The first time I saw a photo of my adopted South American son Michael (not his real name), I fell in love with him. He had spiky jet-black hair and warm dark eyes. His lower face was shockingly mangled by a horrific venous malformation that occurred in utero. Nevertheless, in the photo he’s smiling and confident. He instantly melted my heart.

A year later, Michael, then 7, arrived at our local airport in my mid-size Midwestern town to move in with my family. He had the clothes on his back, a few special personal treasures in a small knapsack, and he was clutching a teddy bear. His future would be filled with playing with my seven other children and schoolmates — as well as undergoing a grueling series of surgeries to repair his face in hospitals in multiple large coastal cities, which were often followed by infections, one so severe he was convinced he was about to die.

“I love you,” he told me in his hospital bed once as he experienced a 104-degree fever. “You’re the best mom ever. Tell Dad I love him.”

A physician from my hometown who travels internationally to help children born with cleft palates had spotted Michael in a South American Catholic clinic, where he had been brought by his father. The doctor thought a specialist surgeon he knew of was the best hope to treat Michael’s daunting condition — but that would have to be in Boston, where the surgeon worked. He later switched to a New York hospital, where Michael has also traveled for operations.