The Little Mo Effect: A Surgeon’s Compassion for a Charismatic Moroccan Boy Transforms Many Lives

By Pier Boutin M.D.

High in the Atlas Mountains of Morocco, the chance encounter of an orthopedic surgeon and an impish boy clad in bright pink rubber boots changes both their lives…

Dr. Pier Boutin responded to the call for orthopedic surgeons after the 2010 Haiti earthquake. Leading the first surgical team to arrive in Port-au-Prince, she witnessed devastating trauma and unimaginable suffering. To distract from the haunting memories she traveled to Morocco. In the Atlas Mountains, she came upon a three-year-old boy stumbling around on deformed feet.

Walking is vital for survival in these remote mountains. With untreated clubfeet, this child faced a dismal future. Yet despite his struggles to walk, he giggled and smiled. His magnetic charm captivated her. She could not walk away.

His needs eclipsed her own despondence after the trauma of Haiti.
She thought, "If he can smile despite his disability, why can't I?"

This chance encounter would affect many lives for years to come.

Dr. Boutin's compassion and determination overcame all obstacles to bring this child, Little Mo, to the United States to treat his disability.

In the process, she changed his life–but he also changed hers.

• Language: English
• Publisher: BookBaby
• Release date: Jan 2, 2023
• ISBN: 9798985806458

Book preview

Chapter 1

Helping one person might not change the world,

but it could change the world for one person.

—Anonymous

An hour after landing in Casablanca, KK, Julie, Tracy and I crowded around a low and wobbly table at the airport café. My long legs wouldn’t fit underneath, but I managed to weave my limbs around the legs of KK’s chair. Miniature cups filled to the brim with Moroccan coffee smelling of cinnamon, ginger and cardamom rattled and threatened to spill any time one of us dared to touch the table or adjust our legs. We clutched our coffee as harried travelers burdened with too many suitcases squeezed by the tables. Some hauled large boxes held together with tape while others pushed carts piled mountain-high with sacks secured with hemp. No one traveled empty-handed.

A bustling cacophonous wonderland surrounded us. Less than twelve hours earlier, I had driven to the airport from my home in Massachusetts. KK flew from California while Julie took a bus to the airport in New York City. Tracy traveled from her home in Bermuda to join us at our rendezvous in the Casablanca airport, where we waited for our guide.

The noisy vibrant energy contrasted with the desolation that had permeated my mood back in the States. The bright colors, excited noises and animated crowd shook the walls of my stoic façade. With the culture switch came an inner emotional shift, leaving me feeling exposed and unmasked. Tracy noticed the change in my expression and asked, Pier, are you okay?

She assumed my funk derived from increasing joint pains. I had been experiencing autoimmune inflammatory symptoms for some time, and medication did little to quell the painful swelling of my hands, knees and ankles. Also, I had broken my back, shoulder wrists and ribs over the past four years. Worst of all, a few years before this trip, I had surrendered to the pain and given up my practice as a surgeon to focus on my health. That excruciating decision demolished me.

It’s hard to go from running marathons to walking, I told Tracy.

I know you can’t exercise like you used to, but you’ll get better, Tracy said. Look at me! I’m perfectly happy walking.

I told her there was more to my mood. It’s not just that, it’s complicated…. I could no longer pretend. I’m not okay. Ever since working in Haiti, I’ve been feeling down, and I don’t know what to do about it. The stuff I saw after the earthquake haunts me.

While we sat around the airport table, I told my friends, It’s not that I can’t exercise anymore. I’ve lost my compass. I feel useless. Haiti made me realize how much I lost when I stopped practicing surgery. That’s where I came alive.

Ten months earlier, although I was not regularly practicing as a surgeon, I had responded to the call for French-speaking orthopedic surgeons to provide immediate help in the wake of the 2010 earthquake disaster in Haiti. Our team of medical professionals arrived in total darkness in Port-au-Prince’s largest public hospital. All but three of the medical buildings had collapsed. We worked twelve- to sixteen-hour days to triage and tend to hundreds of people lying with open wounds and mangled limbs in the courtyard. With minimal tools, we operated in make-shift conditions for two weeks.

Haiti had a huge impact on me on so many levels, I tried to explain to my friends. Even though the work made me feel useful and energized, it left me stressed. I’m not sleeping very well. I paused for a second and added, And things are not good at home, with my marriage.

