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t m c » p u l s e | n o v e m b e r 2 0 1 7 29 cases fit in with certain complex clinical conditions, most doctors don't recognize. But through this lens of understanding the interactions between reconstruction and allotransplantation, clinical solutions emerge that were previously unidentified. Hopefully, enough people have heard about this … that they'll be able to identify us as a resource when these kinds of rare cases come around." Meanwhile, Mary Jane continues to inspire awe in everyone who hears about her donation to Marian. For the Fields sisters, though, it was a no-brainer. "I'm not surprised by what she did," Marian said. "She knows that if the tables were turned, it would be the same for me." After all, they are two halves of the same whole. When Marian and Mary Jane were still in the womb, the doctor listened to their mother's protruding belly during checkups and heard one strong heartbeat. He con- cluded that one large baby was on the way. In reality, two hearts were beating as one. Sixty-six years later, their hearts continue to beat in perfect harmony. "We were in sync even back then," Mary Jane said. "We're not just sisters and we're not just twins. We're best friends. What we have is special." We get along really well. It seems silly to force a separation. If we lived in separate houses, we would always be at each other's house. It's just nice to have your best friend around all the time. — MARIAN FIELDS Soft-tissue sarcoma patient "There is some poetic element to bring- ing a new level of closeness to two people whose bodies and minds were already so connected," Selber said. When the twins woke up from anesthe- sia, they both immediately asked Selber how the other was doing, before asking about themselves. Both procedures went smoothly, but Mary Jane had a slightly more challenging recovery than expected due to the 25 years of steroid medication for her pituitary condition. "You can't die. I can't live with that guilt," Marian said to Mary Jane over the phone from the room next door. "Marian, I'm not going to die," Mary Jane said. "I'm the stronger Catholic. You wouldn't know how to plan my funeral." The Fields sisters were discharged in late July and have since returned to their home in Missouri, where they've regained a sense of normalcy neither had experienced since 2011. Setting the stage With two history-making surgeries under their belts, Selber and Gaber are pioneering a new frontier in innovative transplant and recon- structive plastic surgery at the Texas Medical Center. Beyond the clinical significance of the Fields transplant, the entire surgical process with the twins proves that their previous collaboration during the skull-scalp-kidney- pancreas transplant "wasn't a fluke," Gaber said. Instead, it bears testament to the power of collabora- tion and continues to strengthen the need for a growing vascularized composite allograft program between MD Anderson, Houston Methodist and other institutions within the Texas Medical Center. "It's one of the really good examples of how collaboration in the Texas Medical Center can happen. You have the surgical expertise in a couple of institutions, the oncology expertise from MD Anderson … and the transplant expertise right across the street at Houston Methodist," Gaber said. "It's very exciting that we can work together to benefit more patients." Currently, the most common types of vascularized composite allografts involve hand and face transplants, but Selber and Gaber aim to tap into the high volume of clinical cases in the Texas Medical Center and offer creative solutions that take them off the beaten track of conventional reconstructive surgery, transplantation and cancer reconstruction. "We've sort of cornered the market on really weird cases," Selber said. "Where these unique reconstructive transplant