CHENNAI, India — Moments before the plane touches down, Jay Tronson swallows a Vicodin to ease the pain that feels like an ice pick in his left hip.

It's nearly 4 a.m., his brain feels like mush and all he can think of is the bed in his hotel room. He can hardly believe he's in India. The 54-year-old Texan has never left North America before. Never had a passport.