I was surprised to be exposing so much of myself in front of Julie, someone I did not know well. We had met six months earlier through her best friend KK. Julie was a petite documentary film director of Native American descent—and also an expert photographer and fitness buff. She jumped into the conversation as if we had been friends for years. Start from the beginning. Why aren’t you sleeping? she asked.

I wake up with flashbacks of Haiti, I explained. I saw too many bloated dead bodies. I know I couldn’t fix everything, but I was in charge of triage and surgery. Did I make the right decisions? Could I have saved the leg? Could I have changed the outcome? I know it’s stupid, but I can’t stop thinking about it. I’m in a rut.

Surgery had been so much more than my job. I had climbed over many slippery, barbed walls to become an orthopedic surgeon. By the age of nine, I had decided to be a physician and never wavered. Every class and every summer job I chose was aimed at bringing me closer to my goal—medical school. My career, identity and self-worth had melded into one entity. And then, suddenly, I forfeited my career, a decision that had a cataclysmic impact. Without direction or purpose, my health deteriorated further. I busied my days with irrelevant household chores and the drama of my two teenagers. Simple tasks exhausted me. I couldn’t explain how I had previously managed two toddlers, a burgeoning career and triathlon training. Now, without goals, I found little joy or energy. My friends had witnessed my slow descent into despair and gradual defeat, which also accentuated the emptiness of my marriage. My husband seems to have moved on without me, I told my friends. He’s hardly ever home, and even when he’s there, I feel ignored.

Tracy reapplied her lipstick and sighed. I want to see the old Pier back. Where’s the strong woman who could break down barriers? But my confidence and drive had faded after I stopped operating. I felt like a loser.

It was a relief to let my guard down. My friends made me feel that my issues were real and warranted; I wasn’t going crazy. Craving a reboot, I was hoping to find strength and new energy through this Moroccan escape with girlfriends.

It was KK who had sensed my anguish and proposed this adventure to Morocco. I had met her several years ago during a summer vacation on the beach. Her natural blonde hair and athleticism gave little indication that she was a powerful lawyer for a major Hollywood movie company. She impressed me from day one, when I watched her work on a sticky legal problem—she needed to determine the responsibility of an ill employee who had exposed her fellow workers to a serious infection. She handled the complex situation with confidence and empathy. Such clarity had eluded me for years. KK had planned and coordinated each detail of the trip—travel agents, itinerary, drivers, and hotels.

I had asked my friend Tracy to join us. She and I had become fast friends twenty years earlier, in graduate school, where she studied law and I studied medicine. I don’t believe she ever attended class before noon or left the apartment without her trademark red lipstick and high heels. She surprised her friends and family when she quit her law practice to explore Nepal with only a backpack and passport. She returned a year later and became president and chief executive officer of an international trust company. Her diplomatic skills and determination propelled her to the top of her field. While she traveled the world interacting with prominent figures, my world shrank.

Julie turned to me and said Okay, we won’t solve anything today. Forget it all for a while. Let’s have fun. This change of scenery is just the distraction you need. We clanked our empty coffee cups and cheered, Here’s to us and our Moroccan adventure!

Chapter 2

As we stepped out of the Casablanca airport to meet our guide, we watched the crowd of fellow travelers and their welcoming parties. Women concealed in full-length black burkas mingled with others decked out in brightly colored form-fitting dresses with their hair and faces exposed. I spotted some clad in Western garb— jeans and t-shirts. Mothers pulled their children as they tried to herd them toward the exit. Boys darted between and under the throngs of people. Men draped in long robes or squeezed into American-style blue jeans milled around. Taxi drivers shouted at the top of their lungs. A strong aroma of coffee and cumin piqued my nostrils. My senses had reached overload capacity when our guide, Abdul, spotted us in the crowd.

Abdul expertly snaked his way between travelers and their belongings and led us to his air-conditioned jeep. When we shut the car doors, we entered another world: the noises, smells and oppressing heat dissolved. During the six-hour ride to our first destination, KK shared our itinerary for the next week. She had planned each day down to the hour. The journey sounded beyond belief.

Tracy, KK, me and Julie in front of the UNESCO World Heritage Site.

