Bright Eyes and the most contagious smile

Saturday's are nice because they are half workdays. India is different from the US in that school and work are usually six days a week - one reason to be glad that I went to school in the states. Last Saturday, a young father brought in his four year old little boy for examination. Looking at him I was somewhat surprised that he was four because he was the size of an average two year old. One other feature was alarming in such a small child - he had massive ascites causing his little belly to be totally distended and tense. He was breathing rapidly and would cough intermittently. Being a small hospital with only xray imaging in house we sent him to have an ultrasound at a nearby clinic. Today father and son returned with the report was brief and handwritten on a folded piece of letterhead. Liver masses with blocked portal vessels. We have no other investigations at this point and his history is only significant for ascites starting in the first week of life! He is a bright eyed sweet natured little boy who was staring intently at Hannah and I. We immediately grabbed our cameras and took pictures of him as most kids love seeing themselves on the digital cameras. His smile blew us away and he even started laughing in a high pitched little squeal. We worked hard to distract him with finger puppets from the procedure to drain the fluid from his belly. After several hours we only got a little fluid to come out. We have no way of knowing the prognosis since we have no idea what is growing in his liver. As father and son left the clinic, the father could not keep back the tears from flowing and soon the little boy's flowed too. We hope to refer him to a University hospital where the facilities are better suited for diagnosis and treatment. For now, all of our hearts are heavy as we think of the little ones in our lives and how dear they are to us and how helpless we feel toward this little bright eyed child of God.