities early on. >> yes. mohamed, he's the smaller one, and he's used to be very active from the very beginning. being the leader when it comes to rolling and pushing and when it comes to flashing smiles. so he was the rascal. we call him the rascal in contrast to his brother we

dubbed the philosopher because he tended to look at you and to examine you. i was always saying that we're not examining him, he's examining us. >> before very long the story began to spread about these poverty-stricken boys from the poor village up the nile and their awful dilemma. their faces were on television. their names were on the lips of people in the streets and back alleys of teeming cairo. they became egypt's babies. to give the twins a sense of family, nasser assigns two nurses, one to each boy, to feed them and bathe them and take them out in their new stretch stroller, an adapted tandem baby carriage. it is, like any of the assignments they took on for nasser, difficult and challenging. but they have no idea just yet

how emotionally charged this will be, how dangerous. and nasser begins to have dreams for the two little boys in his care. >> i asked for each of these twins to enjoy the simple fact of life, being able to run separately to their mothers and hug them. >> you have that dream a lot? >> oh, yes. it's an obsession that i want to see these kids enjoy life, not just exist because living is enjoying your existence. now they are just existing. they are not living. >> some say, huh-uh, shouldn't try it. >> well, are you going to leave them suffer in front of your eyes when you have the chance that they are going to be treated in the best place in the world. this is the question. >> october 2001.

nasser's colleague, pediatric surgeon dr. mamdouh aboulhassan contacts his friend, dr. kenneth salyer in texas. they had met when mamdouh attended a training session at the world craniofacial foundation, a nonprofifit organization in dallas hospital in texas. salyer heads up the foundation. >> and i sent him an e-mail with their photos. i just want to ask him, have you seen conjoined twins like that and how can we separate them? and from this started this long journey of hope. >> the foundation agreed to have them evaluated. but of course even if they could be separated, the boys' family could never afford the price. this could cost $2 million, maybe more. in a good month ibrahim could count on perhaps $50. so it makes all the difference when the foundation decides the doctors will donate their services. and for sabah and ibrahim, that means there is hope for their little boys.

>> it's a kind of second birth for them to go to america because when people say america here, it's great. it means a lot. >> but ibrahim will not go himself. this simple man chooses to remain in egypt to look after his family and place his faith in nasser. >> translator: i had to trust nasser because he loves my boys, not like other children but as if they are a gift from god. >> and so in june 2002, dr. nasser, dr. mamdouh, and their medical team take the twins onto an airplane bound for a brave, new world. then, arriving in dallas with his team and two tired little boys, nasser takes a part of this from his own children and presents the whole vexing case to dr. kenneth salyer.

coming up -- >> the most difficult case that i've ever had to deal with. >> doctors face a choice -- whether to let the twins go through life joined at the head or risk death by trying to give them a more normal life. what makes the sleep number store different? the sleep number bed. the magic of this bed is that you're sleeping on something that conforms to your individual shape. you can adjust it to whatever your needs are. so whatever you feel like, the sleep number bed's

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june 22nd, 2002. after 22 hours and a 7,000-mile voyage, 1-year-old egyptian twin boys mohamed and ahmed joined tightly together at the head arrive safely in dallas, texas. dr. nasser, who cared for the twins in cairo, now passes this responsibility on to dr. kenneth salyer. here in dallas everyone hoped and many people expected the finest doctors, the best

machines, and generous financing would all combine to make sense of the impossible choice. but time and tests revealed an outlook which was even more complicated than anybody had imagined. >> this is an orchestration of the most complex surgical procedure that occurs on this earth. there's no question about that in my mind. >> these are the images that confront dr. salyer. a tangled confusion of blood vessels he's never seen before. major veins that originate in one twin, snaking their way deep into the other twin's head. mohamed and ahmed are not only stuck firmly together, they depend on each other for their lives. mohamed, the smaller but more outgoing twin, has more delicate, narrower veins in his head than his brother, and salyer is forced to concede he is the more vulnerable in surgery. surgery they're not even sure is possible. >> as we've moved through it,

