Summary:

This film traces the shared career and dissolution of Beverly and Elliot Mantle, male identical twins (both played, thanks to seamless special effects, by Jeremy Irons) who are gynecologists, running a successful fertility clinic in Toronto in the 1980’s. They share both work and personal lives; Elliot, the dominant twin, lectures at the hospital, accepts awards, plays the smooth professional--and seduces women. Beverly, the quiet one, sees patients, does research--and sometimes has affairs with women his brother passes on to him.

They usually draw the line at patients, not because of ethics, but because "it’s not safe." Their dealings with women have to be carefully compartmentalized, for the ambiguous intimacy of the gynecological doctor-patient relationship is difficult and dangerous for the twins, who form a psychologically unstable and deeply interdependent relationship on their own, likening themselves to the original Siamese twins, Eng and Chang, whose names they eventually take on, too.

Their symbiotic system is disrupted when a television actress, Claire Niveau (Genevieve Bujold), consults them about her infertility. She has a trifurcate uterus--the twins call her a "mutation"--and will never have children. Elliot, fascinated, seduces her, and then gives her to Beverly, who falls in love, with disastrous consequences. When Claire discovers that they’ve deceived her and temporarily leaves, Beverly becomes addicted to the amphetamines and sleeping pills that Claire habitually abuses.

The drugs impair his work, he begins to hurt patients, is hospitalized, and after a calamitous breakdown in the operating room (where Beverly attempts to use the monstrously beautiful surgical instruments he designed himself

"for operating on mutant women") both brothers keep their hospital privileges only on condition that they don’t use them. Elliot tries to rehabilitate Beverly, but realizes that the need to do so comes from their absolute interdependence--they might as well be physically joined. So Elliot begins taking drugs as well, and when Claire returns and Beverly goes back to her, Elliot breaks down completely.

The rest of the film traces Beverly’s failed attempt to become a separate individual. The instruments he invented are now, he says, "for separating Siamese twins," and, in a terrifying surgery scene, the drugged Beverly "operates" on his conscious though equally drugged brother, apparently disemboweling him. Next morning, Beverly leaves the apartment where his dead brother lies and calls the woman he loves, but he cannot talk to her. He goes back, his bid for independent identity a failure, and the film ends on a shot of the two, dead, in an embrace echoing the Renaissance anatomical illustrations of in utero twins which illuminate the film’s opening credits.

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