Hazel McHaffie

ITV

Extraordinary twins: Separate or together?

There are times in life where I’m rendered speechless in the face of courage or fortitude way beyond my comprehension. And this week brought just such a moment: listening to the parents of conjoined twins in the ITV/STV programme, Extraordinary Twins, and to the doctors who undertake this gruelling and risky surgery.

The questions are overwhelming and often unanswerable. As one surviving separated twin said, whatever you decide you will be criticised. Ethics may be my field of interest, but these issues are in a different league from most.

Not only do the families have to contend with the shock of discovery when scans reveal this extremely rare anomaly, but they are then faced with a raft of massive questions.
Do we go for abortion?
If not, how will we feel when they are born?
How will we deal with other people’s reactions?
How will we care for these children?
Will we choose to have them separated?
When is the right time to do so?
How will we cope if one or both then die(s)?
Can we handle the responsibility?
What will it do to us and our family?
Can we live with the sense of guilt?
Will the children resent/hate us for making this decision?
Tears at my heartstrings just contemplating these dilemmas.

All this came across powerfully in the programme, through the experience of families who’ve trodden this path. I was on an emotional and ethical roller coaster throughout.

For some, separation was impossible, the shared parts were too intimately and vitally interconnected and important to each. One set of sisters shared sensations: even feeling the other one being touched, and seeing what the other was being shown! Another set spoke the same words together. In other cases, where separation might be possible, a joint life was deemed better for them, and indeed was way more full than I could ever have imagined. Some pursued different careers, got married, drove a car together!

But for others, the advantages of separation were compelling, though the risks were always huge. The burden of responsibility came across powerfully through the experience of one couple who were very undecided about separation, and inclined to wait till the twins could decide for themselves. They were put in touch with another mum whose girls were joined in exactly the same way – separate heads and torsos, but just one set of legs. Her bright, bubbly girls were now leading separate lives, both with one prosthetic leg and a colostomy bag. Her advice was robust: we parents choose to bring our children into the world; it’s our job to choose what’s right for them. Don’t you want independence for them? she challenged. (This idea of parental responsibility was a view I heard time and again in my own interviews with parents of infants for whom life-and-death decisions had to be made, so it resonated with me.) But this couple remained undecided. They visited other families – where different decisions had been made, met the children, asked them the questions, listened with strong emotion to the replies. And bravely came to their own considered conclusion.

As for the surgeons concerned – well, I can’t begin to imagine the price they pay. The series of operations needed to separate conjoined twins is tremendously complicated and only a small number of surgeons in the world are skilled in this work. They plan meticulously beforehand, every move plotted and rehearsed before they ever pick up a knife. The theatre is packed with people and machinery. Some parts of the procedure take many many hours – in one case 17! Sometimes the surgeons’ stamina and ability to make decisions, as well as the condition of the children, makes it necessary to stop mid-operation and continue another day – seems impossible, huh? Sometimes sadly the separation is a success, but the babies suffer complications like brain damage or stroke. Sometimes they die. But these skilled and exceptional doctors not only bear the responsibility, but also engage emotionally with the families. It was so lovely to watch one cranio-facial consultant visiting the children he had separated, months after surgery, and playing with them so beautifully. Heroes without a doubt.

I salute them all. They moved me to tears. I have absolutely no idea what I would choose in these circumstances.

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Going gently into that good night

Until this week I have to admit that I’ve never watched the soap, Coronation Street. But there was so much hype about Monday’s double bill featuring the suicide of a character called Hayley Cropper, that I felt compelled to see it. After all, exploring real moral questions through fiction is what I’m all about.

For those of you who don’t know, (as I understand it) Hayley (once Harold) is a transgender person who survived local prejudice, married cafe owner Roy, and developed pancreatic cancer. Monday was the day she had resolved to end her suffering by taking a self-administered (don’t even touch the glass, Roy) cocktail of drugs. Cocktail of drugsRoy is hoping against hope that when it comes to it she’ll change her mind and they’ll have longer together. ‘There’s still joy to be had.

I came to this my first episode without any emotional attachments to the Croppers, but the whole scene was handled so gently and sensitively that the millions of viewers for whom this represented a personal tragedy must have found it harrowing. It felt as if we were in that flat with them. The touching last conversations … Hayley’s struggle to iron Roy’s best shirt so he turns up respectably clad for her funeral … Roy’s decision not to have a ‘special’ on the cafe menu on this terrible day … the anxiety and concern of the neighbours … all provided heart-wrenching pathos to the last hours of this desperately sick woman. I haven’t been party to her struggles over the past few months but I have seen other real people die of this horrible illness, and in a way their suffering overlaid Hayley’s for me. Seeing her quiet smile as the music of Vaughn Williams’ The Lark Ascending stole through the room, listening to her settled resolution, watching her determined drinking of that fatal cocktail, the peaceful waiting – I was willing all the assorted well-wishers not to disturb their precious last hours together. This was a moment for absolute privacy and solemnity. And from where I sat, ITV got most of it right.

