Dreger, Alice Domurat. One of Us: Conjoined Twins and the Future of Normal. Cambridge, MA: Harvard University Press, 2004. 198 pages, 11 Halftones; 1 Line Illustration, $22.95 Cloth 0-674-01294-1.

Reviewed by William Etter, Irvine Valley College

Exploring the extent to which political and social identities are determined, or are understood as being determined, by anatomy, Alice Domurat Dreger considers how such "anatomical borders" delineate our thinking about individuality, intimacy, social validity, personhood, rights, and self-determination. By defamiliarizing the established notion among normal "singletons" that conjoinment necessarily constitutes confinement and a loss of individuality that must be "corrected" through medical intervention, Dreger's book offers important insights into both the demographically uncommon condition of conjoinment and more widespread erroneous social views that equate disability with a loss of "physical integrity" and consequently a tragic loss of freedom, will, and coherent selfhood. Dreger's sources—ranging from medical journals to media reports to historical studies, literary criticism, and works by artists with disabilities—represent a broad interdisciplinary approach to the subject that allows the author to mount an effective, engaging, and historically informed critique of social and medical drives for normalization. Most importantly, Dreger listens to the voices of conjoined twins themselves and other people with, to use Dreger's phrase, "unusual anatomies" and places these frequently ignored voices in dialogue with the statements of physicians and other "normal" individuals, the latter of whom are all too often the most dominant voices with respect to disability issues.

Dreger astutely analyzes the medicalization of disability and modern medicine's acquisition and interpretation of knowledge about non-normal physiologies, the attention this field grants to patients' bodies to the exclusion of the patient as a unique self, its rhetoric of biological determinism, its equation of reality with normality, and its lack of awareness regarding the ways culture and politics influence supposedly objective medical treatment. Medical interventions aimed at achieving physical normalization are designed, Dreger demonstrates, to "construct an architecture of certainty" in our social relations (p. 4). Dreger's keen awareness of the psychosocial pressures exerted upon well-meaning parents, physicians, and individuals with physical differences lends richness to her analyses, even as it further complicates the medical and social controversies discussed. Dreger candidly discusses the challenges faced by these figures, while critically interpreting their decisions and the consequences of these decisions for people with disabilities.

Non-conjoined individuals, "singletons," pity and wish to separate conjoined twins, Dreger asserts, because of their reverence for a particular, monolithic concept of "individuality" rooted in a rigid conception of anatomy. While accounting for, and even celebrating, individuality and the variety of human identity, Dreger's analysis of conjoinment also encourages us to question the meaning, limits, and value of individuality as well as the socially constructed nature of these elements. Some of the book's most provocative insights relate to the suggestion that the lives of conjoined twins can serve as powerful models for revising and improving social and political relations among all people. Because "dual-consciousness conjoined twins, develop...distinct but co-operative personalities," Dreger claims, "Many conjoined twins are models of cooperative behavior" in which an individual contributes to the life of a collective unit without the sacrifice of his or her individuality (pgs. 22, 44). Readers interested in drawing theoretical connections between disability and civil rights, post-nationalism, or multiculturalism may find useful material for study in these thoughtful discussions.

The intersection of social stigmas associated with race and disability is given some consideration throughout the book, though its analysis could be more thorough. Instances of such intersection are certainly prevalent and suggestive: Chang and Eng Bunker's (the original "Siamese Twins") ownership of slaves, prejudices against the brothers and their descendents due to their Asian heritage; Millie and Christina McCoy, the 19^th century African American conjoined twins; and the "Two-Headed Boy of Bengal," whose double skull is the property of the museum of the Royal College of Surgeons in London and whom Dreger discusses briefly in her chapter on human physical difference as spectacle. As she concludes the book Dreger does discuss the notion of "natural defects" as a socially constructed, historically powerful factor in the lives of African Americans and people with disabilities, comparing present-day prejudices against disability with 19^th century "scientific" justifications for the subjugation of women and African American slaves. Readers might wish for more of this sort of analysis throughout the book, but Dreger does provide enough historical evidence and anecdotes to allow interested readers to begin exploring this dynamic on their own.

In the later chapters of her book Dreger also identifies some of the most disturbing assumptions that drive the medical normalization of conjoined, intersex, and short-statured anatomies. People with these conditions are studied, made into spectacles, and subjected to extensive and often painful physical manipulation for the ultimate purpose of removing or "preventing future instances" of these human differences. When, as Dreger points out, these physical differences are understood by the individuals possessing them as an integral part of their selves, however, it is in fact the valuable, unique identities of individuals that are threatened with eradication. Dreger's insight that such an end might be the "future of normal" is both profound and horrifying.