Big Ammachi (Mariamma)
Big Ammachi, whose birth name is Mariamma, is twelve years old when she marries Big Appachen and moves to Parambil. Though she is lonely, she develops close relationships with the people around her as well as the natural world, and she cultivates her Christian faith. Though she experiences consistent tragedies, including the untimely deaths of many loved ones, she never fails in her role as matriarch and maintains her hope that someone will cure the Condition. Open and loving, she cares for the children of her husband's distant relatives and embraces changes at Parambil that improve the community's quality of life. Her biological children are Baby Mol and Philipose, though she acts as a mother to Elsie and Mariamma. She dies peaceably, knowing that Mariamma will fulfill her life's purpose of curing the Condition.
Digby Kilgour
Born in Glasgow, Scotland, to a single, Catholic mother, Digby is traumatized by his mother's depression and eventual suicide. He copes with his difficult life by drawing images from Gray's Anatomy and tireless study. After graduating from medical school, he encounters prejudice for his Catholic heritage and moves to Madras where he can freely practice surgery. Despite his cruel and incompetent supervisor, Claude Arnold, Digby hones his skills as a surgeon, develops his talent as a painter, forms friendships, and falls in love with Celeste Arnold, Claude's wife. His life is changed forever when a fire in his apartment kills Celeste and leaves Digby with severe burns, which permanently damage his hands. Ashamed of his affair and afraid he will never practice surgery again, Digby seeks refuge at the home of a friend and former patient. He feels connected with the leprous community at Saint Bridget's where he receives surgery for his hands and the support necessary to heal his emotional wounds. Though his motor skills remain limited, he takes over for Rune Orqvist, performing surgery for the Saint Bridget's residents. He falls in love with Elsie and fathers Mariamma, though their relationship is kept secret. He cares for Elsie despite her deteriorating condition and supports her art, even when it worsens her leprosy.
Elsie
A lifelong artist, Elsie is the daughter of Chandy who helps rehabilitate Digby through art. She meets Philipose, her future husband, for the first time in the car after Philipose saves the boatman's son. Later, she meets Philipose again on the train from Madras, where they share a mutual attraction, and she draws his portrait. She agrees to marry Philipose, believing that he will support her art career. Elsie's devotion to her art is intense and all-consuming, but she develops strong friendships with the residents of Parambil, considering Big Ammachi her mother. She struggles with Philipose's indecision and inability to be fully present in their marriage, as he refuses to spend time with her family or accompany her to Madras to receive an art award. She gives birth to their son, Ninan, who dies a tragic and gruesome death. Blaming Philipose, who is unreachable in his opium addiction, she leaves Parambil and falls in love with Digby. Her art reaches new heights during their time together, but she returns to Parambil to see Baby Mol, who is dying. Unable to return to Digby, she gives birth to their child, Mariamma, at Parambil and fakes her own death when she realizes she has contracted leprosy. Elsie bravely moves to Saint Bridget's where she lives out the rest of her days creating art even as her body deteriorates.
Philipose
Philipose is Big Appachen and Big Ammachi's only son, husband to Elsie and father to Ninan and Mariamma. Though swimming gives him debilitating vertigo, he unsuccessfully attempts to learn, to Big Ammachi's dismay. He is thoughtful and romantic, but often overly anxious and indecisive. Interested in literature from a young age, he writes a successful series of stories called the "Ordinary Man" column and studies at home after his disability prevents him from attending college. After Ninan's tragic death, for which he is partly responsible, Philipose develops an opium addiction that destroys his marriage. When Elsie disappears and is assumed dead, Philipose reinvents himself, recovering from his addiction by maintaining strict routines and daily writing habits. He is a devoted and involved father to Mariamma, though he is unable to leave Parambil. When Philipose suspects Elsie is alive, determined to make amends, he boards a train that derails into the water. Though he survives the initial crash, he loses his life trying to save a drowning child.
Mariamma
Mariamma is the daughter of Elsie and Digby Kilgour, though she is raised by Big Ammachi and Philipose. As a child, Mariamma is inquisitive and adventurous, swimming in the river each morning and studying biology. She possesses a unique talent for extrapolating information from limited data; for example, visualizing three-dimensional models of the human body from the images in her copy of Gray's Anatomy. After seeing the suffering of lepers at the Maramon Convention, she decides to pursue medicine and enrolls at Madras College. There, she performs phenomenally and exchanges letters with Lenin, her childhood rival who becomes her friend, and then her lover. Using her astounding motor skills, she works on a research project dissecting the limbs of people with leprosy. After Philipose's death, she studies his brain and realizes that a small set of tumors cause the Condition; this discovery inspires her to pursue neuroscience, and she begins her career at the newly-built hospital at Parambil. There, she studies the Condition, and after reading Philipose's journals, realizes that Digby is her father. Mariamma is highly intelligent and competent, never doubting her skills or dreams, and makes insightful connections that help realize Big Ammachi's dream of curing the Condition.
