Accidental Brothers

by Dr. Nancy L. Segal

  Carmelo was tall at nearly six feet and lean and tan from working hard outdoors. They had met as neighbors when she was sixteen and he was twenty, then married and started a family after he completed his military service. Carmelo lived in casual shirts, blue denim or khaki-colored jeans, a broad-rimmed hat, and high rubber boots to protect against the mud. Like his wife, his lined face and hands made him look older than he was. He seemed to always need a shave to smooth out his beard, as well as a dentist to replace several missing teeth. No doubt he also suffered bitterly from the death of their older child.

  * * *

  Ana’s contractions had already started, so she was feeling desperate to reach the hospital in Vélez. The possibility that she was experiencing false labor—the kind in which contractions are irregular and spread out, rather than real labor in which contractions are regular and close together—did not cross her mind.1 Still, something was going terribly wrong with this pregnancy, her seventh. Ana had delivered one girl and five boys. Most of her children had been born at home, as was customary for the women of her tiny district, because the hospital was far away and usually unnecessary for giving birth. But this time Ana had no choice because she had become increasingly ill since her fifth month. Even scarier was the real possibility that she was carrying twins, a high-risk pregnancy under any circumstances—too little womb space for two babies, as well as high maternal blood pressure, especially in women older than forty, can imperil such pregnancies. And twins are four times more likely to die from the hazards of delivery than nontwins.2

  Ana’s home, a simple wooden structure without electricity or running water, was about seventy miles from the modern hospital in Bucaramanga, the capital city of Santander, the Colombian department, or state, that includes La Paz.3 She had successfully delivered five of her six older children at home, but its extreme isolation, lack of modern conveniences, and inaccessibility to urgent medical care made it no place for a difficult pregnancy and delivery. Her only option was to deliver her babies at the local hospital in Vélez, and the only way to make it through the first part of the journey to La Paz was on foot—people in her remote area were used to hiking long distances because there were no roads. From La Paz, Ana would need to get to Vélez, a long four-wheel drive across uneven terrain, rocky streams, and muddy corridors. She began her journey at six o’clock in the morning and arrived at the hospital at two in the afternoon.

  Ana had only a vague idea that she was about to deliver identical twin sons, William and Wilber, her seventh and eighth children. That night, weak and exhausted from a caesarean section delivery, she caught only the slightest glimpse of her two premature babies, who were quickly taken from her for physical evaluation. The baby she named William was fragile, unable to digest or eliminate normally. He required more intensive treatment than the simple hospital in Vélez could offer.

  “Do you have family in Bucaramanga?” her doctor wanted to know. He reasoned that relatives could bring the infant to the better-equipped medical facility there, stay with him, and return him to his parents when he recovered. But Ana had no relatives in Bucaramanga. “What about Bogotá, much farther away?” Yes, her younger sister Edelmira lived there. So the next day Ana’s mother, seventy-six-year-old Eva Castillo, who lived in La Paz, made the 120-mile, six-hour journey to the Hospital Materno Infantil with baby William, riding a bus all the way on via Vélez Chipata. Subjecting a fragile, sickly newborn to potential infection from other riders and the uncertainties of public transportation was risky, but ambulances and medical vans were unavailable at such short notice.

  The baby was wrapped in blankets, which made it hard to see his face. After bringing him to the hospital, where Aunt Edelmira was waiting, Eva returned to La Paz. The plan was for Edelmira to bring William home to Ana and Carmelo a week later by ambulance. For his return trip the baby was again completely concealed by blankets wrapped tightly around him. Tubes stuck out from everywhere. You couldn’t see his face.

