CHAPTER 23

Summary

• Big Ammachi is struggling to return to normal life after JoJo's death. Her life and rhythm feel off, and she senses a spirit caused the incidents in her cellar.
• She experiences other odd events around her house and attributes them to the spirit, thinking it is JoJo's birth mother trying to communicate with her.
• Her husband attempts to be intimate with her, making clear he wants more children and particularly a son to replace JoJo, but she's not yet ready.
• Big Ammachi finds solace in her garden and her daughter, Baby Mol. Her husband begins to connect with Baby Mol, showing his softer side.
• She and her husband decide to seek a diagnosis for Baby Mol's strange behavior and developmental delay. They travel to Cochin to see a respected physician and enlist Ranjan, a much-traveled twin, to accompany them.
• In Cochin, they enjoy the new sights and experiences. At the end of the day, they visit the clinic of Dr. Rune Orqvist.
• A backstory for Dr. Rune Orqvist is provided. He's a Swedish doctor who ended up in India and made a name for himself by treating a wide range of conditions.

• The chapter tells the story of the Swedish doctor Rune Orqvist, who cares for a variety of patients in Cochin, India, with a sliding scale for his fees based on wealth. His initial support of Eleanor Shaw's health issues leads to her husband, Benedict Shaw, funding the creation of a large nursing home and clinic, proving the impact of a single patient.
• In 1913, Big Ammachi, her mother and Baby Mol visit Rune's clinic. Baby Mol has obvious developmental issues, but is still cheerful and engaging. Rune is immediately able to recognize Baby Mol's symptoms as a thyroid condition known as cretinism.
• Rune tragically informs Big Ammachi that there is no cure for cretinism, and Baby Mol will always be like a child. He reassures her that it was not her fault and that God's will is a mystery. Ammachi is devastated but grateful for the disheartening news.
• Later at the clinic, Rune also determines that Big Ammachi's mother has advanced cancer that has spread throughout her body. He advises Big Ammachi to give her opium for pain management when necessary.
• Big Ammachi thanks the doctor for his kindness and knowledge, expressing her wish that he could help them further. At home, she breaks the diagnosis of Baby Mol's condition and her mother's cancer to her husband. The chapter ends with Big Ammachi's prayers, hoping for a remedy for her family's misfortune.