# The Complete Works of Count Tolstoy/Volume 18/The Death of Iván Ílich/Chapter 4

IV.
All were well. It was impossible to call ailment that of which Iván Ilích now and then said that he had a peculiar taste in his mouth and an uncomfortable feeling in the left side of his abdomen.
But it so happened that this discomfort kept growing and passing, not yet into a pain, but into the consciousness of a constant weight in his side and into ill humour. This ill humour, growing and growing all the time, began to spoil the pleasure of the light and decent life which had established itself in the family of the Golovíns. Man and wife began to quarrel more and more often, and soon there disappeared the ease and pleasure, and with difficulty decency alone was maintained. The scenes became more frequent again. Again there were left some islets, but only a few of these, on which husband and wife could meet without any explosion. Praskóvya Fédorovna now said not without reason that her husband was hard to get along with. With her usual habit of exaggerating, she said that he had always had such a terrible character that one had to have her goodness to have stood him for twenty years. It is true, the quarrels now began with him. It was he who began to find fault, always immediately before dinner, and frequently just as he was beginning to eat, during his soup. Now he remarked that some dish was chipped, or the food was not just right, or his son had put his elbow on the table, or there was something wrong with his daughter's hairdressing. For everything he blamed Praskóvya Fédorovna.
Praskóvya Fédorovna at first retorted and told him ​disagreeable things, but he once or twice flew into such a rage during the dinner that she understood that this was a morbid condition, which was provoked in him by the partaking of the food, and she curbed herself: she no longer retorted, but only hastened to eat her dinner. Praskóvya Fédorovna regarded her humility as a great desert of hers. Having made up her mind that her husband had a terrible character, and had been the misfortune of her life, she began to pity herself, and the more she pitied herself, the more did she hate her husband. She began to wish that he would die, but she could not wish this, because then there would be no salary. And this irritated her still more against him. She considered herself terribly unfortunate even because his very death could not save her, and she was irritated and concealed her irritation, and this concealed irritation increased her irritation.
After a scene, in which Iván Ilích was particularly unjust, and after which he during the explanation said that he was indeed irritable, but that this was due to his disease, she said to him that if he was ill, he had to undergo a cure, and so demanded of him that he should consult a famous physician.
He went to see him. Everything was as he had expected; everything was done as such things always are. The expectancy, and the assumed importance of the doctor, which was familiar to him and which he knew in himself in the court, and the tapping, and the auscultation, and the questions which demanded previously determined and apparently useless answers, and the significant aspect which seemed to say, "Just submit to us, and we shall arrange everything; we know indubitably how to arrange it all, in the same fashion for any man you please." Everything was precisely as in the court. Just as he assumed a certain mien in respect to the defendants, so the famous doctor assumed the same mien.
​The doctor said, "So and so shows that inside of you there is so and so; but if that is not confirmed by the investigation of so and so, we shall have to assume so and so. If we assume so and so, then—" and so forth. Iván Ilích was interested in but one question, and that was, whether his situation was dangerous, or not. But the doctor ignored this irrelevant question. From the doctor's standpoint, this question was idle and not subject to consideration; there existed only a weighing of probabilities,―between a floating kidney, a chronic catarrh, and the disease of the cæcum. This dispute the doctor decided in the presence of Iván Ilích in a brilliant manner in favour of the cæcum, with the proviso that the investigation of the urine might give new symptoms, and then the case would be revised. All that was precisely what Iván Ilích had a thousand times done in just as brilliant a manner in the case of defendants. The doctor made his résumé in just as brilliant a manner, and looked with a triumphant and merry glance over his glasses at the defendant. From the doctor's résumé Iván Ilích drew the conclusion that things were bad, and that it was a matter of indifference to him, the doctor, and, for all that, to all people, but bad for himself. This conclusion morbidly affected Iván Ilích, provoking in him a feeling of great pity for himself and of great anger against this doctor who was indifferent to such an important question.
But he did not say anything; he only got up, put the money down on the table, and said, sighing, "We sick people no doubt frequently put irrelevant questions to you. Is this, in general, a dangerous disease, or not?"
The doctor cast a stern glance at him with one eye, above his glasses, as though saying, "Defendant, if you do not remain within the limits of the questions put to you, I shall be obliged to order your removal from the court-room."
