The story of Safa and Marwa Bibi is one that speaks volumes to the power of compassion. It also shows us just how far medicine has come.

Safa and Marwa are twin girls who were born joined at the head, meaning their skulls were fused together. The girls are what is known as craniopagus twins, the vast majority of whom do not survive beyond childhood.

Once Pakistani businessman Murtaza Lakhani donated the £1 million ($1.3 million) needed to cover the girl’s medical costs, the twins underwent three major operations in February 2019 at the Great Ormond Street Hospital (GOSH) in London. After more than 50 hours in the surgeon’s room, the girls were successfully separated. Now, more than a year since the surgery, the girls have returned home to Pakistan to their delight of their mother.

Lead surgeon Owase Jeelani said he and his team of 100 people were “very pleased” for the family, but he also told the BBC that he still feels some apprehension about the overall outcome. You see, Jeelani was faced with a near-impossible decision to make during surgery. The twins had a network of shared blood vessels which nourished both their brains, and only one twin could receive some of the key blood vessels. Marwa, who was the weaker twin, was given those blood vessels. This led Safa to have a stroke, which has left her with permanent damage to her brain that may never allow her to walk.

“It’s a decision that I made as a surgeon,” said Jeelani, who is a highly experienced neurosurgeon. “It’s one that we made as a team. It’s a decision we have to live with.”

Although it’s not a perfectly happy ending, Safa and Marwa are now back at home where her parents and siblings can take care of them—and that’s a lot more positive than what we typically happens with craniopagus twins.

As for our compassionate surgeon Owase Jeelani, he has gone on to perform more surgeries to separate craniopagus twins. In January 2020, the same surgical team successfully separated twin boys from Turkey who were joined at the head. The process for those twins was much faster than with Safa and Marwa, and they were returned home to Turkey before their second birthday where they are expected to make a rapid recovery.