So to get only left twins, you need something that holds the flat molecule, blocks its underside, and adds the fourth piece from above. Chemists call it a helper, or a catalyst.
A helper is a different molecule, added in small amounts. Often it works like a clamp with two jaws. The top jaw is a metal atom, like rhodium or zinc: it holds the fourth piece and joins it onto the flat molecule. The bottom jaw is a bulky handed part that wraps round underneath and blocks that side. The metal and the handed part are joined together: they're all one helper molecule. Because the helper is handed, the flat molecule only fits into the clamp one way round, so the fourth piece always lands on the same side. And a right-handed helper is the mirror image of a left-handed one: everything is flipped, so it blocks the other side and makes right twins. Left helper, left twins; right helper, right twins. (Some helpers skip the metal and are just a small handed molecule from nature.)
There are thousands of different helpers, and chemists keep inventing more. The catch: each helper usually works well only for certain reactions, so finding the right one for a new medicine can take a lot of trial and error.
A rough picture of the metal's job: think of a hand holding a Lego brick and pressing it onto another brick until it clicks, then letting go. The bricks are now joined to each other, and the hands are free for the next pair. (Unlike glue, the helper's metal doesn't end up in the finished molecule. Chapter 5 has a twist on this.)