Thursday, August 14, 1997
Couple put faith in doctor
Jewish twins survive birth,
share Muslim physician's name

BY MARK CURNUTTE
The Cincinnati Enquirer

Doctor and twins
Dr. Tariq Siddiqi holds twins Gabriel Tariq Fine Koreman and Elijah Tariq Fine Koreman.
(Michael E. Keating photo)
| ZOOM |
The day after Islamic suicide bombers killed 15 and injured 150 in Jerusalem's major outdoor market, a Jewish family from Mount Washington took home twin sons named for the Muslim doctor who saved their lives.

The tribute's larger meaning was not lost on the grateful parents, Tammy Fine and Jeff Koreman, or the doctor, Tariq Siddiqi, a Pakistan-born specialist in high-risk pregnancies at University and Christ hospitals.

"Once you come outside of your environment and see ethnic or religious groups that are looked upon as people you're supposed to hate, you see that they are the same as you," said Dr. Siddiqi, 45. "If religion is practiced the way it's preached, there is no faith that says harm or hurt each other."

The twins' names are Gabriel Tariq Fine Koreman and Elijah Tariq Fine Koreman. They were born July 11 at University and left the hospital July 31.

"The boys wouldn't be here if not for Dr. Siddiqi," Ms. Fine, 33, said. "Our religious views are God is God. Specific faith is immaterial. Dr. Siddiqi is one of the greatest people we've ever met."

It was March when Ms. Fine's sister, Dr. Mindy Hastie of Indian Hill, suggested she see Dr. Siddiqi. During her 18th week of pregnancy, Ms. Fine's abdomen grew 13 centimeters, an abnormally large increase. Dr. Siddiqi made an immediate diagnosis, Twin to Twin Transfusion Syndrome. It strikes 5 percent of all twin pregnancies but only identical twins, who share a single placenta. If left untreated, the syndrome is fatal in 9 cases out of 10. Of the estimated 6,000 U.S. babies afflicted each year, 4,000 die. Even after receiving treatment, many die.

In the syndrome, one fetus receives too much blood, the other too little. The fetus that receives more blood - in this case, Gabriel - develops a larger heart and too much amniotic fluid.

The smaller fetus, know as the "donor" or "stuck" twin, develops in a small, dry sac and eventually becomes plastered against the wall of the uterus. That was Elijah.

Elijah was essentially pumping nutrient-rich blood into Gabriel, who was producing great amounts of fetal urine to try to compensate for the fluid rush.

Dr. Siddiqi gave the couple three choices:

  • Do nothing, which would likely end with the fetuses aborting themselves.

  • Experimental laser surgery, which is available in only two hospitals in the United States - none in this area - at a cost of $18,000.

  • Serial reduction amniocentesis, which Dr. Siddiqi said is as effective as the second option. The logic: By decreasing the amount of fluid in the big sac, the flow of fluids between the two sacs might increase.

Guided by ultrasound pictures, Dr. Siddiqi extracted fluid from the large sac five different times between early April and the boys' July 11 birth by Caesarean section. He stuck a needle through Ms. Fine's abdomen and directly into the larger sac.

"No one knows exactly why this can work," Dr. Siddiqi said. But it did in this case.

Within weeks, the small fetus began growing in a sac that was filling with fluid. The size of the sacs began to balance.

Gabriel, who grew in the larger sac, weighed 6 pounds. Elijah was 5 pounds, 4 ounces. They were born six weeks early.

On July 29, Dr. Siddiqi also performed the ritual circumcision, the bris, at University Hospital. The family's rabbi, Richard Steinberg of Isaac M. Wise Temple in Amberley Village, officiated. "His instincts and intuition are amazing," Mr. Koreman said of Dr. Siddiqi. "He couldn't tell us what to do, but Tammy said, 'If I were your daughter, what would you suggest?' And he gave us an honest answer. He was so cool, collected and calm.

"We'll never forget him."