Digby watches Mariamma enter Saint Bridget's and is conscious of how different the place must be from what she is used to.
They visit Lenin in a secluded room of the leprosarium, where he lies unconscious and severely emaciated.
Mariamma examines Lenin to assess his condition and remarks on a facial paralysis that suggests a tumor on his left acoustic nerve.
They attempt to lower Lenin's intracranial pressure by situating him upright rather than flat on the bed.
Mariamma concludes that a tumor near the brain stem is blocking the flow of cerebrospinal fluid and causing Lenin's unconsciousness; she suggests making a hole in his skull to tap one of the ventricles and drain the fluid.
Following Mariamma's instructions, Digby helps her to execute the procedure, marking locations on Lenin's skull and using the twist drill he uses for long bones to create the hole.
They successfully drain the fluid and are relieved when Lenin begins to show signs of consciousness, staring out at them, particularly Mariamma.