we've gone from it's doable, it's not doable, there's -- we could do it and i can see how we can make it happen, and then all of a sudden we get new information and then it's like i don't know how we're going to make this happen. >> but for now mohamed the rascal and ahmed the philosopher are blissfully ignorant of all the weighty opinions around them, playing new games with their nurses. watched over by nasser, apparently in no danger at all, no closer to surgery. but a little closer to the man who would decide their fate. how long did it take to become attached to these two? >> not long. and even to develop a favorite. you know, because one has much more compelling eyes and he sort of takes you in. and then you're caught. >> which one is that? >> mohamed, the small one. >> the one who might be more vulnerable. >> right. and of course that -- i may be

influenced by that fact. i probably am. how are you doing? >> as he is by the undeniable fact that besides the complications of their conjoinment, there's not a thing wrong with them. >> we have right now two normal children. >> healthy? >> healthy. >> apparently rather happy. >> becoming more happy as they've been here. we have them in physical therapy, and they've responded wonderfully. they're up on their hands and knees and balancing and laughing. >> the surgeon can even imagine the day, if the boys are not separated, when they might actually be able to stand up, even walk in some fashion. and yet this most accomplished of doctors who says he's only lost 3 patients in 16,000 surgeries knows that separating the boys might kill them and even if it doesn't, it might

mean permanent brain damage and paralysis. why are you still saying my intention is to go ahead? >> because we do have a window of plasticity. >> a window of plasticity is a period of time in which very young children, up to about 5 years old are sometimes able to recover from extensive brain trauma. in this case that might mean the twins could actually recover the use of paralyzed arms or legs. salyer says this really happened in the only other separation of twins joined at the head in which he was involved. >> one of them had severe neurologic damage, which as a little infant she totally recovered from. >> even so there is a significant risk that separation could cause permanent brain damage in one or possibly even both of the boys. a fact that's caused intense disagreement in salyer's team and personal anxiety. there are members of your team who have told you that this

isn't a good thing to do. >> and that really makes it very difficult for me. at the same time i have this inner drive and this inner faith of the right thing to do for these kids is separation. >> does any one of these other people who disagree with you ever look you in the eye and say don't be a hot dog, back off on the ego? >> it really isn't an ego thing, believe it or not. i don't need to separate a child to satisfy my ego. i'm there with a talent that i feel i'm supposed to use to help those kids. >> the specialist surgeons on salyer's team varied wildly in their opinions of how to help

the kids and what the outcome of the surgery might be. and then there's the ethical question of whether to risk sacrificing one life to save another. >> there are some forms of conjoined twins where you really have one that's a parasite. so there it's not a decision. but when you have two total human beings, i don't think that's a good solution. i don't like that approach. i'm not on a plan of sacrifice one. i'm on a plan of save two kids. >> you know that your chances of saving two kids is not that good. >> chances are not good. but we have to go for that. to me that's the only way. and it's possible. >> coming up next -- doctors weigh the medical options while the twins' father turns to his faith. >> he's kind of put it in the hands of god. >> he has. oom dumped me here... oh, oh. oooh! will love ever come my way? oh my! ♪ i believe in miracles

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and it hasn't been going exactly as planned. cut. cut! [ monica ] i thought we'd be on location for 3 days -- it's been 3 weeks. so i had to pick up some more things. good thing i've got the citi simplicity card. i don't get hit with a fee if i'm late with a payment... which is good because on this job, no! bigger! [ monica ] i may not be home for a while. [ male announcer ] the new citi simplicity card. no late fees. no penalty rate. no worries. in your breakfast cereal, what is? now, in every box of general mills big g cereal, there's more whole grain than any other ingredient. that's why it's listed first. get more whole grain than any other ingredient... just look for the white check. and i'm a master roaster at starbucks coffee. brian hayes. i'm a master roaster at starbucks coffee. sitting right here we have 40 years of roast experience. how can we use that and do more with it? new starbucks blonde roast was created

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and the pros pekt of separating them is all consuming for dr. kenneth salyer. he is now as obsessed as dr. nasser abdel al, the boys' egyptian doctor. and both of them watch the egyptian nurses, who have spent nearly every day of the boys' lives caring for them, changing them, feeding them, and playing with them. wafa looks after mohamed, and nagla cares for ahmed. >> translator: we love these children like mothers, and we feel like mothers. sometimes we even sleep with these children. >> do you begin to understand the degree of closeness that these boys would have? >> translator: they already feel very close to each other. if one of them is hungry or needs something, they'll start crying, and his brother, even though he doesn't need anything, also gets upset because his brother is crying. >> translator: mohamed tries to turn himself around so he can get close to his brother, even though he can't. so he reaches over to touch his hand. >> so when you think about the