  * * *

  On December 21, 1988, two days before Ana Delina’s baby William arrived in Bogotá, another mother, thirty-six-year-old Luz Marina Castro Chavez, gave birth to identical twin sons, Jorge and Carlos, at the city’s Hospital Materno Infantil. Luz was forced to use this public facility because she had lost her health insurance. Four years earlier she had had health insurance as a seamstress employed by the Manhattan Company and she had delivered her older daughter, Diana Carolina, in one of Bogotá’s preferred public clinics, the Clinica San Pedro Claver. But that job had ended when the company closed, and her children’s father, Norman Enrique Bernal Triviño—who was still married to someone else—was rarely around and hardly supportive.

  Luz was a slim beauty. A photo taken when she was twenty-four for her official identity card shows shoulder-length brown hair, dark eyebrows, and a flawless complexion. In her later years Luz cut her wavy hair short and put on several pounds, but retained her natural attractiveness. She was a hard worker, willing to do whatever it took to keep her growing family healthy and safe. Abandonment by her partner did not demoralize her—instead, Luz resolved to make the best of things as life progressed—but in photos taken in those years she never appears to be fully smiling. Several of her sisters lived with her and helped her raise her two sons and daughter, and some donated money for the boys’ schooling. Luz had great respect for education and would encourage her children to achieve all that they could. She ruled with a velvet glove minus the steel fist, an approach that would cause her kids to laugh, not to cry.

  Luz’s babies were born somewhat early, at thirty-five weeks, which is about the average length of a twin pregnancy.4 However, the twin baby she named Carlos was anemic and needed medicine and extra care. Luz saw her babies just briefly after they were delivered because they were immediately transported to incubators in the nursery. She remained in the hospital for five days to recover from her caesarean section delivery. Most twins delivered by planned C-section have better outcomes than those delivered by intended vaginal delivery; this was known in 1988, when the Colombian twins were born, and remains true today.5

  Conditions in the nursery were chaotic. Luz’s sons were two of the approximately ten to fifteen babies delivered at the hospital each day by the same physician and several physicians worked there. After they were born, a staff member attached adhesive tape with handwritten identifying information to the infant’s wrist. Premature babies like Jorge and Carlos (those born before thirty-seven weeks) were sometimes placed together on a large table.6 Luz’s older sister Maria Teresa recalls seeing one of the newborn twins with a small identification band wrapped around his tiny wrist. “Babies can rip these bands off by themselves,” the nurse told Maria Teresa. And according to Maria Teresa, because the babies were born just days before the Christmas holidays, “the nurses were probably drunk—seriously!”

  Of course, by the time Luz was well enough to spend extended time with her babies, someone had already mistakenly switched the twin she had named Carlos with Ana Delina’s infant twin named William. Luz had no way of knowing this, nor did anybody else. Like all new mothers, Luz accepted the babies brought to her by the hospital staff and never thought that something was amiss. Why would she? Why would any new mother question whether the infants handed to her were hers? Even when babies do not resemble their biological parents, mothers find ways to justify their newborns’ appearance, usually attributing any differences to their partner’s side of the family—“dark-skinned like his grandfather” or “light-skinned like his uncle.” That mothers generally attribute infants’ unusual looks to paternal relatives is probably no accident. Because of women’s hidden ovulation, internal fertilization, and continuous sexual receptivity, a man can never be certain that a child delivered by his partner is truly his. Evolutionary reasoning suggests that her attribution of differences to the father may actually help reassure a man that he is truly the father, but whether newborns actually resemble their fathers more than their mothers and the significance of father
-child resemblance for childcare and investment are widely debated.7

  Both Luz and Ana grew increasingly aware of their sons’ lack of physical similarity to each other as they grew up. And the lack of resemblance of one boy to the rest of their family also became more evident. However, each mother decided that the whimsical ways of gene transmission, mostly on the father’s side, were responsible. They had no idea that the minute Carlos arrived in Bogotá, a series of events had transpired to keep him there and send William to live in La Paz in his place. The twins’ lives and the lives of their families had taken a drastic detour.