As we approached the UNESCO World Heritage site of Ksar of Aït-Ben-Haddou, a light from the heavens illuminated the village and transfixed us. The six-hundred-year-old mud-constructed dwellings melded with the sand dunes as the last rays of sun painted the landscape a dusty rose. The iridescent shadows and lights reflected off the sand-toned village in such a unique way—no wonder movie directors favored this setting. Scenes from Babel, Gladiator and The Jewel of the Nile flashed across my mind as the magical vista seduced me and raised my spirits.

Ksar Aït-Ben-Haddou had blossomed at the height of the trans-Saharan Trade Route. This passageway connected the North African coast with Europe and was used by merchants to trade gold, salt and slaves. We crossed a shallow river to reach the majestic tribal village, stretching our legs as we climbed in and around the towers, gates and dwellings. Remnants of geometric carvings hinted at the exotic Moroccan style known around the world. From here, we headed to the Sahara Desert, beginning our action-packed adventure.

On our way to the Sahara, we drove through the Valley of Roses. Rows of pink buildings lined the streets in honor of the Festival des Roses, which takes place in May. The farmers reap more than 4,000 tons of petals every season. The aroma of roses perfumed the air. We stopped to buy the famous rosewater, which was supposed to purify the skin and, the seller told me, make me look ten years younger. I fell for it all, purchasing bottles of rose oils, jars of creams and bars of soap. Beautified and giddy with the overpowering scent of roses, we had to roll down the car windows to catch fresh air.

By late afternoon, we arrived in the oasis town of Erfoud, the last town before the desert. Stones embedded with fossils dating back to the Devonian Period, 380 million years ago, lined the shops’ entryways. These artifacts originated from the first Mediterranean Sea, which extended into what is now the Sahara Desert. Abdul led us into the shops; some of the shop owners had brokered arrangements with the guides to lure the tourists. The treasures inside the stores were wonderful and the salesmen possessed irresistible persuasive powers. When one of the store owners promised to ship a coffee table and two statues to my home, Tracy reminded me, "Pier, you don’t need another piece of furniture in your house. And this is only day one of our trip." She was right. When my husband and I had merged our two families seven years ago, we had consolidated the furniture from two fully loaded houses, neither of us wanting to discard mementos of our past. Tracy managed to pull me away, and we continued our adventure.

At the edge of the desert, Abdul stopped the car and demanded our full attention. His facial expression turned very serious. Sternly, he impressed upon us the importance of our comportment once we entered this region. Do not smile or laugh and do not look men in the eye. Do you understand? Do you understand? Don’t laugh! He went on to explain that Spanish, French and German women came to this remote area for sex. He said the desert men of the Touareg tribe responded to the slightest nod as a come-on. Our guide frowned and repeated his warning several times. We made light of his advice until we realized he would not move on until we reassured him that we would abide by his rules of comportment.

Finally satisfied, Abdul navigated the jeep over a vast expanse of sand and maneuvered with great skill across the soft dunes toward our sanctuary for the night, La Belle Etoile, an elegant camp—an assembly of tents set up by the Touareg, better known as the Blue Men of the desert. They earned their name from the indigo dye they traded, a commodity valued by Europeans dating back to the Middle Ages. The most successful merchants draped themselves in floor-length traditional sleeved robes, indigo-dyed djellabas. The expensive deep blue color represented prosperity. After a time, the dye permanently stained their skin and they believed the pigment would protect them against malaria and sunstroke. They thus became known as the Blue Men. Enthralled by this legendary tale, I bought a blue scarf from one of the female vendors on the outskirts of the camp. With one hand she pocketed the money, while with the other she twisted and wrapped the scarf around my head in the typical local fashion. Later, when I removed the scarf, my long blonde hair had turned vivid blue.

Without mountains and trees to obscure the desert sun, day turned to night in just a few minutes. Iridescent flakes of gold illuminated the sky and transformed the darkness into a bright celestial tapestry. One after another, shooting stars whizzed across the sparkling astrological map.

Exhausted from a day of travel, I fell asleep within seconds. But it wasn’t long before the same disturbing memories disrupted my sleep, nightmares of the Haitian disaster.