Whatever we think of the issue of assisted dying, or suicide, or the right to die, this programme provided a useful vehicle to promote discussion. Of the tragic situations for which there are no good options. Of the emotional and physical impact of terrible diseases. Of our responses, our prejudices, our beliefs. Of the current law.

And indeed, Lord Falconer, the former Lord Chancellor, is currently working towards launching another bid in real life to legalise assisted dying under certain clearly specified conditions which will reopen the hornets’ nest for sure. So, hats off to another screenwriter and to ITV for bravely raising the issue in such a way as to get ordinary people thinking about these vexed issues for themselves. If you cared about Hayley’s plight, if you were angry with her for doing what she did, if you threw things at the TV, if you wrote to ITV complaining about their depiction of a suicide … then spare a thought for those for whom such dramas are lived realities. What would your answer be?

A safe distance away I might share another such challenging film production – but that’s for another time. Today belongs to Coronation Street.

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Interviews

You may or may not be aware that I’ve recently added a new page to my website: Interviews. Obviously not all interviews are available in an accessible format, but the ones I’ve done this year that were recorded can be seen at the click of an icon, giving folk an idea of what I think and how I come across. Apparently I do a lot of hand gesturing!

Having added a third interview this week, I was watching other interviews on TV with more than usual interest. And one with Fay Weldon, the veteran novelist, jumped out at me – not just because she has very large hands which she uses a lot close to her face, but also because I’ve actually met, and subsequently corresponded with Fay. We appeared together at a Literary Salon at the Brighton Festival many moons ago, and she gave two of my novels very kind endorsements back in 2005. I was particularly pleased with her comment that they were ‘…medical, ethical, romantic and fascinating. An entirely new genre for fiction‘. Back then it lent credence to my contention that there was an unfilled niche in the market for these stories. Fay Weldon said so!

Anyway, she was on BBC Breakfast this week talking about her new book, Habits of the House, and Bill Turnbull and Susanna Reid asked her lots of good questions. Some interviews come across as very superficial and rigged, don’t they? but this one wasn’t; they seemed genuinely interested and engaged. I discovered that she chose the title because a much-travelled guest in her own home once said, the secret of being an accommodating guest is learning the habits of the house. Fay’s ears pricked at this: an excellent title for a book. I agree, but I like the concept behind the comment too.

There’s a sticker on Habits that says, if you enjoyed Downton Abbey you’ll love this book. No, Fay admitted, she hadn’t watched Downton Abbey – she was ‘too jealous’ to watch it ‘without pain’ – but she was happy with the caption as a marketing ploy. She was also quick to chip in that she was there first, and this I can believe. Publishers have their own speed of working, and the time lapse between conceiving a book and its appearing in the bookshops is considerable, usually years. It’s frustrating when you the author are then thought to have copied someone else’s idea. I’ve had news items as well as TV dramas mirroring points in my plots before my books reach the bookshelves. However, Fay’s an experienced interviewee, and she managed to make all her responses sound amusing and faintly self-deprecating, and she kept her toothy smile fixed firmly in place.

Habits of the House is about a large household with servants and rich masters. I haven’t read it (yet) but the first paragraph sets the tone:

In late October of the year 1899 a tall, thin, nervy young man ran up the broad stone steps that led to No. 17 Belgrave Square. He seemed agitated. He was without hat or cane, breathless, unattended by staff of any kind, wore office dress – other than that his waistcoat was bright yellow above smart striped stove-pipe trousers – and his moustache had lost its curl in the damp air of the early morning. He seemed both too well-dressed for the tradesmen’s entrance at the back of the house, yet not quite fit to mount the front steps, leave alone at a run, and especially at such an early hour.

I draw a veil over the scathing comments my editor would make if I used that many adjectives and parentheses! But then I don’t have Fay’s credentials or track record or sales figures.

She was asked, why this subject? Haven’t upstairs/downstairs stories been done to death? (Now, you might not know it but this question had particular resonance because Fay wrote the first episode of the legendary BBC film, Upstairs Downstairs, broadcast in the 1970s, a fact which I’d forgotten.) Not a bit of it, she said, we’re all interested in injustice, and the haves and have-nots in these large households are just one expression of that kind of inequality and unfairness. Besides this, her personal fascination with the period around the turn of the 20th century, fuelled by her grandmother’s stories and her grandfather’s writing, make such choices natural ones for her.

Habits is the first of a commissioned trilogy and Fay has already finished the second one, so Bill asked her, did she know what happened in the third book? No, she admitted, she had no idea. Wasn’t that daunting? ‘Very frightening!’ Fay admitted. But her laugh and bounce said she would soon crack that little conundrum. And indeed, I know myself that by the time you’ve written two books about characters, they’ve got passports and birth certificates; indeed it can be hard to keep pace with their antics and decisions.

Watching this interview I concluded that I should try to

  • write an episode for a landmark TV series
  • sit on my hands, or at least keep them low
  • find a very good manicurist
  • come across as warm and witty and humble
  • pretend I’m all at sea and it’ll take a miracle or my huge talent to resolve this situation
  • make sure interviewers give my credentials not me
  • read Fay’s book.

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