The doctor said that so-and-so indicated that there was so-and-so inside the patient, but if the investigation of so-and-so did not confirm this, then he must assume that and that. If he assumed that and that, then… and so on. To Ivan Ilych only one question was important: was his case serious or not? But the doctor ignored that inappropriate question. From his point of view it was not the one under consideration, the real question was to decide between a floating kidney, chronic catarrh, or appendicitis.
It was not a question the doctor solved brilliantly, as it seemed to Ivan Ilych, in favour of the appendix, with the reservation that should an examination of the urine give fresh indications the matter would be reconsidered. All this was just what Ivan Ilych had himself brilliantly accomplished a thousand times in dealing with men on trial. The doctor summed up just as brilliantly, looking over his spectacles triumphantly and even gaily at the accused. From the doctor’s summing up Ivan Ilych concluded that things were bad, but that for the doctor, and perhaps for everybody else, it was a matter of indifference, though for him it was bad. And this conclusion struck him painfully, arousing in him a great feeling of pity for himself and of bitterness towards the doctor’s indifference to a matter of such importance.
He said nothing of this, but rose, placed the doctor’s fee on the table, and remarked with a sigh: “We sick people probably often put inappropriate questions. But tell me, in general, is this complaint dangerous, or not? … “
The doctor looked at him sternly over his spectacles with one eye, as if to say: “Prisoner, if you will not keep to the questions put to you, I shall be obliged to have you removed from the court.”
“I have already told you what I consider necessary and proper. The analysis may show something more.” And the doctor bowed.
Ivan Ilych went out slowly, seated himself disconsolately in his sledge, and drove home. All the way home he was going over what the doctor had said, trying to translate those complicated, obscure, scientific phrases into plain language and find in them an answer to the question: “Is my condition bad? Is it very bad? Or is there as yet nothing much wrong?” And it seemed to him that the meaning of what the doctor had said was that it was very bad. Everything in the streets seemed depressing. The cabmen, the houses, the passers-by, and the shops, were dismal. His ache, this dull gnawing ache that never ceased for a moment, seemed to have acquired a new and more serious significance from the doctor’s dubious remarks. Ivan Ilych now watched it with a new and oppressive feeling.
He reached home and began to tell his wife about it. She listened, but in the middle of his account his daughter came in with her hat on, ready to go out with her mother. She sat down reluctantly to listen to this tedious story, but could not stand it long, and her mother too did not hear him to the end.
“Well, I am very glad,” she said. “Mind now to take your medicine regularly. Give me the prescription and I’ll send Gerasim to the chemist’s.” And she went to get ready to go out.
While she was in the room Ivan Ilych had hardly taken time to breathe, but he sighed deeply when she left it.
“Well,” he thought, “perhaps it isn’t so bad after all.”
He began taking his medicine and following the doctor’s directions, which had been altered after the examination of the urine. But then it happened that there was a contradiction between the indications drawn from the examination of the urine and the symptoms that showed themselves. It turned out that what was happening differed from what the doctor had told him, and that he had either forgotten or blundered, or hidden something from him. He could not, however, be blamed for that, and Ivan Ilych still obeyed his orders implicitly and at first derived some comfort from doing so.
From the time of his visit to the doctor, Ivan Ilych’s chief occupation was the exact fulfillment of the doctor’s instructions regarding hygiene and the taking of medicine, and the observation of his pain and his excretions. His chief interest came to be people’s ailments and people’s health. When sickness, deaths, or recoveries were mentioned in his presence, especially when the illness resembled his own, he listened with agitation which he tried to hide, asked questions, and applied what he heard to his own case.
The pain did not grow less, but Ivan Ilych made efforts to force himself to think that he was better. And he could do this so long as nothing agitated him. But as soon as he had any unpleasantness with his wife, any lack of success in his official work, or held bad cards at bridge, he was at once acutely sensible of his disease. He had formerly borne such mischances, hoping soon to adjust what was wrong, to master it and attain success, or make a grand slam. But now every mischance upset him and plunged him into despair. He would say to himself: “there now, just as I was beginning to get better and the medicine had begun to take effect, comes this accursed misfortune, or unpleasantness… ” And he was furious with the mishap, or with the people who were causing the unpleasantness and killing him, for he felt that this fury was killing him but he could not restrain it.
One would have thought that it should have been clear to him that this exasperation with circumstances and people aggravated his illness, and that he ought therefore to ignore unpleasant occurrences. But he drew the very opposite conclusion: he said that he needed peace, and he watched for everything that might disturb it and became irritable at the slightest infringement of it. His condition was rendered worse by the fact that he read medical books and consulted doctors. The progress of his disease was so gradual that he could deceive himself when comparing one day with another — the difference was so slight. But when he consulted the doctors it seemed to him that he was getting worse, and even very rapidly. Yet despite this he was continually consulting them.
That month he went to see another celebrity, who told him almost the same as the first had done but put his questions rather differently, and the interview with this celebrity only increased Ivan Ilych’s doubts and fears. A friend of a friend of his, a very good doctor, diagnosed his illness again quite differently from the others, and though he predicted recovery, his questions and suppositions bewildered Ivan Ilych still more and increased his doubts. A homeopathist diagnosed the disease in yet another way, and prescribed medicine which Ivan Ilych took secretly for a week. But after a week, not feeling any improvement and having lost confidence both in the former doctor’s treatment and in this one’s, he became still more despondent. One day a lady acquaintance mentioned a cure effected by a wonder-working icon.
Ivan Ilych caught himself listening attentively and beginning to believe that it had occurred. This incident alarmed him. “Has my mind really weakened to such an extent?” he asked himself. “Nonsense! It’s all rubbish. I mustn’t give way to nervous fears but having chosen a doctor must keep strictly to his treatment. That is what I will do. Now it’s all settled. I won’t think about it, but will follow the treatment seriously till summer, and then we shall see. From now there must be no more of this wavering!” this was easy to say but impossible to carry out. The pain in his side oppressed him and seemed to grow worse and more incessant, while the taste in his mouth grew stranger and stranger. It seemed to him that his breath had a disgusting smell, and he was conscious of a loss of appetite and strength. There was no deceiving himself: something terrible, new, and more important than anything before in his life, was taking place within him of which he alone was aware.
Those about him did not understand or would not understand it, but thought everything in the world was going on as usual. That tormented Ivan Ilych more than anything. He saw that his household, especially his wife and daughter who were in a perfect whirl of visiting, did not understand anything of it and were annoyed that he was so depressed and so exacting, as if he were to blame for it. Though they tried to disguise it he saw that he was an obstacle in their path, and that his wife had adopted a definite line in regard to his illness and kept to it regardless of anything he said or did. Her attitude was this: “You know,” she would say to her friends, “Ivan Ilych can’t do as other people do, and keep to the treatment prescribed for him. One day he’ll take his drops and keep strictly to his diet and go to bed in good time, but the next day unless I watch him he’ll suddenly forget his medicine, eat sturgeon — which is forbidden — and sit up playing cards till one o’clock in the morning.”
“Oh, come, when was that?” Ivan Ilych would ask in vexation. “Only once at Peter Ivanovich’s.”
“And yesterday with Shebek.”
“Well, even if I hadn’t stayed up, this pain would have kept me awake.”
“Be that as it may you’ll never get well like that, but will