  * * *

  Jorge and his brother Carlos (who was really Ana’s child) came home four days after their birth to a five-room house in Bogotá’s working-class neighborhood of Quiroga. The twins were breast-fed one at a time by their mother while their aunt Blanca Cecilia held the other one.

  Doctors had advised Luz to engage her twins in “kangaroo care,” the practice of daily skin-to-skin contact between mothers and newborns, especially preemies, to promote body warmth and psychological well-being.8 The physicians Edgar Rey Sanabria and Héctor Martínez developed kangaroo care in Colombia in 1979. Luz used this method with Jorge while a cousin, Patricia, did the same for Carlos. Their division of labor suggests that Luz spent more time feeding, bathing, and playing with Jorge than Carlos; if so, this seems odd at first because Carlos was the sickly baby and needed more attention. However, mothers of extremely low birth-weight twins often favor their healthier infant.9 Explanations include more favorable perceptions of the healthier twin and less positive feedback when mothers direct their attention to the less healthy twin. Of course, these differences are relative, may shift with family circumstances, and do not imply neglect or abuse of the less healthy twin. However, twin babies are more likely to be abused or maltreated than nontwins because of financial pressure and/or lack of support in some families. When only one twin is abused, it tends to be the less attractive or less healthy one.10

  Jorge may also have looked and sounded more familiar to Luz. As an infant Jorge looked a lot like his older sister, Diana, when she was born—even his ears stood away from his head at the same angle. And the cries of babies as young as two to five days old mimic the melodic patterns of their mothers’ native tongues, sounds they heard while in the womb.11 Both Luz and Ana spoke Spanish, but Luz’s educated, soft-spoken speech contrasted sharply with Ana’s fast country dialect. Perhaps Luz was unknowingly drawn to Jorge’s more familiar baby noises.

  * * *

  Neither Ana Delina nor Luz Marina ever suspected that one of the twins they were raising was someone else’s child. That is much less surprising than it seems. Questioning whether a baby is truly hers is not part of the human female psyche. During the course of human history women typically gave birth at home, attended by several relatives or friends, so they had no need for such concern. Today most babies in the United States are born in hospitals where room for error clearly exists, yet few women worry—an evolutionary legacy.12 Ana Delina delivered all her older children at home except for Edgar, the child closest in age to the twins. Delivering Edgar in a hospital was a better plan at that time because Ana’s mother was away and no one was available to assist in her delivery.

  Human lives intertwine and intermingle in unexpected ways. We cross paths with hundreds of strangers, often on a daily basis, but only a fraction of these people become our friends. No one could have imagined that, twenty-five years later, two pairs of accidental brothers living 150 miles apart—William and Wilber in a tiny isolated rural community, and Jorge and Carlos in a lively metropolitan capital city—would learn that they were mismatched identical twins, not fraternal twins at all.

  Accidental Brothers

  Who we are and how we got that way partly reflect the social influences in our cultures and communities. But we are not blank slates upon which family, society, and other external influences leave a predictable or indelible mark—this outmoded thinking, which dominated American psychology from the 1920s through the 1970s, has been replaced with a more reasoned, balanced view, thanks to genetics-based research on behavior and disease. Except for identical twins, everyone has a unique set of about nineteen thousand genes, which interact with environmental events to shape our abilities, temperaments, and tastes.13 Reunited identical twins are the privileged few who can see how their genes perform in places they have never been and with people they have never known. The rest of us can only imagine how things would have turned out had we lived in a different neighborhood, gone to a different school, or married a different person.

