- .Gracie Attard was born a Siamese twin, joined to sister Rosie end to end
- .The girls, born in 2000, shared an aorta, a bladder and circulatory systems
- .Yet while little Gracie was robust, Rosie was weak and ailing
- .Doctors believed unless the girls were separated, both would die in months
- .But separating the sisters would kill Rosie, who needed her twin to survive
- .Rina and Michael could not bring themselves to allow one daughter to die
- .Three Appeal Court judges decreed the twins should be separated
- .Rosie duly died, three months, six hours after the complex surgery
- Gracie, now 14, gives her views on her origins for the first time
Bright: Gracie, who was born a Siamese twin, is now 14 and is determined to become a doctor
Only little by little did Gracie Attard learn the story of her twin Rosie, the sister who’d died shortly after their birth. There was no sudden revelation, just a drip-feed of information; a slow-dawning realisation.
‘Mum and Dad used to take me to the cemetery where Rosie is buried and tell me: “She’s your sister, and you were twins.” Actually, they said we were joined together,’ she says. ‘Later I heard them use the word “conjoined”. I didn’t know what it meant, and when I was about seven I got my first dictionary and looked it up.
‘Then I felt confused, but I said to Mum: “I know what it is now,” although I still didn’t really understand.
‘A year or so later, I looked on the internet and found out that our story was a big one that went round the world. I didn’t think about that. I just wanted to know exactly what happened.
‘I read the stories and it felt as if I was reading a book about someone else. I didn’t exactly feel detached, but I wasn’t really involved either. It all happened so long ago, when I was a tiny baby.’
Gracie is 14 now, and a livewire. Shrewd, funny and voluble, she loves to cycle and swim. She is determined to become a doctor and has strongly held opinions on most things.
But for a few intensely fraught weeks after her birth in a Manchester hospital on August 8, 2000, her very existence was the subject of an ethical debate that gripped the world.
Gracie was born a Siamese twin, joined to her sister Rosie, end to end, at the abdomen and spine. They shared an aorta, a bladder and circulatory systems. Their tiny legs were splayed at right angles from their shared trunk.
Yet while Gracie was robust, Rosie was weak and ailing. In fact, Rosie was only alive because of Gracie. It was Gracie’s healthy heart that was pumping blood into her sibling. In effect, Gracie was her twin’s life support system.
What should be done? Opinion was polarised. Doctors believed unless the girls were separated, within months both would die. Yet separating them would kill Rosie. So should her life be sacrificed to save Gracie?
For Michael and Rina Attard, the twins’ parents, the dilemma was heartbreaking. Both devout Catholics, they had never considered aborting the twins when scans revealed they were conjoined. They could not, therefore, bring themselves to allow one to die to save the other.
So they resolved to leave their girls conjoined. ‘We decided it was better to put their future in God’s hands,’ says Rina.
But they were over-ruled by the judiciary. Three Appeal Court judges decreed the twins should be separated. At this point the Attards decided to fight no further. Rosie duly died, three months, six hours after the complex 20-hour surgery to separate them, at St Mary’s Hospital on November 7, 2000.
Gracie, of course, lived. And although doctors were cautiously optimistic, her progress has surpassed all expectations.
Her legs were broken and re-set in the correct position; her misaligned pelvis straightened. ‘She should walk and lead a relatively normal life,’ said one of her surgeons at the time.
Gracie, however, has amazed everyone with how she’s coped.
Last week, Judge Sir Alan Ward, the former Lord Justice of Appeal who had ruled the twins should be separated, spoke at the Cheltenham Literary Festival about Gracie and how she has prospered.
Tribute: Gracie with dad Michael, mother Rina and younger sister Rosie - named in memory of her twin
He was there with novelist Ian McEwan whose latest book focuses on parents and the dilemmas posed by their ethical beliefs when their children are sick.
Gracie has never spoken before. She has neither given her views on her origins nor disclosed how she felt when she learned her sister had died so she could live. The questions are complex and challenging.
But now — a bright teenager with a sharp, questioning mind and strong, cogently expressed views — she’s talking exclusively to the Mail at the home on the Maltese island of Gozo she shares with her parents and 12-year-old sister, also called Rosie in memory of her dead sister.
‘I wish baby Rosie was here, obviously, but she died when I was tiny so I don’t have any memory of her,’ says Gracie.
