IamA curator at the Medical Museion where the Conjoined Twins from 1848 are exhibited. AMA!

What ethical and taste issues does the Museion consider when displayed human remains such as those of the conjoined twins?

Great question.

First of all, we follow the ICOM Code of Ethics and specifically their standards on human remains. We will never exhibit anything without a reason. Also, when exhibiting such human remains we try to do it with the utmost respect and care. I personally believe that the case showing the conjoined twins is one of the most beautiful we have in the museum.

There are major cultural differences when it comes to taste. Danes are usually not squeamish, but we did end up posting a notice at the entrance to the exhibition warning parents about the contents. When asked if the exhibition is appropriate for children, we usually say that everyone is welcome but children should visit only in the company of adults.

Unlike big commercial exhibits such as Body Worlds, we are non-profit and our aim is to educate and fascinate. Not make money :)

Hi, and thank you so much for doing this AMA! I'm curious about the exhibit you have regarding obesity and Roux-en-Y surgery. What kind of selection process does the Museum go through to decide what topics will be selected for exhibits such as this? Can you tell a bit more about what kind of information or exhibits are displayed specifically about the Roux-en-Y surgery, and whether only beneficial outcomes are highlighted or if possible drawbacks, complications, or negative outcomes from the surgery are also presented? Also, we know that obesity can be a highly contentious topic; has this affected this exhibit and its reception from museum-goers at all?

Thanks for the excellent questions.

The process of deciding a topic for an exhibit is never the same. But usually, it starts with a fascination from someone in the staff. For the obesity exhibit, we had originally planned an exhibit focused on surgery in general, but during planning we found this particular kind of surgery especially fascinating because it ties multiple areas together (obesity, diabetes, metabolism, etc) that were of special interest to us at the time. So the exhibition in some sense became more narrow in focusing on one type of surgery rather than surgery in general, but also became more broad as we made the overall topic obesity.

In the (surgery part of the) exhibition we display objects used by surgeons when performing RYGB, such as surgicals ports, laparoscopic cameras, ultrasonic scalpels, etc. These are show-cased next to surgical equipment used to perform abdominal operations 100 years ago. There is also some information about alternative surgical procedures, such as the gastric band and the endobarrier.

We have also included video screens featuring interviews with people involved in the surgery, i.e. the patient, the surgeon, the referring GP and a researcher. The each provide their own personal opinions about the pros and cons of the surgery.

Finally, some rather big machines used in surgery for anaesthesia, etc. are included in the exhibit.

Reception generally has been good, although we did receive some criticism for not doing enough to involve local interest groups, e.g. The Danish Association for Obesity.

Hope this answers some of your questions!

Thanks for answering my questions. I have kind of a one-sided view of the Roux-en-Y surgery because I learned about it as a person who is feeding tube dependent from other patients in a support group for tube fed adults. There are a number of patients in our group who had this surgery and due to complications are now feeding tube dependent or TPN (IV nutrition) dependent for the rest of their lives. I would imagine that this complication is quite rare, but I don't know the actual numbers. It's interesting to see what the benefits of this surgery are; it definitely helps me understand better why it might be worth taking the involved risks to have this surgery.

For most people who have this surgery it's a last resort. In other words, they are so heavy that their obesity will kill them unless they lose weight.

Another interesting fact is that people who are also type 2 diabetics are more or less cured of their diabetes when they have this surgery. And this happens within days, so it's not because of weight loss.

That was the most striking information I saw when exploring the information about your exhibit. Diabetes runs in my family, so I found that really compelling. I have a host of other health issues, thankfully not diabetes, but more information about how endocrine diseases work could certainly benefit across other patient populations as well!

Definitely. And the intestines are indeed a very active endocrine organ. Speaking of the gut, our next exhibition project might interesting you too. It's called Mind the Gut and focuses on how the gut and gut bacteria affect our mind and vice versa...

Wow, yes, I will definitely check that out! I had a fecal microbiota transplant last year and have done a lot of research on gut bacteria. The neurological studies (on alzheimer's etc.) that they've done with fecal transplants are utterly fascinating!! As a neuro patient, all of this interests me immensely.

It's so fascinating. We have to stop thinking about the gut bacteria (or any bacteria living inside or on us) as invaders. They are part of what it means to be human. We can't disregard them. They have to be considered in most aspects of health and disease.

You can check out out project website at http://mindthegut.museum, although most content is in Danish at the moment.

Thanks!

You're welcome. Thanks for the questions!

I always wondered... The twins could be separated using modern medicine? Or it would be a desperate case even today?

Yes, it's not unlikely. However, we don't know exactly why they died, so separating them may not have saved them.

Did they share an umbilical cord? Or did each have their own?

So I did a bit of researching and as it turns out they did indeed share a navel and umbilical cord.

After their birth they seemed to have completely separate vital functions. The only thing indicating a internal connection was that when one child's breathing was disturbed (while nursing or crying), the other child face's was slightly flushed...

Fascinating. Thank you for answering!

You're welcome!

I don't know, but I'll see if I can find out! It's late here now, so I'll ask some colleagues tomorrow...

Do you guys exchange any exhibits or work with the Mutter Museum in Philadelphia?

http://muttermuseum.org

Not on a regular basis, however, we do lend objects to other museums. I don't recall any such exchange with the Mütter recently, but I recall lending a very special vial containing a diarrhoea sample(!) from a cholera patient to the Wellcome Collection in London.

I do love the Mütter Museum though!

What do they smell like?

I have never smelled them, but I imagine the two wet specimens smell like formaldehyde. I'll ask the conservators tomorrow!

UPDATE: the dry skin specimen doesn't really smell. The skin is very thin and dry. Different materials were used for the taxidermic preparation, but none of them had any smell.