She was standing before a class of restless third-graders in Thrissur, chalk in hand, trying to explain a lesson, when her father appeared at the doorway. He was panting. He had run all the way from the post office.
He held out a yellow slip of paper.
You have been selected. Medical College, Sevagram.
In that moment, her life changed.
She was Pushpam Chakupurakal, born on 3 February 1948 in Thrissur, Kerala — the youngest of six children, four daughters and two sons, in a household not far from the famous Vadakkunnathan temple where the annual Pooram festival arranged twenty-one majestic elephants in caparisoned splendour. Her father ran a small pet shop. Her mother, a quiet and determined woman who had endured a difficult marriage, had given her children one instruction that functioned as both compass and command: study hard, be independent, do not let anyone dictate your days and nights.
She had been studying hard. She had also, in the interim between finishing her B.Sc. and the telegram’s arrival, been teaching third-graders. The teaching was not the life she had imagined. The telegram was the interruption she had been waiting for without quite knowing it.
The Convent and the World Beyond Its Walls
Her entire education until Sevagram had been conducted within walls.
She had studied first at a local sisters’ convent, then at St. Antony’s High School, where she stayed in a hostel run with military precision: parents dropped children at the gate and collected them only during vacations. A whole world existed outside, but for the students the bell, the rosary, the classrooms, and the dormitories were the universe. Later came St. Mary’s College in Thrissur — again an all-girls institution.
Sevagram was the first co-educational institution of her life.
The doctors at the nearby government hospital in Thrissur had been her childhood role models — a couple whose quiet authority in the community she had watched from a respectful distance. Her father, though not educated beyond a certain point, had encouraged her in his own steady way. Her mother’s instruction — be independent — had provided the direction. A small advertisement spotted in a local Malayalam newspaper had provided the occasion.
The journey to the interview was its own education. She and her father travelled first to Madras, then took the Grand Trunk Express to Wardha East. He knew no English and very little Hindi. She had studied Hindi as a subject, but spoken Hindi was another matter. At Wardha station, when her father asked her to request water from a shopkeeper, she froze. The word — pani — had temporarily vacated her memory entirely. They stared at each other for a moment, and then laughed, which was perhaps the most useful preparation for Sevagram they could have had: the willingness to be lost, briefly, and to find it funny.
From Wardha station, they took a tonga to Sevagram. She had never seen a horse-drawn carriage before. The cart jingled along dusty roads lined with tamarind trees, and she felt she had stepped into a different country.
Sevagram: The First Co-educational World
The interview board was intimidating. She told them about the convent education, the nuns who had taught compassion and selfless service, the encouragement of her parents, and the dream to serve people. That was all she had. It was enough.
She left the classroom and boarded the train again — this time, not as an interviewee but as a medical student.
Sevagram in 1969 was unlike anything she had known. A tiny village, sparse in facilities, bound by Gandhian discipline. They wore khadi, refrained from eating meat, cleaned their surroundings, and joined the Sarva Dharma Prarthana morning and evening. At first, she wondered if she could adapt. Her mother’s training — that a girl must learn to adjust quickly — helped. Her convent years had taught her prayer, service, and discipline. Sevagram felt like an extension of that life, only simpler and more austere.
She and the other girls rose at dawn and sat cross-legged in the veranda for prayers. By evening they repeated the ritual under the cooling sky. Life was bare and frugal, and filled with the particular richness that frugal communal lives produce in young people who are paying attention.
Her closest friend was Saroj Taksande, with whom she shared a room for all five years. Among the others were Jayashree Deshmukh, Rajani Rane, Lata Chaudhury, and Bhakti Dastane — Bhakti, the local girl from Wardha, who disappeared on Fridays to spend weekends with her parents and returned on Mondays while the rest of them remained in the hostel. A Sunday film at Durga Talkies in Wardha was the height of excitement. Once, she and Jayashree walked from Sevagram to Wardha at dawn, sipped coffee at a small stall, and took the bus back. Simple pleasures threaded into memory with the needle of repetition.
Over time, she learned Marathi well enough to converse with patients in the wards. For a girl who had once forgotten pani in front of a shopkeeper, it was a quiet triumph.
Zambia: Medicine at the Edge of Epidemic
After her internship, she pursued a diploma in gynaecology and obstetrics at GMC Nagpur, then returned to Thrissur to work at the newly founded Amala Cancer Hospital. In August 1978, she married. Her husband, who held a posting in Zambia, took her to Lusaka — a city and continent utterly different from Sevagram or Thrissur.
For the next decades, she witnessed the devastating epidemic of HIV from inside it.
She watched it sweep through families with the particular horror of a disease that travels through the most intimate connections — men bringing it home to wives, mothers transmitting it to children, the virus moving through the architecture of family and trust in ways that conventional public health responses were slow to understand. Death was not a statistic in Lusaka in those years. It was a name, and then another name, and then another.
In 2004, she trained in public health at Johns Hopkins, focusing on HIV treatment and prevention — acquiring the formal framework for work she had been doing in the field for years. That same year, she lost her husband.
She continued to live in Zambia. It had, by then, become home — the home that Sevagram had prepared her for by teaching her, across five years of unfamiliar food and unfamiliar languages and unfamiliar disciplines, that adaptation was not the abandonment of the self but its deepest exercise. The girl who had forgotten the word for water in Wardha had learned, long since, how to be present wherever the work required her.
The Homecoming
She attended the golden jubilee of her batch. The distance and the years have made the annual reunions difficult to reach, though she has longed to. Yet, every now and then, she closes her eyes and returns to 1969.
She sees the seventeen-year-old girl from Kerala arriving at Sevagram with no Hindi, no Marathi, carrying only dreams. She sees her learning to adapt, finding friends in a girls’ hostel where Nalinitai Ranade’s voice rose in Vaishnava Janato before the day had properly begun. She sees her learning to examine patients in a language she had not spoken at home, to find her footing in wards that looked nothing like the government hospital in Thrissur she had watched from the outside as a child.
And she sees her father on the doorstep of a classroom in Thrissur, panting, holding a yellow telegram that said: you have been selected.
The word for water came back to her eventually. So did everything else.
Dr. T.R. Pushpam completed her MBBS from MGIMS, Sevagram, with the inaugural batch of 1969, and pursued postgraduate training in Obstetrics and Gynaecology at GMC Nagpur. She worked at Amala Cancer Hospital, Thrissur, before moving to Zambia in 1978. She trained in public health at Johns Hopkins University in 2004, specialising in HIV treatment and prevention. She lost her husband that year and continued to live and work in Zambia. She attended the golden jubilee of her batch.