Lenin
Son of Kora and Lizzi, Lenin is born under dramatic and bizarre circumstances; as a fetus, he sticks his fist through a wound in Lizzi's uterus, recalling the signature pose of Soviet Union leader Vladimir Lenin. After his parents succumb to smallpox, Lenin receives help from a pulayi woman, an experience he believes is spiritually significant. Even as a child, he devotes himself to spirituality and social justice, but is forced to leave school due to his extreme expressions of faith. He briefly lives at Parambil, where his preciousness and aggressive sense of justice make him difficult to control; he is forced to join a seminary. Dissatisfied with his religious community and desiring to take concrete action, Lenin joins the Naxalites, an insurgent, Maoist group known for revenge killings. Though Lenin does not personally engage in violence, he experiences starvation and witnesses the murder of his mentor, compelling him to flee and visit Mariamma, though his outlaw status prevents them from being together. Suffering from the Condition, Mariamma helps him get brain surgery, and he is taken into custody by the police, promising to return to Mariamma after his imprisonment and work toward social justice without violence.
Baby Mol
Baby Mol is Big Ammachi and Big Appachen's first child. She is playful, friendly, and beloved by everyone, with an uncanny ability to predict death, storms, and visitors. Baby Mol has congenital iodine deficiency syndrome, a developmental disability, and is deeply affected by her loved ones' feelings. She and Big Ammachi peacefully pass away together in their sleep.
Claude and Celeste Arnold
Claude Arnold is the privileged youngest son of a wealthy and influential British colonial family. Despite his lack of talent, integrity, and passion, he is given a high-up position in the Indian Medical Service, performing surgery on British patients at Madras Hospital. Claude often shows up to work intoxicated, is bigoted and dismissive towards his Indian colleagues and patients, and is cold towards his wife, Celeste, insisting that their children be sent to boarding school in England despite her objections. Eventually, Claude's malpractice results in the death of Anglo-Indian hockey player Jeb Pellingham, a tragedy that he says is "no harm done." Claude attempts to discredit Digby's testimony by filing for divorce from Celeste, citing a fictitious affair; his plan destroys his marriage, and he is found guilty during his hearing, though he likely continues to practice surgery elsewhere.
Celeste, by contrast, loves India, having grown up in Calcutta with missionary parents and an Indian nanny. A fan of Hindu devotional paintings, she bonds with Digby over their shared passion for art. Hungry for companionship, Celeste begins a friendship with Digby that evolves into an affair when she attempts to warn Digby of Claude's plan. When she decides to break off their relationship to discover her own identity, Digby's apartment catches on fire, killing her.
Big Appachen
Big Appachen is the forty-year-old widower who marries Mariamma when she is 12. Big Appachen is the father of Jojo, Baby Mol, and Philipose, and the younger brother of Thankamma. Throughout his life, Big Appachen suffers from limited hearing and intense fear of water, as his mother secluded him in Parambil to protect him from the Condition. He is quiet and reserved, and cannot read, but is quick to care for Mariamma and his family, even to his own detriment. For example, he walks for days to retrieve Mariamma's mother, whom Mariamma fears is being mistreated. He also gives away large parcels of land to any relative who asks, even distant relations who exploit his generosity. He eventually dies after suffering stroke-like symptoms, leaving Mariamma in charge of the family.
Shamuel
Shamuel is the beloved and respected estate manager of Parambil who helped raise Big Appachen and his children; he is Joppan's biological father. Though Shamuel is intelligent, fiscally responsible, and wise, he refuses to be recognized for his accomplishments or receive affection, as he has internalized shame around being a member of the pulayar caste. He even disciplines Joppan for trying to attend school, though he encourages Philipose's education. Shamuel lives to an advanced age, working for the Parambil family until the day he dies. His funeral is well-attended, and he leaves behind a small fortune to Joppan, hoping his son will continue the tradition of serving the Parambil family.
Joppan
Joppan is Shamuel's son, Philipose's close friend, and father to Podi. As a child, Joppan is admired for his intelligence and self-confidence. After he is brutally beaten for attempting to attend school, Joppan works on a barge, earning a living outside of Parambil and joining the Communist party. Intellectual and passionate about undoing colonialism and the caste system, Joppan rejects Philipose's offer to take over his father's role as caretaker of Parambil and instead tries to expand his barge business. However, when Joppan's employees go on strike, he loses his business and returns, accepting Philipose's reduced offer. When Mariamma expands the hospital, he works as her surgical assistant, learning medicine quickly and competently.