possibility of them being separated, it must get -- how do you feel about it after having been with them so long? >> translator: i am dreading the decision. i know that it's so risky, and i only pray to god that something will work out. >> but when asked to face the possibility that one or both of the twins might not survive surgery, the thought is simply too much for wafa, who looks after the smaller, more vulnerable twin, mohamed. yeah. she says she feels like a mother whose baby is about to be taken away from her. >> translator: this is an impossible decision for us. these boys are like our sons. so which one should we sacrifice for the other? >> they wish, they tell us, that the decision could be put off for at least a year, time perhaps to find another solution for their babies or, better still, says wafa, let the boys grow up and decide for themselves what they want. but all the doctors know that if they're going to perform surgery

it will most likely be soon. but dr. salyer knows that to accomplish this he needs to reach out and find an elite group of pediatric neurosurgeons. he does find them. but the question is can they help? >> initially it was quite daunting. it was very difficult to figure out the exact anatomy. >> dr. dale swift is one of the team that would attempt to come up with a surgical plan for ahmed and mohamed. swift and his colleagues conduct ct scans, mris, arteriograms, and using the data they commission replica models of the twins' heads. here in life size is the exact configuration not just of the boys' heads but of the increasingly complex web of blood vessels inside. >> it will show us the arteries or the veins or the scalp or the bone or dura. >> you actually took them home?

>> oh, yeah. every night. >> sat up, looked at them? >> yeah. till i -- till i fell asleep. >> even on vacation he spends hours puzzling over the apparently impossible tangle. but he's conflicted. the boys are healthy, happy, and winning hearts among the medical staff. already the nurses see progress, the boys learning to stand up, take baby steps, and some of their own crafty moves. >> there we go. >> they have a life. they seem to be enjoying it. salyer sends the boys to florida for some special therapy, after which there's a trip to disney world, all of which only sharpens swift's worries that such a drastic operation could end all of this, that it risks permanent brain damage and paralysis, even death. this is where the ethical issues become so complex that two ethics committees worked on this. >> what's best for the boys for their whole life? how are they going to enjoy

their life to the fullest? and we believe that for the boys and their interaction with society, that it will be better for them to be apart. >> but swift and his team will not make the final decision. while the twins' mother stays in egypt to look after the twins' siblings, their father, ibrahim, flies to dallas. nothing will be done without his agreement. >> we've had a lot of communication with especially their father, who seems to understand very well what the risks are. >> he's kind of put it in the hands of god. >> he has. he has. >> coming up -- time is running out. will the family and doctors decide to separate ahmed and mohamed? and after 16 months a mother is reunited with her boys. [ male ae a shadow of your former self? c'mon, michael! get in the game! [ male announcer ] don't have the hops for hoops with your buddies? lost your appetite for romance?

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msnbc now.

i'm alex witt. a new poll shows mitt romney has a lead among hispanic republicans in florida. the abc news poll shows 35% would vote for romney. 21% would say gingrich is their choice. santorum received % and ron paul received 6%. they make up 10% of the republicans likely to vote in tuesday's primary. for all of this and our political coverage, but for now we'll take you to the d documentary mystery "double lives." for a year and a half medical city hospital in dallas, texas, has been home to conjoined twins ahmed and mohamed. it's june 2002 when they arrive from cairo with a dedicated medical team. here in dallas doctors not only question how to separate the twins without sacrificing one for the other, but they also must face the ethical question. should they? is it really the right thing to

do? >> we are dealing with something unprecedented. >> in the fall of 2002 the doctors and family decide it is the right thing to do, there will be an operation, they will do it. but now the task, and it is immense. in ahmed and mohamed's case there is some good news. though the boys' brains touch each other, they are apparently independent, and doctors believe they can be teased apart. however, exposing the brain can also lead to complications. >> in order to minimize the risk of infection, you have to make sure that you have sufficient coverage of the brain. >> doctors decide the boys' own skin can, in fact, cover the head wounds. and so in april 2003 the twins undergo the first phase toward their separation. >> and we have to really expand them to -- >> the procedure involves dr. salyer inserting silicone balloons under their skin and

