Explore Opportunities: Serving God Takes Courage! {Part 1}

Note from Poppy: This story about a young Indian boy dying from rabies moved my heart. But even more inspiring is the way God led this Christian doctor to risk his own life to take care of him. As you think about what opportunities God has for you to explore, think outside the box as this couple did who are serving at a mission hospital in India. How can you be His heart and hands to someone in your world today?

I want to share the story of a 12-year-old boy who came to our hospital about a month ago and who helped us grow in our faith and trust in God. His story began almost 8 months before. While he was playing outside with some of his friends he was attacked by a street dog. He reported it to us as an unprovoked attack. India has a huge problem with stray dogs. Most cities and towns have thousands of street dogs that rummage through trash. Of course animal control and the idea of spaying or neutering really does not exist here and thus these animals continue to breed and carry along with them a host of diseases. When this boy was attacked it was a fairly significant bite, and the dog took off at least a chunk of skin because he still had a large scar on his leg when I first met him in the casualty department 8 months later.

As is often typical in Bihar, India, the family did not seek any medical attention for the bite due to costs. This boy came from a large family with multiple brothers and sisters and, because they did not have money, they did not seek any advice from a medical professional. We know that an unprovoked attack by a dog here in India often carries with it the strong chance of rabies infection so the usual recommendation would have been a dose of rabies immunoglobulin followed by a series of 4 to 5 rabies vaccines administered over a month. Rabies immunoglobulin costs about 2500 rupees per dose, and the vaccine is about 300 rupees per dose. For most of our poor families, to get a complete series of rabies vaccine and immunoglobulin is almost unaffordable since the entire cost would be almost 4000 rupees which is more than what a laborer would make in a month. So most families just take their chances. The same was true for this young boy. The family let the wound heal on its own and everything seemed fine until about two days prior to his arrival at our hospital when his family started to notice some strange behavior.

He started to become agitated at home and the family noticed that he was having difficulty sleeping at night. Then his symptoms worsened to where he could no longer swallow well. At first when he drank water he felt like he was choking and so he kept vomiting/spitting out any liquids. About a day later even the sight of water made him feel uncomfortable and he would start having spasms of his throat when water approached his mouth. The family had asked other people in the village who warned them about the possibility that the child had rabies and so his mother, along with one of his brothers and some other extended family members, made the two hours journey to us for evaluation. The junior doctor covering casualty during that day was a doctor from one of our sister hospitals and was here for a month long deputation. He was not absolutely convinced the child had rabies and so he asked me to evaluate the patient. I had read about rabies but had not seen a patient with it so I was also quite skeptical on my first evaluation.

I was not sure how much other people in the community might have put ideas into his head about the symptoms of rabies and so I wondered if he was acting out these symptoms because he was afraid. We tried giving him water and within a few seconds of the water touching his lips he did the same thing the family described to us was happening at home – he became very agitated and then spit the water back out and begged us not to bring the water to him. The remainder of his exam was normal except his pupils seemed dilated. Because we were not sure about the diagnosis, we admitted him to the hospital for observation in the children’s ward.

I went back home and read some more about rabies and watched some videos on YouTube (modern day encyclopedia) to see what other patients with rabies looked like. The more I read, the more I became convinced the child likely had rabies. Of course, only time would tell and, if indeed his symptoms were due to rabies, the symptoms would get worse. I checked on him that evening with the two junior doctors assigned to pediatrics. They had observed his behavior over the course of the day and he seemed to be getting more anxious and had difficulty staying in bed. His mother who seemed absolutely overwhelmed by what was happening continued to console him and hold him in his bed. That evening we tried another test to see if he was showing signs of rabies and turned on the fan in his room. Almost instantly he started to have severe chocking spasms and begged us to turn off the fan. Water was brought again to him and this time even the sight of water was fearsome to him. After observing that behavior we were fairly certain he had rabies and by this point the decision was made to transfer him to an isolation room to protect the staff and the other patients.

The fear in our staff and the fear inside me was palpable. What if he got agitated and bit one of us? Should we just send him home? Perhaps just keep him locked in the room to prevent injury to anybody else?

Rabies is caused by an RNA lyssavirus that is transmitted to humans from an animal bite (typically dogs, foxes, bats etc.). After the initial bite because of infected saliva the virus enters the body and slowly travels up the peripheral nerve. Depending on where the bite is on the body it can take anywhere from a few weeks to months for it to present with symptoms. The virus travels up the peripheral nerve to the spinal cord at about 1-2 mm/day. Once the virus enters the central nervous system it rapidly causes an encephalitis and usually from the onset of symptoms almost 100% of patients die within a week. Up until 10 years ago no one had ever survived rabies infection if they were not vaccinated, but in 2004 in Milwaukee there was a young girl who did survive rabies infection after a bat bite after being placed in an artificial coma. There have been a few more case reports of patients with rabies who have survived since then but they have all been bat bites with the theory being that the bat rabies virus might in some way be less fatal than the dog rabies virus for which there have still been no known survivors. Usually patients develop the furious form of rabies (80%) in which they become increasingly agitated and delirious with the classic signs of hydrophobia (fear of water) and aerophobia (fear of wind). The remainder of the patients develop the form where they become paralyzed and the level of agitation is much less.

Earlier that day we had just inaugurated the new palliative care department at our hospital. Just that afternoon, when this boy came into casualty, the ribbon cutting ceremony was being done to open up the eight beds that would be made available to care for patients needing palliative care. The question arose in my mind as to whether we should care for this child in the palliative care area until his likely death in 5-7 days if indeed he had rabies. I struggled with these thoughts that night. In fact I could not sleep as I agonized about what would be the best thing to do for this child.

Around 2 AM I got out of bed and spent time praying as to what we should do...

This is a long, but powerful story, so I've broken it up into two parts. Please stay tuned for Part 2 on Thursday!

This post is part of my Daring to DREAM series. Click here to view all the posts in this series.

Tweetables:"The story of a 12-year-old boy who helped us grow in our faith and trust in God: http://wp.me/p2JdPr-QM via @Choose2Grow" - Click here to tweet this."How a young boy with rabies led to a doctor finding courage in God to love and serve: http://wp.me/p2JdPr-QM via @Choose2Grow" - Click here to tweet this.Poppy SmithInternational speaker, multi-published author, Bible teacher, and spiritual coachInspiring Women to Thrive! Permission to use this article is granted provided the following credit is fully included.Poppy Smith is funny, warm, and passionate about helping women grow spiritually and personally so they experience the love and power of Christ in life’s ups and downs. A former teaching leader with Bible Study Fellowship, Poppy has a Masters in Spiritual Formation and ministers extensively as a retreat and conference speaker both in the US and around the world. For more information about Poppy’s heart, her books and ministry, please visit her website at www.poppysmith.com.