Outside the Box

When the media spotlight found Dale Swift ’80 in 2003, as he was helping to separate Egyptian twins joined at the skull, it introduced us to a pediatric neurosurgeon who’s not afraid to bypass conventional wisdom to do things better.

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Swift and the four other doctors who make up Neurosurgeons for Children used to work in relative obscurity. They were admired in their field and beloved by their patients, but they were unknown to the rest of us, whose children will never need brain surgery.

That all changed two years ago when a Dallas plastic surgeon approached the practice about separating Ahmed and Mohamed Ibrahim. The Egyptian toddlers were born attached at the skull, with blood vessels draining into each other’s brains.

The neurosurgeons took a year to research the Ibrahim case and any similar surgeries. They weighed their options, questioned the ethics and risks, built models, drew plans. Swift spent a day in Los Angeles with surgeons who had separated Guatemalan twins. During a meeting in Japan, he talked to doctors who successfully separated twins from Nepal.

Children’s Medical Center of Dallas, where Swift’s practice is based, was a good fit for the undertaking. Children’s specializes in pediatric surgical and intensive care support along with its strengths in neurosurgery, cardiology, hematology, and oncology.

The thirty-four hour operation in October 2003 involved sixty medical personnel who rotated in and out of the OR – among them the five neurosurgeons, two craniofacial surgeons, a pediatric plastic surgeon, general surgeon, oral surgeon, nine anesthesiologists, and six pediatric nurses. All of the staff members donated their time. A special surgical bed to hold the conjoined boys was also donated.

The hospital’s public relations team conducted their own year-long preparations for the onslaught of media attention. A sea of satellite trucks set up camp for a week, with national reporters broadcasting live outside the hospital, once the Ibrahims arrived at Children’s. The p.r. staff scheduled press conferences each morning and afternoon of the operation to provide updates from the surgeons while protecting the medical staff and the twins’ parents from prying reporters.

"We had to prepare for the worst," remembers Reyes Abila, hospital public relations director. "We were carrying death statements with us, just in case."

Instead, the surgery was successful. Headlines proclaimed, "We have two boys!" Today, one year later, those boys are learning to walk, talk, eat, and play – all of which pleases their neurosurgeons. After undergoing one last procedure this winter to reconstruct the boys’ skulls, the family plans to return home to Egypt.

To see so many people all around the world following the twins’ story was "heartwarming," Swift says. But the press attention? "Irritating."

Once the procedure was mapped out and the special bed constructed, the surgical work itself was not that challenging, he says. "We’ve done longer surgeries, more complex cases with complicated tumors, operations with more potential for blood loss or death."

Suddenly, though, his work got noticed. Back home in Lorain, Ohio, his mother was telling a friend in the grocery store about her son’s involvement in separating the twins. A stranger, overhearing the conversation, ran up to give Mrs. Swift a hug.

Swift grew up in Lorain, the oldest of three kids. His parents came from Pittsburgh, where his father worked in the coal mines to put himself through school to become a psychologist. His mother taught kindergarten. Swift worked in Lorain’s steel mills during summer breaks from Wooster.

He came to the College thinking he would study psychology, but the brain’s chemistry soon intrigued him. Ted Williams (chemistry, emeritus), his I.S. adviser, remembers Swift – who was Phi Beta Kappa and earned many departmental honors – as a "maverick." "He made it clear he wasn’t interested in the mainstream," Williams says.

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