gradually inflating them with saline, causing the skin to stretch. >> guess what? it's too big. >> five tissue expanders are inserted under their skin near the crown of each of their heads. >> and one of the critical issues for these children is to have a complete tissue seal of both heads. so this is -- these maneuvers long term are critical in determining their outcome. ♪ happy birthday to you >> two months after the tissue expanders were put in, the boys happily celebrate their second birthday. but they're showing troubling signs. their brains are not developing like normal 2-year-olds. and without surgery doctors believe the impairment will get worse. and another major concern. the twins share blood vessels. in fact, each has major vessels that drain blood from the left hemisphere of the brain into the other's head. >> a substantial portion of each

boy's blood supply was going actually to his twin. and it was relatively balanced. so blood was coming in, and it was going partially to their brother. and you can imagine if you tie off your drainage of blood from your brain, your brain will get swollen and could become severely damaged. so we were concerned. we didn't know exactly how the brain would reroute the blood. >> the surgeons believe that small blood vessels will take up the flow and do the job. but these vessels are so minuscule they can't even be seen on scans. still, the surgeons are cautiously optimistic. on october 4th, 2003 the twins' mother, sabah, arrives in dallas after not seeing her boys for 16 months. the surgery is only a week away. this is the moment about which she has been dreaming. >> translator: whenever i go to bed at night, i feel that they are both with me but separated, not joined.

i hug them, and i sleep. >> october 11th, 2003, the day of the separation surgery. it's an emotional one for everybody. >> translator: i was very frightened. i had visions of uncontrolled bleeding, paralysis, or worse. >> at 9:07 a.m. the twins are wheeled into the o.r. >> one, two, three, up and over and down. >> ventilate. >> a team of more than 50 doctors and nurses and technicians go to work and warn that the operation, whether a success or a failure, can take up to four days. the team has already gone through two dress rehearsals to minimize any glitches that could happen. basically, there's a point of no return, right? >> we had made the decision, and we had to go forward. there was no more preparation to be done and no more planning.

it was ready to go. >> already the doctors have been able to use the most sophisticated medical models. here in surgery the boys are strapped to yet another device, a rotating operating table created specifically for this procedure, allowing doctors unprecedented access. >> what it allowed us to do was to say, okay, let's rotate. without physically lifting the children, without being concerned that one child was going to rotate more than the other. >> in addition, the custom-made table will split in two when the twins are separated, allowing a team of doctors to work on each boy. first, surgeons open the scalps. >> we had to make sure the scalp was healthy. then we had to remove the tissue expanders. then we had to take the bone off, open the dura. then we had to find the appropriate blood vessels and divide them. >> at each interval doctors look for any swelling of the brain. so far there isn't any.

>> everything made sense. we all had this image in our minds of what we would find, and as we turned each corner we found it. >> just the way you expected it would be? >> well, it took a year, so, i mean -- >> for all the warnings beforehand, the surgery itself is going smoothly. when swift and the other surgeons confront that tangled confusion of blood vessels, it parts just as they hoped it would, with minimal bleeding. they don't know if the divided blood systems will function correctly. not yet. but so far the news is good. word goes out. >> during the progress of the separation that everything was going fine, i was not surprised. i knew that the hands of god were there in surgery, in the o.r. >> and then the one moment that surprises them. all the tests had told swift that the boys' brains, though squeezed tightly together, were entirely separate. but are they? >> let's say you have two wet pieces of paper and they stick together. well, sometimes they come apart and each page is one.

and sometimes if you keep tearing, it will tear the other page, you know, a lot. >> so it wasn't a question of them, actually the brains had become fused. >> no. they were stuck together, and we had to pry them apart. >> okay. we're getting ready to separate. >> finally, the moment arrived. >> we're moving back. we're moving back. one, two, three, move back. >> we released the yoke that held the tables together, and we just gradually pulled them apart. we looked in, looked in, and they were separate. >> the twins are now separated. but amazingly, there's almost no reaction in the operating room. >> we've got the two boys, and of course they're separate, but there's hours of work to be done. >> not like you'd go hooray and celebrate. >> no, not at that point. not at that point. >> but if the mood in the o.r. is business-like and calm, the waiting room is anything but. there's a rush of emotions.