"I have already told you what I consider necessary ​and proper," said the doctor. "Further things will be disclosed in the investigation."
And the doctor made a bow.
Iván Ilích went out slowly, gloomily seated himself in the sleigh, and drove home. All the way he continued analyzing everything which the doctor had said, trying to translate all those mixed, obscure scientific terms into simple language, and to read in them an answer to the question, "Am I in bad shape, in very bad shape, or is it still all right?" And it seemed to him that the meaning of everything said by the doctor was that he was in bad shape. Everything in the streets appeared sad to Iván Ilích. The drivers were sad, the houses were sad, the passers-by, the shops were sad. But this pain, this dull, grinding pain, which did not leave him for a minute, seemed, in connection with the doctor's obscure words, to receive another, a more serious meaning. Iván Ilích now watched it with another, a heavy feeling.
He came home and began to tell his wife about it. His wife listened to him, but in the middle of the conversation his daughter entered, with a hat on her head; she was getting ready to drive out with her mother. She made an effort to sit down and listen to all that tiresome talk, but did not hold out, and her mother, too, did not stop to hear the end of it.
"Well, I am very glad," said his wife. "So now, be sure and take the medicine regularly. Give me the recipe,—I will send Gerásim to the apothecary's."
And she went out to get dressed.
He did not dare to draw breath while she was in the room, but when she left, he heaved a deep sigh.
"Well," he said, "maybe it is, indeed, all right yet.”
He began to take medicine, to carry out the doctor's prescriptions, which were changed in consequence of the urine investigation. But here it somehow happened that in this investigation and in what was to follow after it ​things became mixed up. It was impossible for him to make his way to the doctor himself, and it turned out that things were done differently from what the doctor had ordered. Either the doctor had forgotten something or told an untruth, or was hiding something from him.
But Iván Ilích none the less began punctually to carry out the doctor's instructions, and at first found some consolation in performing this duty.
Iván Ilích's chief occupation, since his visit to the doctor, became a punctual execution of the doctor's instructions as regards hygiene and the taking of medicine and the watching of his disease and of all the functions of his organism. People's diseases and health became his chief interest. When they spoke in his presence of sick people, of such as had died or were recuperating, especially of a disease which resembled his own, he, trying to conceal his agitation, listened, inquired, and made deductions as to his own disease.
The pain did not subside; but Iván Ilích made efforts over himself, in order to make himself believe that he was feeling better. He was able to deceive himself so long as nothing agitated him. But the moment he had some unpleasantness with his wife, some failure in his service, bad cards in vint, he immediately felt the full force of his disease. Formerly he had borne these failures, hoping that he would mend what was bad, would struggle and gain some success, would get a full hand; but now every failure sapped his strength, and cast him into despair. He said to himself: "I had just begun to mend, and the medicine had begun to act, when this accursed misfortune or unpleasantness befell me—" And he was furious at the misfortune or at the people who caused him an unpleasantness and were killing him, and he felt that this anger was killing him, but was unable to keep from it. It would seem that it must have become clear to him that this embitterment against circumstances and ​people only intensified his disease, and that, therefore, he ought to pay no attention to unpleasant incidents; but he made the very contrary reflection: he said that he needed calm, and watched everything which impaired his calm, and became irritable with every least impairment. What made his condition worse was his reading books on medicine and consulting doctors. His health declined so evenly that he was able to deceive himself when he compared one day with another,—there was little difference. But when he consulted doctors, it seemed to him that he was growing worse, and very rapidly at that; but, in spite of that, he constantly consulted doctors.
This month he called on another celebrity: the other celebrity told him almost the same as the first celebrity, but put the questions differently. The consultation with this celebrity only increased Iván Ilích's doubt and fear. The friend of a friend of his, a very good doctor, determined the disease in a still different manner, and, although he promised a cure, he with his questions and assumptions still more confused Iván Ilích and intensified his doubts. A homoeopathist determined the disease in a still different way and gave him some medicine, and he took it for a week, secretly from all. But at the end of the week he felt no relief and lost his confidence in all former treatments and in the present one, too, and so became still more dejected. At one time a lady acquaintance told him of a cure by means of holy images. Iván Ilích caught himself listening attentively and believing the actuality of the fact. This incident frightened him.
