This story goes way beyond any definition of nursing and healthcare delivery. It is a story of selflessness and compassionate care for a child. Karen Mott, an oncology nurse at the MetroWest Cancer Center, first met Patricia McNulty in 2011. She was a patient of hers who was battling aggressive head and neck cancer. As she and Patty grew closer, Karen discovered that Patty had a 9-year-old son named Stephen. He was the reason she was trying to fight the cancer, the reason she needed to live. To make things worse, Stephen’s father had suffered brain damage as a result of a car accident and was left permanently physically and mentally disabled and therefore unable to take care of Stephen.
By 2012, Patty’s cancer had spread, and it was clear that she was running out of time. 

This is Karen Mott’s story as told to Melany Warnick.
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As a nurse at the cancer care center where I’ve worked for seven years, I’ll do almost anything to make a patient feel better. I’m quick with blankets and juice and will gladly hold a hand for a prayer. But when I met Patricia McNulty at the MetroWest Cancer Center in Framingham, Massachusetts, in 2011, she didn’t want my help.

She was a tiny 44-year-old single mom getting high doses of chemotherapy to battle an aggressive head and neck cancer. Unlike many of our other patients, Patty was alone during her treatment, but no matter what I did, I couldn’t get her to open up. She just buried herself in a book or pulled a blanket over her head to fend off the conversation.

Eventually, I hit on a reliable way to make Patty smile: mentioning her nine-year-old son, Stephen. She’d tell me how well he did in school, how he’d been selected to read a poem he wrote at a local bookstore. She insisted on scheduling her one-day chemo treatment over two days so she’d always be there to meet his school bus. In fact, Stephen was the reason she was taking such an aggressive course of treatment in the first place. She desperately wanted to live for him.

Stephen was the reason she was taking such an aggressive course of treatment in the first place. She desperately wanted to live for him.

Everything about Patty’s life seemed like a battle. The family was on welfare and lived in a subsidized apartment in a low-income neighborhood. Patty’s boyfriend, Stephen’s father, had recently been hit by a car, and the resulting traumatic brain injury left him disabled. But Patty never complained. She just sucked it up. I think she’d been doing that her whole life.

After a year and a half of chemotherapy, in August 2012, Patty was told her cancer had spread, and I learned she wouldn’t live much longer. My first thought was, “What’s going to happen to Stephen?”

The father of Patty’s two older sons couldn’t take Stephen, nor could any of her five siblings. I knew that Patty wanted to keep her son out of the foster-care system, but planning for her death proved so excruciating, she just didn’t talk about it. She couldn’t.

Because her cancer was terminal, Patty became a patient of our hospital’s hospice program. Suddenly my husband, Michael, who works as the hospice chaplain, started hearing about Patty and Stephen too. The hospice nurses would share stories at their meetings about how bright and unusual the boy was, but no one seemed to know how to resolve the issue of what would happen to him when his mom died.

Even though I hadn’t known Patty that well, the situation gnawed at me. Something inside me was telling me that Michael and I could take the boy in.

But could that idea be any crazier? We’d never fostered kids before or talked about adoption. At that point, we were practically empty nesters. We’d already launched our two daughters, 21-year-old Kelsey and 19-year-old Morgan, into college and careers, and our 15-year-old son, Casey, had only three more years of high school before he was out the door too.

Michael, who at 63 is ten years older than I am, had actually started fixing up our four-bedroom house, thinking that we’d sell it and move into an active adult community in a few years. Now all of a sudden, I was contemplating bringing a grade-schooler to live with us? And what about paying for another college education? We’re not wealthy by any means.

One night in September, out of nowhere, Michael said, “I think we’re supposed to take this kid.”

I couldn’t believe it. “I’ve been thinking the same thing,” I replied.

“That’s probably a sign, huh?” Michael laughed. We’re both deeply religious, and Michael, in particular, knows what it feels like when God’s telling you to do something. Seven years earlier, he’d sold a successful business and gone to divinity school for just that reason. This felt similar.

With our children’s go-ahead, Michael and I sat down with Patty at her house a few days later. By the end of the day, it was agreed: Stephen would come to live with our family after Patty was gone.

All of this, we knew, was tough medicine for such a little boy. We were total strangers to him, and he to us. To get to know one another better, we invited Patty and Stephen over for lunch the next weekend. While Patty poked around what would become her son’s new home, Stephen rattled off the names of all the U.S. presidents in chronological order in 20 seconds. “Wow,” I thought. “This kid really is unusual.”

That, I realized, was only the tip of the iceberg. Stephen talked politics like a grown-up. He was a gifted reader and writer. But he was also as goofy and silly as any other fourth-grade boy.

I couldn’t get over how resilient he seemed. For all the ways he’d had to grow up fast, because of his mother’s illness, his dad’s accident, and his family’s poverty, Stephen was still just a kid. Almost instantly he started cuddling up to Michael and me. I was bowled over at how naturally he fit with our family.

AsPatty dwindled, Michael and I took over a lot of her care, stocking her fridge and arranging for a hospital bed to be delivered to her apartment.

One morning in October, after Stephen had left for school, Patty quietly slipped away. Michael and I picked Stephen up after school, drove him to a nearby park, and sat on a bench by a pond. I finally managed to say, “Stephen, we’re sorry to have to tell you this, but your mom passed away this morning.” The sound that came out of his mouth was like nothing I’d ever heard before. This skinny little guy sat between the two of us and just wailed and wailed. That was, I think, the hardest thing we’ve ever done. It was as if his whole world was just destroyed. Finally, we took him home with us.

For months, Stephen slept in Casey’s room so he wouldn’t have to be by himself. Stephen saw a grief counselor, and we created a meditation space with some of Patty’s things where Stephen could go to feel close to her. When we finally moved him to his own bedroom, he woke up crying almost every night.

All we could do was love him and pull him into the thick of our busy family life. He joined a basketball team. He had play dates with my coworker Beth’s children, where under Stephen’s theatrical direction, they’d create skits. Some weekends we took road trips to neighboring states, places he’d never seen because his family hadn’t owned a car.

On Christmas Eve, I learned that Stephen had never met Santa Claus, so I called the local mall to find an on-duty Santa Claus, shared a bit of our story, then rushed with my daughters to take Stephen to see him. Watching Santa hug Stephen close and have a beautiful heart-to-heart with him about his mother was one of the most moving moments of my life. The expression of pure joy on his face made all of us weep.

Recently, the students in Stephen’s class had to write a poem that started with “Home is …” He was so sad because most of the other kids wrote poems that started with “Home is my mom doing …” But he ended up writing this:

Home is Karen listening to her inspirational meditation videos.

Home is Mike’s delicious mac ‘n’ cheese.

Home is feeling cared for, loved, and protected.

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