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The boy sat in the packed waiting room, engrossed in his handheld Nintendo and paying no attention to the noisy milieu of sick children, their parents and hospital staff.

It was just after 10 in the morning, and already Hoang Son Pham, a 10-year-old Vietnamese orphan, had been whisked through two introductory appointments with doctors and staff at Children's Hospital Boston, and he now awaited another.

Starting today, a world-renowned team of specialists will begin the process of removing a giant, tangled mass of blood vessels from the left side of Son Pham's face, using a series of injections over a period of months and leading to a complex and risky surgery to remove the mass.

Seated near the boy yesterday were two Canadians who have fought for nearly two years to bring Son Pham out of a crowded Vietnamese orphanage for treatment - first in Toronto, where they were ultimately denied, and now Boston.

For them, the struggle has been a roller coaster of emotional highs and lows. And this next step will be no different.

"I'm so glad we're finally, finally here," Olwyn Walter, vice-president of the Ottawa-based charity the Children's Bridge Foundation, had said earlier that morning, tearing up in the hospital cafeteria.

Feeling less positive was Tan Ngo, the Vietnamese-Canadian program manager of Children's Bridge who will act as an interpreter for Son Pham during his hospital stays.

"I'm worried," he said, eyeing Son Pham and his Nintendo.

Terrible scenarios have played out in his mind, he said. And he can't stop dwelling on the decision announced last November by a team of specialists at Toronto's Hospital for Sick Children, after four months of medical assessments.

Mr. Ngo said he wonders: If Toronto won't do it, why will Boston?

Sick Kids spokeswoman Lisa Lipkin said yesterday that the hospital's position has not changed, and that doctors there believe pursuing treatment is "not in Son's best interest" - due to the physical, social and mental toll it would have on the boy.

Boston doctors say they are not speaking to reporters until they can nail down a treatment plan for Son Pham.

But in a previous interview with The Canadian Press, John Mulliken, the veteran surgeon who is co-director of one of the most respected vascular anomalies centres in the U.S., said he's confident surgery will ease the boy's breathing and eating, and significantly reduce the size of the mass. If left alone, it could eventually block the boy's airway, he said.

Today, doctors plan to insert a tracheotomy tube that will funnel air directly into Son Pham's lungs, bypassing the swollen tissue that would block his airways should subsequent treatments cause his vascular anomaly to swell.

Outside the waiting room, Mr. Ngo spoke about the fears that have been gnawing at him for weeks.

"I'm the one who brought him here. I'm the one who helped to bring him to Canada. I'm the one who signed the papers," Mr. Ngo said.

He glanced down at Son Pham, who had followed Mr. Ngo out of the waiting room and was now dangling from a handlebar, smiling his lopsided grin.

"If something happened to him here ... my God," Mr. Ngo said.