Shoshamma and Uplift Master
Shoshamma is a distant relative of the Parambil family who inherits property on the estate after her brother's death. Her husband, called Uplift Master for his contributions to the community, is a former employee of the East India Trading Company. Using his creativity and skill in navigating bureaucracy, Uplift Master successfully improves conditions at Parambil, incorporating the area as a village, securing funding for schools and public services, and bringing electricity to homes. He is simultaneously generous and self-important, and stubbornly refuses to be intimate with his wife after she makes an insulting joke; in response, he develops a dependency on alcohol. He serves as a translator during the Maramon Convention, and uses the opportunity to plead with the Malayali community to prioritize health and build a hospital. Later, he is humiliated when one of his employees embezzles money, but then comes out of hiding to help Mariamma navigate the political tension preventing the hospital from opening.
Doctor Rune Orqvist
Rune Orqvist is a Swedish physician who washed ashore in Kochin and opened a practice serving the city's diverse communities. In Kochin, he is known for his kindness, patience, and unexpected vices. He assesses Baby Mol and Mariamma's mother, explaining their conditions with encouragement and reassurance. After a spiritual awakening, Rune joins a monastery and then opens Saint Bridget's, a community for people suffering from leprosy. He performs innovative surgery on the Saint Bridget's residents, specializing in regaining hand motor function. He helps Digby recover from his burn injuries before dying of a heart attack.
Honorine Charlton
Strong-willed and straight-forward, Honorine is the middle-aged matron at the Madras hospital. She is from the North of England and immediately connects with Digby, acting as a friend and surrogate mother. Honorine loves living in Madras and has a diverse circle of friends, to whom she introduces Digby. Extremely competent in the operating theater, Honorine helps save lives and is present when Claude kills Jeb. After Digby's accident, Honorine visits him, forgiving his mistakes and encouraging him to forgive himself. She later testifies against Claude and shares the news of his dismissal from the Indian Medical Service.
Jojo
Jojo is Big Appachen's son from his first marriage. Jojo is two when Big Appachen and Mariamma marry, and he immediately embraces Mariamma as his new mother. Jojo is afraid of water, and resists bathing, but enjoys climbing trees and performing tricks for his friends. After swinging down from a tree and landing in an irrigation ditch, Jojo drowns in a shallow pool of water.
Thankamma
Thankamma is Big Appachen's elder sister. Thankamma is lighthearted and encouraging, caring for Mariamma like a daughter after the young girl's marriage. She teaches Mariamma to cook and gives her advice about dealing with her brother.
Lizzi and Kora
Kora is a distant relation of Big Appachen, and Lizzi is his compassionate, unusually beautiful wife, whose appearance is often compared to paintings of the Hindu goddess Lakshmi by artist Raja Ravi Varma. During their brief time at Parambil, Lizzi befriends Elsie and sits for a portrait, an experience that inspires her to take charge of her marriage and confront Kora's shady business practices. Though Kora is affectionate towards his wife, he is highly incompetent and regularly loses their savings. He also suffers from the Condition and asthma, which results in hallucinations when the couple lives at high altitudes. During one such episode, he attacks Lizzi, slicing a wound in her womb through which her unborn son sticks his fist. Though fearful and in tremendous pain, Lizzi is composed and forgiving. She and Kora are Lenin's parents, and they live in a rundown hut, where they both die during a smallpox epidemic. Kora's last piece of advice to his son is to "follow the straight path," warning Lenin against the unethical schemes that ruined his future.
Odat Kochamma
An elderly, distant relation of Big Appachen, Odat Kochamma arrives at Parambil after Mariamma's mother grows ill. Irreverent yet extremely religious, Odat Kochamma helps Mariamma heal from Jojo's death with her crude jokes and good cooking. Extremely loyal and loving, Odat Kochamma lives to an advanced age, and Mariamma senses her spirit even after her death, especially during Elsie's harrowing labor.
Franz and Lena Mylin
Franz and Lena Mylin are a British couple who befriend Digby after he treats Lena for peritonitis, which Claude diagnosed as seasickness, giving her a transfusion of his own blood, thus saving her life. After Digby's accident, Lena and Franz host him at their estate while he recovers, later introducing him to Rune. Digby confides in Lena when he falls in love with Elsie, and she encourages him to carefully and kindly pursue her.
Cromwell
Originally a driver for the Mylins, Cromwell is Badagas man who becomes Digby's friend and business partner. While Digby convalesces at the Mylin's home, Cromwell takes him on healing walks through nature. The two later purchase an estate together, helping each other stave off isolation and tending to the land.
Chandy
A wealthy man and father to Elsie, Chandry becomes devoted to Saint Bridget's after Rune saves his life. Chandry is known for being a kindhearted and responsible father, despite his chronic alcoholism. He agrees to Philipose's proposal of marriage, knowing that it will help support Elsie's career. He dies of a heart attack a few months after Ninan's death.
Koshy Saar
A scholar of English and an eccentric war veteran, Koshy Saar takes responsibility for Philipose's education after a bike accident, lending him classic novels, teaching him English, and inspiring him to pursue writing.
