After the funeral, Mariamma returns to Madras at Uma’s urgent telegram, bringing a translated copy of the Parambil genealogy. In the Pathology Specimen Room, she and Uma review symbols of drowning, water aversion, dizziness, deafness, and facial weakness. Uma shares the autopsy result: no lethal trauma—Philipose drowned—then leads Mariamma to the Brain Room.

With Dr. Das, they examine Philipose’s brain. Under magnification, symmetrical yellow nodules sit on both acoustic nerves. Frozen and permanent sections show spindle cell palisades, confirming acoustic neuromas. Das explains how such tumors, though benign, compress balance and hearing fibers, then the facial nerve. Because they are bilateral and given the family history, he frames it as a variant of neurofibromatosis, likely distinct from classic von Recklinghausen’s.

Mariamma contemplates the labyrinths and how disrupted vestibular signals forced Philipose to rely on vision and foot sensation—leaving him helpless in darkness or water, leading to drowning. Das notes emerging CAT scans could detect small tumors but that risky posterior fossa surgery is reserved for larger, symptomatic lesions amid critical vessels and cranial nerves.

Imagining Big Ammachi beside her, Mariamma transforms grief into purpose. She resolves to make the cerebellopontine angle her battlefield, to study these tumors and become both scientist and neurosurgeon.

She completes a year-long internship and a second year as senior house surgeon in general surgery. Despite resistance to women in neurosurgery, she earns a coveted Vellore training spot, sponsored with a two-year pre-training service obligation and two years post-qualification. Leaving Madras, she becomes the first—and only—physician at a new, well-equipped mission hospital near Parambil.