  This book describes the exciting days that followed my learning about the Colombian twins, tempered by the knowledge that many lives were in disarray. I also experienced the thrill of starting a collaboration with a new colleague in Colombia, a place I had never been. I had seen and listened to the twins on TV and wanted to know more about them: Did they play sports and listen to rock music? Did they have romantic partners or were they unattached? What truly defined each of them? Most important, what were the switched twins, William and Carlos, doing and thinking when they learned that the lives they were living belonged to someone else? Also, the mysteries surrounding the exchange of the two babies were deepening, a perplexing and frightening, yet unanticipated prospect for all expectant parents. And central to this story is what my colleagues and I learned about the similarities and differences in the real twins’ abilities, personalities, habits, and mind-sets during our memorable days in Bogotá and one extraordinary day in La Paz. Events from this first visit were captured in a New York Times Magazine article published several months later.14

  Accidental Brothers tells the story of four young men—Jorge, Carlos, William, and Wilber—who found out that almost nothing about their lives was as it was supposed to be. We explored the lives they lived, the lives they lost, and the lives they gained, helping them and our colleagues make sense of the twins’ similarities, their differences, their identities, and their futures. We followed their transition from fraternal to identical, from city to country, and from anonymity to celebrity. Their resilience impressed us as they became four brothers, not just two, which they did with grace and good humor.

  The days in Bogotá brought surprises, expanding my thoughts about behavioral origins and outcomes. Because of these twins I grew wiser in many ways. My time spent with the accidental four was precious because of the insights I gained, not just from testing but from the comments, looks, and gestures the twins casually expressed while we snacked in local food shops, rode around Bogotá in taxis, or relaxed in my hotel lobby. More than twins, they were young men who were mulling over career plans, relationship issues, and other personal goals when their nightmarish circumstances began to unfold. I marveled more than ever at the parade of unexpected events that takes us from place to place. These visions are at the heart of Accidental Brothers.

  Chapter 1

  A Dubious Double

  Brothers from La Paz

  Some twins seem to belong together, but others don’t. Abby and Becky Moore are fraternal twins, but you would never know it to look at them. Abby’s long blonde hair and bangs border her round face and forehead, while Becky’s short red hair accentuates her thin face and freckles. At age seven Abby towered nearly five inches over her sister and was eighteen pounds heavier. When the twins attended a birthday party, a friend’s mother, who did not realize they were fraternal twins, actually introduced them to one another. But Becky looks a lot like her older brother, Adam.

  No one would think that the Spooner-Durrant sisters are twins, but Lauren and Hayleigh are a fraternal pair. Lauren has the complexion of their fair-skinned mother, Alison, while Hayleigh resembles their dark-skinned dad. The twins’ physical divergence is striking, but perhaps not surprising since many different genes working in concert significantly affect skin color.1 Each twin apparently acquired different sets of those genes from each parent. In an unusual quirk of fate several years later, Alison deliv
ered her second set of fraternal female twins, Leah and Miya, who show the same contrasting appearance as their older sisters. Bystanders seeing the family walk through a shopping mall or enjoying a Sunday brunch might easily assume that the different children were either adopted or brought together by their parents’ second marriage, but they would be wrong: the children in both pairs are ordinary fraternal twins, conceived naturally like any other pair.

  William and Wilber, and Jorge and Carlos, became unwitting members of an extremely rare group of “presumed twins.” Such twins may, or may not, show the skin color contrasts of biracial twins like Hayleigh and Lauren, and Leah and Miya, but they hardly look related. In fact, these presumed twins are accidental brothers and sisters, brought together by a random act of fate—the inadvertent switching of two babies in a hospital nursery. But people believed that William and Wilber were fraternal twins—after all, their mother had a multiple pregnancy and two babies came home. People often tease presumed twins and their families because it is hard to imagine how the same couple could produce two such different children. However, most people know that fraternal twins inherit different genes from their parents, sharing an average of 50 percent of their biological relatedness, just like full siblings—and this bit of knowledge helps them reconcile the differences they see. Still, the extremely divergent looks and behaviors of these twins become a constant topic of conversation, more so as they grow older. That is because genetic influence on individual differences, known as heritability, becomes more important over time, emphasizing the twins’ differences even more. This happens because as adults we move away from our families and gain greater control over our environment, so our choices are better reflections of our genetic predispositions. Genetic effects are amplified as we age.2