everybody cries. everyone. ibrahim has been nervously smoking a cigarette when he gets the news. all the months of worry, responsibility, lifted in an instant. he embraces nasser. and faints. >> translator: even if i had 100 years, i could never explain to you what i felt right then. >> he obviously was pretty wound up, and the release of that tension must have been amazing. for him, for everybody. >> he just dropped on the floor. and while he was on the floor, he was babbling with words, he says "it's impossible. it's impossible." he said, "i don't know how to thank you or what -- how to reward you for this." >> but there's still hours of work to be done. >> the expanders had come out, and you were left with tissue that was stretched out. membranes of tissue. so then we take those membranes

and we sew them back in to create a complete membrane over the brain that would be a barrier for any bacteria. >> ready? >> then, after a marathon 33 hours of surgery, it's over and the boys are wheeled out in separate gurneys. [ applause ] to protect the boys in surgery doctors have given them drugs to create, artificially, a coma. this allows their brains to adjust. now the process of returning them to consciousness begins. now, everything happens with deliberate slowness. for several days doctors have been removing the medications that have kept the boys in an induced coma, and first there will be flickers of reflex action, sensitivity to light, a sudden movement of a limb. in fact, very quickly the twins are moving. arms, legs. responding to people. at one point mohamed actually reaches up and touches his nurse's cheek. however, danger remains.

but now at least they can all plan for what comes next, which is a lot. is it possible for anyone to understand what that feels like? >> no. >> translator: no. nobody can understand. no one can feel as happy as i feel. >> coming up, the joyful homecoming. a new beginning. and more surgery for the twins. >> they're amazing boys. they're grateful for everything. hey, mom? what? pay you? for what? for unloading the dishwasher?! kid, you need to pay me for making this delicious -- whoa. hold on there, mom. kitchen counselor. um, mom, i think what she means is "greasy dishes." yeah. in fact, check it out. cascade complete pacs are the ones with the real liquid top. they fight tough greasy messes better than the other tablet, which can leave more tough grease behind. oooh, clean. there's only one cascade.

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♪[music plays] ♪[music plays] purina one beyond. food for your cat or dog. on october 11th, 2003, 2 1/2-year-old twins ahmed and mohamed, born conjoined at the head, are successfully separated. [ applause ]

five months later the twins are back in the operating room for reconstructive surgery. >> they both had two large holes in their skull after separation, and the idea was we need to fill all that in so they have a solid skull. >> more than two years after the separation surgery they're ready to come home. ♪ on november 20th, 2005, cairo airport is filled with excitement. the celebration is about to begin. egypt's favorite sons are returning home, finally, after more than three long years. and then, after the doors open, there standing by himself is mohamed. and in the arms of his mother is ahmed. the two totally separate 4-year-old boys.

the reaction is overwhelming. >> my dream for them actually crystallized. i wanted these boys to come back with two separate passports. ♪ >> the twins must still wear helmets to protect their heads and give their skulls more time to heal. >> look. look, egypt. >> ahmed. >> for the family life in egypt will be different now. the twins' brother and sister will remain in their village of qus with relatives so they can attend their same school. but the parents, sabah and ibrahim, will be in cairo with the twins so they can be close to the hospital, where they'll continue to get free medical treatment. >> who are you going to talk to? >> the transition is a tough one. finding a place to live is a

problem. they can't afford an apartment. ibrahim needs a job. but in just five weeks a generous donor finds an apartment for them and puts it under the twins' name. he also gives ibrahim a job. life for the twins is a constant series of visits to the hospital for testing. they're now under the care of dr. mamdouh, who accompanied them to dallas and has been with them the entire time. >> i'm worried a lot about their bone growth and bone healing because the cranium, the brain tissue is a very weak tissue and even the slightest murmur might cause an injury. >> in some ways the boys' development is about two years behind children their own age, and the surgery did leave signs of disability. >> push. good. >> mohamed does not have full use of his right hand.

ahmed is unable to walk on his own. >> good boy. >> three times a week dr. samy nasseh volunteers his services, gives the twins physical therapy. >> good boy, ahmed. >> he believes ahmed will walk on his own but it will take a long time. >> and stand up. he needs the assistance of two for him to stand up and walk. but for five months we think, i believe that we can increase the assistance and he can walk independently. >> stand on your right foot. >> goals are set for mohamed as well. >> for mohamed to use his right arm independently right now he needs some percussion on the arm to open his fingers and he can open, but there is no definition, no fine movement in his hand. so we are going to work on the fine coordination to make him independently using his right hand.