Heartbreak: Michael and Rina with Rosie's coffin. Both devout Catholics, they never considered aborting the twins when they found out they were conjoined
‘I don’t feel guilty that I lived and she died because what happened wasn’t my decision. I haven’t cried, but there is sadness. Sometimes I want her to be with me. We were the same age. We’d probably think like each other.
‘Sometimes when I need someone to help me, say when I’m taking an exam, I’ll say in my head: “Help me, my little sister.” Because that’s what sisters do. They help each other, don’t they? And I’ve thought: “Would she look like me? Would we share the same interests?” ’
Gracie has learned — via the internet, and perhaps earlier than her parents would have wished — about the moral debate provoked by her birth; about the vexed questions her parents faced.
Vibrant: Today Gracie, pictured left aged three, is utterly engaging company. She says she would like to go back to England, though her parents, entrenched in their close-knit community have never been travellers
‘I understand how difficult it must have been for Mum and Dad,’ she says. ‘I think I’d have died if we hadn’t been separated — and I’m alive. I thank God for that. I don’t think too much about what might have been. The best is here. I just think of myself as very lucky.’
If Gracie’s approach is mature, considered, forensic, it is because she has the mind of a scientist.
Her favourite subjects are chemistry and biology. She corresponds regularly by email with one of the surgeons, Adrian Bianchi — also Maltese and a Catholic — involved in the operation to separate her from her twin.
Sometimes when I need someone to help me, say when I’m taking an exam, I’ll say in my head: “Help me, my little sister.” Because that’s what sisters do. They help each other, don’t they?
Gracie Attard
‘I tell him about my exams, and that I’m doing well,’ she says. ‘And if I have any questions he says: “You’re welcome to ask.” ‘I’d like to be a doctor, perhaps a children’s doctor, because I want to help people. Maybe it’s because doctors saved my life, but I think I’d want to anyway,’ she says.
Gracie has a crackling wit and barely draws breath as she chatters. At 14, she believes she’s far too young to have a boyfriend — ‘I want to enjoy my life first!’ — but eventually she’d like to marry and have a brood of children. When I was five, I thought I’d like to have ten children,’ she says, ‘but I’ve revised that figure now. I don’t want that many because I’d be working day and night to provide for them. I’d never leave that hospital!’ she laughs.
I ask her what she imagines life would be like for her parents if she wasn’t around. ‘Very quiet,’ she deadpans.
It is difficult, meeting Gracie and seeing how she thrives both mentally and physically — her dainty legs carry her effortlessly; her mind buzzes with ideas — to imagine her parents’ shock when she and baby Rosie were born.
Michael, a plasterer, now 58, and Rina, 48, a full-time mum, travelled to England for the birth because their tiny Mediterranean island did not have the sophisticated medical facilities or expertise to cope.
Support: Gracie, pictured aged three with little sister Rosie, said that she turns to her twin when she needs help
Rina recalls the awful fear that consumed her in the weeks before the birth. ‘I didn’t want the twins to be born because I knew something was terribly wrong. I just wanted them to stay inside me,’ she says.
‘They gave me a Caesarean and I asked to have a general anaesthetic because I wanted to be asleep. When I came round they were in the neonatal unit and to start with, I couldn’t look at them. It was two days before I saw them, and when I did I fainted.
‘Michael helped me up. He said: “Just start by touching their fingers.” So I did. Little by little I stroked their tiny hands. You have to understand that then, in Gozo, if you had a handicapped child it was something frightening. There was superstition. But now it’s more accepted; we know handicapped people just have different needs.’
We held her for four or five hours. We were expecting her to die but there were still many tears
Michael Attard
Michael, gentle and quietly spoken, swiftly saw beyond the twins’ physical abnormality, and love consumed him.
‘I went to look at them two hours after they were born,’ he says. ‘They were covered in a blanket. I didn’t see the extent of their problems. Then I went again, and again. After a while, you just start seeing them as two normal babies. You get used to how they are. I washed them every morning. I talked to them and Gracie seemed to respond.
‘She smiled. They used to kick each other, too, and I could see the spirit in Gracie even then. I’d tell her: “You’re the little naughty one.” She had a loud cry. When she wanted some milk you knew about it. The nurses would come running with the bottle.’
Yet set against the burgeoning love they felt for their girls was a deep, abiding fear. ‘The doctors told us Gracie had a good chance of surviving if they were separated, but I couldn’t see how she’d live,’ says Rina.
‘I thought: “How can they not die if they’ve been cut apart?” We didn’t want the operation. At the time there were so many unforeseen things. Would Gracie spend her life in a wheelchair? Would her brain work properly?
