Alan Shapiro, M.D., FAAP, first met the adolescent after he had endured months of stressful events. The boy had witnessed his best friend’s murder and decapitation by Guatemalan gangs, left his family and made the harrowing trek on the top of la Bestia (the Beast) train across Mexico. Smugglers led him to the U.S. border, extorting the last of his money. He was apprehended by a Customs and Border Protection agent immediately. The month that followed was a blur: bunking in the shelter, awaiting placement with a sponsor and being sent by bus to the East Coast.