After completing his medical education he began a medical journal named "The Ambrosia" while practicing medicine in Tiruchi. This medical journal lasted approximately three or four years until Kuppuswamy tired of his simple work as a journal writer. In 1923 he left Malaysia and returned to India to pursue a spiritual quest. Upon his return to India in 1924 he visited Varanasi, Nashik, and then Rishikesh, where he met his Guru, Vishwānanda Saraswati. It was Vishwānanda who initiated him into the Sannyasa order and gave him his monastic name. After initiation Sivānanda settled in Rishikesh and immersed himself in intense spiritual practices. Sivānanda performed austerities for many years but he also continued to nurse the sick. With some money from his insurance policy that had matured, he started a charitable dispensary at Lakshman Jhula in 1927, serving pilgrims, holy men and the poor using his medical expertise.