"Is it possible I have mentally grown so feeble?" he said to himself. "Nonsense! It's all bosh! I must not submit to my small faith, but, selecting one physician, must strictly adhere to his treatment. I shall do so. It's all over with that. I will not think, and will stick to the one treatment until summer. We shall know what to do after that. Now there is an end to wavering!"
​It was easy to say all that, but impossible to execute it. The pain in his side was still annoying and seemed to be increasing and growing more constant; the taste in his mouth grew more and more queer,—he thought a disgusting smell came from his mouth,—and his appetite and his strength grew weaker and weaker. It was impossible for him to deceive himself: something terrible, new, and more significant than anything that had ever taken place in his life was now going on in him. He alone knew of it, and all those who surrounded him did not understand it, or did not wish to understand it, and thought that everything in the world was going on as before. That tormented him more than anything. His home folk, especially his wife and his daughter, who were in the very heat of calls, he saw, did not understand a thing about it and were annoyed because he was so cheerless and so exacting, as though it were his fault. Though they tried to conceal this, he saw that he was an obstacle to them, but that his wife had worked out for herself a certain relation to his disease and held on to it independently of what he said and did. This relation was like this:
"You know," she would say to her friends, "Iván Ilích, like all good people, is unable strictly to take the prescribed cure. To-day he will take the drops and eat what he is ordered to eat, and will go to bed early; to-morrow, if I do not watch him, he will forget to take the medicine, will eat some sturgeon (and he is not allowed to eat that), and will sit up playing vint until one o'clock.
"'When did I do it?' Iván Ilích will say in anger. Just this once at Peter Ivánovich's.'
"'And yesterday at Shébek's.'
"'It makes no difference, I cannot sleep from pain anyway.'
"'Whether from pain or from anything else, you will never get well this way, and you only torment us.'"
​Praskóvya Fédorovna's external relation to her husband's ailment, which she expressed to him as much as to others, was this, that Iván Ilích had himself to blame for this ailment, and that this whole ailment was a new annoyance which he was causing his wife. Iván Ilích felt that that came involuntarily from her, but that did not make it any easier for him.
In the court Iván Ilích observed, or thought that he observed, the same strange relation to himself: now it seemed to him that people peeped at him as at a man who was soon to make a place vacant; now his friends began in a jesting manner to tease him on account of his suspiciousness, as though the fact that something terrible and horrible, something unheard-of, which was taking place in him and gnawing at him and drawing him somewhere, were a most agreeable subject for jests. He was particularly irritated by Schwarz, who with his playfulness, vivacity, and comme il faut ways reminded him of what he had been ten years before.
Friends come to have a game, and they sit down at the table. The cards are dealt; the new cards are separated, and the diamonds are placed with the diamonds,—seven of them. The partner says, "Without trumps," and supports two diamonds. What else should one wish? It ought to be jolly and lively,—a clean sweep. And suddenly Iván Ilích feels such a gnawing pain, such a bad taste in his mouth, and it feels so queer to him to be able with all that to find any pleasure in a clean sweep.
He looks at Mikhail Mikhaylovich, his partner, as he with the hand of a sanguine man strikes the table and politely and condescendingly refrains from sweeping in the stakes and moves them up to Iván Ilích, in order to give him the pleasure of taking them in, without going to much trouble or stretching his hand far.
"Does he really think that I am so feeble that I cannot stretch out my hand?" thinks Iván Ilích, and he ​forgets what is trumps, and unnecessarily trumps his own cards, and loses the clean sweep by three points, and, what is more terrible still, he sees Mikhaíl Mikháylovich suffering, and that makes no difference to him. And it is terrible for him to think that it makes no difference to him.
All see that it is hard for him, and they say to him: "We can stop, if you are tired. You had better rest."
Rest? No, he is not in the least tired, he will finish the rubber. All are sad and silent. Iván Ilích feels that it is he who has cast this gloom over them, and he cannot dispel it. They eat supper and leave, and Iván Ilích is left alone with the consciousness that his life is poisoned for him and poisons others, and that this poison does not weaken him, but more and more penetrates all his being.
And it was with this consciousness, in addition to the physical pain, and with terror, that he had to lie down in his bed, and often be unable from pain to sleep the greater part of the night. In the morning he had to get up again, go to the court, or, if not in court, stay at home all the twenty-four hours of the day, each of which was a torment. And he had to live by himself on the edge of perdition, without a single man to understand or pity him.