[3] Arlene Aguirre, a Silaynon nurse working in Manila, discovered at her four-month ultrasound that her sons were conjoined twins.
[4] As a Catholic, she refused to have an abortion, and gave birth to Carl and Clarence on April 21, 2002, ten days before her due date, via C-section.
[4] By February 2003, the boys had difficulty eating and were often ill.[4][5] The Philippine Airlines Foundation and the American nonprofit Children's Chance helped Arlene connect with New York neurosurgeon James T.
[4] Goodrich's team spent six months researching, preparing, and communicating with the Aguirres' doctors in the Philippines before they accepted the case.
[6][4][7] In September 2003, tissue expanders (pouches filled with saline) were implanted under the boys' scalps to create more skin to cover the twins' wounds after separation.
[9][10] On August 4, 2004, the final surgery was completed and, at two years old, Clarence and Carl became the first craniopagus twins to be separated using a staged method.