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As a nurse at MetroWest Cancer Center in Framingham, Massachusetts, Karen Mott tried hard to get one patient to open up. But Patrician McNulty usually tried to avoid conversation—unless it was about her nine-year-old son, Stephen. After McNulty went to hospice when her cancer took a bad turn, Mott wondered what would happen to Stephen. He couldn’t live with his father, who had permanent brain damage from a car accident, or any of his mother’s five siblings. McNulty didn’t want him in foster care. So after Stephen’s mother passed away, Mott and her husband, who have three other older children, brought him into their own family and adopted him.

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