>> the twins attend school. once a week they go to a private english-speaking school for free. >> ahmed. >> they're a bit shy. they used to stay by themselves whereas now they're a proper part of the class. they really try and join in the classes as much as they can. >> within a few short months after returning home the boys are progressing enormously. >> their english improved a lot. you can have conversations with them. >> yay. >> flowers. >> their parents say mohamed and ahmed love learning and are not in the least self-conscious about their disability. >> translator: they carry on with their life normally and don't feel there is anything wrong with them. >> stop it. >> they're amazing boys. everything they've been through and to be here now and so happy

and so friendly and so smiley. >> hi. >> you know, they're grateful for everything. they're lovely children. >> coming up -- >> go. go. >> ahmed's struggle to walk. ♪ happy birthday >> and the twins celebrate another birthday. [ woman ] my boyfriend and i were going on vacation, so i used my citi thank you card to pick up some accessories. a new belt. some nylons. and what girl wouldn't need new shoes? we talked about getting a diamond. but with all the thank you points i've been earning... ♪ ...i flew us to the rock i really had in mind. ♪ [ male announcer ] the citi thank you card. earn points you can use for travel on any airline, with no blackout dates.

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after a hero's welcome home to egypt, ahmed, mohamed, and their entire family begin a new life for themselves. >> hey. how are you? how are you? >> good. >> in may 2006 the twins have a very special visit. >> how's your english? >> good. >> is your english good? >> yes. >> dr. salyer's visit to cairo

is twofold. he'll tour the facility run by dr. nasser and, of course, check up on mohamed and ahmed. >> it's been a long time. >> okay. >> okay. >> you went over to egypt to see these boys. >> right. >> what was that like? >> it was a wonderful moment. we had an opportunity to see these boys, and they were happy. >> it's still soft right here. i mean, it still hasn't filled in like i wanted it to. >> this is you. that's you. look. see this place right here? it's still a little soft. it has to grow some more. >> yeah. >> it was a wonderful reunion and an opportunity to examine their skulls and see that they're healing. >> next page. >> i know, next. okay, next. okay, next. >> don't forget, there is another one. >> no, i would never forget you. >> how are you doing?

are you doing good? >> yes. >> squeeze hard, hard, hard, hard, hard. wow. ♪ a, b, c, d, e, f, g >> a year later, in june 2007, much has changed since the twins' return home. sabah and ibrahim have a new baby, and the whole family is now together, living in cairo. periodically, the twins still get c.a.t. scans to see how their skulls are healing. >> i see them every four to five months now and examine them for their development of the skills and mainly for their head to see if there's any weak points or any complication present. most of the head is covered by bone, but still there are some defects, especially in mohamed. >> dr. mamdouh believes the twins will probably need more surgery in the future to cover

the weak areas on their skulls. but overall, he is delighted with their progress. >> i think they are very happy children right now. mohamed is more outgoing because he's moving more and making a lot of noises. but ahmed is overcome with shyness. he's getting more and more social. >> to your left. the right foot. >> and the boys are making great strides with their physical therapy. >> good boy. >> this was ahmed when he got off the airplane in cairo. this is him two years later. >> go. go. go. >> in the past ahmed cannot take steps. and now he can walk about 10 to 20 feet without support. >> up. down. >> the change for mohamed has

also been dramatic. >> the function of his right hand right now is 50 percentage improvement more than in the past because in the past he cannot open it and right now he has the ability to open his fingers. >> hold the toy. put it in my hand. good. >> and while dr. samy acknowledges the twins' amazing growth, he still has concerns for them and their future. >> the success of the separation is the state of the children after the separation. the success of the operation is to have a kid, a good citizenship, a kid independent. >> and much of that success depends on their education, which is a major concern for the family. the private school they attended is no longer available to the twins. so the family is looking for a school that can meet their needs. >> translator: i just hope they can go to school, and i think they will need private tutoring to learn how to write. i just want them to go to school, do well, and see them become something big. ♪ happy birthday to you [ singing in a foreign language ]

>> it's been a very long ordeal for these twins, once conjoined. and while they still have many challenges to overcome, ahmed and mohamed by all accounts appear to be incredibly happy as they celebrate their sixth birthday in june 2007. >> translator: frankly, when i saw them conjoined and the medicine doctors, i had no hope. but now everything is good, and i don't ask for more than they have. their progress is more than i could have ever dreamed of. now they are playing and living like other kids. >> i think we showed the world that there should be no price on quality of life. any child should have the opportunity to lead a normal life. and so this is a wonderful story