‘I was so scared. It was all shocking, so overwhelming, and we were under so much pressure. So we thought it was better to leave it to God to decide what would happen.’
Daddy's girl: Rosie takes after her Dad, both in looks — her hair is lighter than Gracie’s, her olive skin darker — and personality. She is quieter, her humour drier. Above, Michael and Rina with Gracie
In the event, the High Court ruled that medical science should intervene. ‘And we accepted that decision,’ says Rina. ‘And, of course, now I look back and we’re grateful. The right decision was made. It was the best option. But I still have days full of sorrow when I think about the Rosie we lost, but it turned out for the best.’
Their grief, however, was raw when Rosie died, just hours after she was separated from the twin who sustained her. Her tiny, inert body was brought to them. They dressed her in a white satin suit and wrapped her in a shawl.
Michael says: ‘We held her for four or five hours. We were expecting her to die but there were still many tears.’ Racked with sorrow, they brought Rosie home for her funeral: the whole island, it seemed, turned out to mourn the baby who had died so her twin could live.
Meanwhile, little Gracie, in the care of doctors and nurses in Manchester, was prospering. Within days she started breathing without a ventilator; she drank voraciously from her bottle.
Determined: Gracie, pictured aged three with her family, has prospered since the operation that separated her from her twin shortly after her birth
‘We stayed for five weeks on Gozo when baby Rosie was buried, and rang the hospital every day,’ says Rina. ‘And when we got back to Manchester Gracie recognised us. She was smiling. One of the nurses had taught her to say her name. It was her first word.’
When she was ten months old, in June 2001, Rina and Michael took Gracie home. ‘It was a very happy homecoming. The whole family welcomed her: aunties, uncles, cousins,’ says Michael.
And so, after almost a year’s absence from their quiet island, during which they’d lived in a hospital in the cosmopolitan bustle of Manchester, the Attards returned to the three-storey house Michael had built in the remote hillside village of Xaghra.
The couple watched with quiet pride as their little girl grew; as she learned to talk, then, at 17 months, to walk; as her sense of mischief developed and a competitive streak emerged.
Today Gracie is utterly engaging company. She says she would like to go back to England, though her parents, entrenched in their close-knit community have never been travellers.
‘We aren’t the sort to go on holidays,’ says Rina. ‘We’ve only been away once — and that was to Manchester when the twins were born.’
‘But I’d like to travel,’ says Gracie. ‘I want to go to England one day, perhaps to go to university — even if I have to swim to get there!’ Her endless chattering earns a gentle teasing from younger sister Rosie, who was born in August 2002.
‘Oh Gracie stop it,’ says Rosie. ‘You talk too much. You’ll send us all to sleep!’
The two girls share the jokey affiliation of siblings. They tease each other constantly and good-humouredly. Firecracker Gracie, dark-haired and pale-skinned, is the image of Rina.
Rosie takes after her Dad, both in looks — her hair is lighter than Gracie’s, her olive skin darker — and personality. She is quieter, her humour drier.
‘So now, whenever someone says my name they are reminded of baby Rosie,’ she explains. ‘And I like that. I’m glad I’m named after my sister.’
Rina recalls her second pregnancy, and the trepidation that accompanied it. ‘I was fearful throughout it,’ she says. ‘I just thought I was a woman who had bad luck. Even though the doctors told me all was well, I still didn’t believe them. I didn’t even trust the scans.
‘And when Rosie was born, I couldn’t open my eyes to look at her. But then Michael said: “Look! We’ve got a beautiful girl,” and the nurses put her on me. Then I opened my eyes and I saw her, and smiled.’
Since then, Rosie, too, has prospered. The first girl in her village to join the Scouts, she describes herself as, ‘adventurous: neither a girly-girl, nor a tomboy’.
She, like Gracie, has ambitions, and wants to become a lawyer. ‘I think I’d be interested in that. I like crime,’ she says.
Michael, ever the indulgent father, looks at his girls with amusement. Rina is clearly proud. They sit in their house, which is tidy and plain, an image of Christ, a photo of the old Pope John Paul and another of Our Lady presiding over them.
Their faith remains strong.
‘We made the decision we thought was the best one for the twins at the time,’ says Michael. ‘But let’s say we’re happy with how things turned out.’
‘Yes,’ adds Rina, smiling. ‘We are very glad now that God had a bit of help from the surgeons.’
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