When I arrived in Port-au-Prince in January 2010 with my father and my husband—both doctors—one lone lamp powered by a small generator lit the courtyard and exposed the mass of wounded assembled on the lawn. I locked my gaze on an overwhelming number of injured people, moaning in pain as they pleaded for help. They recognized us as doctors because of our surgical scrubs, and called out as we made our way across the courtyard. A woman grabbed at the pant leg of my scrubs and begged me to help her young son. She pointed to his arm, which dangled at an unnatural angle, the lower arm attached by a mere strip of skin just above the elbow. Blood and dirt caked his open wound. As far as I could see, hundreds of people lay with open and infected gashes, exposed bones and bloody stumps. They had made their way to the hospital only to discover that the earthquake had destroyed most of the buildings, which were now abandoned. Now they were spread out on blankets and stretchers in the central courtyard, hoping that divine intervention would provide doctors.

I had answered that call; no place on Earth had needed me more. But now in Morocco, with my own aching joints and sleepless nights, what help could I be to anyone?

The next morning, instructed by our guide Abdul, we got up at 5 a.m. and mounted camels by the light of the stars, laughing until our sides hurt as we held on for dear life while these ungainly beasts spasmodically sprang to their feet. We formed a small caravan and rode further into the Sahara to watch the sunrise over the undulating ocean of sand. The early morning rays on the dunes painted the horizon a liquid gold, hypnotizing us, until suddenly KK’s cell phone clamored in the silence.

We shouted at her in unison, Turn that thing off!

Laughing, I added, I can’t even get reception at home!

The incongruous and unexpected sound had shattered the serenity. Even isolated in the middle of the Sahara, technology had found us. Soon the oppressive heat of the rising sun forced us back to the cool of the tents. We exchanged our camel saddles for car seats and headed to the famous Atlas Mountains. I felt myself regaining strength once again as I breathed deeply, appreciating the exotic beauty surrounding me. My negative thoughts began to dissipate.

We stopped for lunch at the Maison Berbère in Rizzani. I suspected our guide earned a kickback every time he brought tourists to this grand carpet store with a small restaurant in the back. We traversed a long corridor and several rooms before we came to the eating area, which consisted of a few benches in the courtyard. At least five layers of patterned rugs of all lengths and widths covered every available surface: walls, ceilings and floors. Our feet floated atop the plush mountains of carpets available for our perusal or purchase. If our eyes hesitated on one rug for even a moment, a salesman would take it down and insist we feel the texture and appreciate the color and the quality. A mere glance would instigate this elaborate comical ritual. But it worked; Julie, Tracy and I each bought several rugs.

The shopkeepers rewarded us with a typical Touareg specialty, La Medfouna, which translates to ‘the buried.’ This delicious meat pie, imbued with local spices, is cooked buried in sand for several hours. The salesmen joined us for lunch, having beyond doubt reached their quotas for the day. They explained in great detail the meaning behind the intricate Touareg rug patterns and colors. Their ancestors had used these carpets as maps. The zigzags represent the convoluted route they took across the desert to meet with as many other tribes as possible. Diagonal crossings with pyramids showed where they encountered another caravan. The Touareg had devised a unique legend. Each color represented a specific terrain: yellow for sand dunes, blue for lakes, black for mountains, red for desert and green for oasis. We soon realized they needed to share their folklore as much or maybe more than they wanted to sell the rugs. We would have liked to hear more, but we still had some distance to travel before nightfall to reach the small village of Imlil at the base of the Atlas Mountains.

In Imlil, we had to change our mode of transportation from air-conditioned jeep to donkey. First, we loaded our four suitcases on the back of one tired-looking creature. Rather than climb up on a donkey, we imitated the guide, donned our backpacks and began the hour-long hike up the stony path to the Kasbah du Toubkal, our home base for the next five nights. Large rocks and hewn logs interconnected end-to-end to form a tortuous snakelike route up to the slope. The verdant canopy limited the fading light and obstructed the horizon. After a treacherous sixty-minute hike, the trees thinned out and revealed a storybook oasis to four weary travelers. We stood in awe—the sight took our breath away. Shrubs, ambrosial with bright red flowers, paired with the gentle murmur of a waterfall to welcome us. A flagstone pathway led to the ancient citadel at the base of the majestic Toubkal Mountains, North Africa’s highest peak at 16,000 feet.

The inscription on a brass plaque at the entrance of the Kasbah read: Dreams are only the plans of the reasonable. The building radiated an aura of tranquility and wisdom, allowing space for imagination and dreams. This message resonated with me, kindling a spark of optimism.

As we stepped into the courtyard, the fragrance of fresh-baked bread beckoned. Hadyah, a