They were all in good health. It could not be called ill health if Ivan Ilych sometimes said that he had a queer taste in his mouth and felt some discomfort in his left side. But this discomfort increased and, though not exactly painful, grew into a sense of pressure in his side accompanied by ill humour. And his irritability became worse and worse and began to mar the agreeable, easy, and correct life that had established itself in the Golovin family. Quarrels between husband and wife became more and more frequent, and soon the ease and amenity disappeared and even the decorum was barely maintained. Scenes again became frequent, and very few of those islets remained on which husband and wife could meet without an explosion. Praskovya Fedorovna now had good reason to say that her husband's temper was trying. With characteristic exaggeration she said he had always had a dreadful temper, and that it had needed all her good nature to put up with it for twenty years. It was true that now the quarrels were started by him. His bursts of temper always came just before dinner, often just as he began to eat his soup. Sometimes he noticed that a plate or dish was chipped, or the food was not right, or his son put his elbow on the table, or his daughter's hair was not done as he liked it, and for all this he blamed Praskovya Fedorovna. At first she retorted and said disagreeable things to him, but once or twice he fell into such a rage at the beginning of dinner that she realized it was due to some physical derangement brought on by taking food, and so she restrained herself and did not answer, but only hurried to get the dinner over. She regarded this self-restraint as highly praiseworthy. Having come to the conclusion that her husband had a dreadful temper and made her life miserable, she began to feel sorry for herself, and the more she pitied herself the more she hated her husband. She began to wish he would die; yet she did not want him to die because then his salary would cease. And this irritated her against him still more. She considered herself dreadfully unhappy just because not even his death could save her, and though she concealed her exasperation, that hidden exasperation of hers increased his irritation also. After one scene in which Ivan Ilych had been particularly unfair and after which he had said in explanation that he certainly was irritable but that it was due to his not being well, she said that if he was ill it should be attended to, and insisted on his going to see a celebrated doctor. He went. Everything took place as he had expected and as it always does. There was the usual waiting and the important air assumed by the doctor, with which he was so familiar (resembling that which he himself assumed in court), and the sounding and listening, and the questions which called for answers that were foregone conclusions and were evidently unnecessary, and the look of importance which implied that "if only you put yourself in our hands we will arrange everything—we know indubitably how it has to be done, always in the same way for everybody alike." It was all just as it was in the law courts. The doctor put on just the same air towards him as he himself put on towards an accused person.

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 of Ivan Ilyich's life or death, but one between a floating kidney and appendicitis. And that 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 always make us wretched."

Praskovya Fedorovna's attitude to Ivan Ilych's illness, as she expressed it both to others and to him, was that it was his own fault and was another of the annoyances he caused her. Ivan ilych felt that this opinion escaped her involuntarily—but that did not make it easier for him.

At the law courts too, Ivan Ilych noticed, or thought he noticed, a strange attitude towards himself. It sometimes seemed to him that people were watching him inquisitively as a man whose place might soon be vacant. Then again, his friends would suddenly begin to chaff him in a friendly way about his low spirits, as if the awful, horrible, and unheard-of thing that was going on within him, incessantly gnawing at him and irresistibly drawing him away, was a very agreeable subject for jests. Schwartz in particular irritated him by his jocularity, vivacity, and savoir-faire, which reminded him of what he himself had been ten years ago.

Friends came to make up a set and they sat down to cards. They dealt, bending the new cards to soften them, and he sorted the diamonds in his hand and found he had seven. His partner said "No trumps" and supported him with two diamonds. What more could be wished for? It ought to be jolly and lively. They would make a grand slam. But suddenly Ivan Ilych was conscious of that gnawing pain, that taste in his mouth, and it seemed ridiculous that in such circumstances he should be pleased to make a grand slam.

He looked at his partner Mikhail Mikhaylovich, who rapped the table with his strong hand and instead of snatching up the tricks pushed the cards courteously and indulgently towards Ivan Ilych that he might have the pleasure of gathering them up without the trouble of stretching out his hand for them. "Does he think I am too weak to stretch out my arm?" thought Ivan Ilych, and forgetting what he was doing he over-trumped his partner, missing the grand slam by three tricks. And what was most awful of all was that he saw how upset Mikhail Mikhaylovich was about it but did not himself care. And it was dreadful to realize why he did not care.

They all saw that he was suffering, and said: "We can stop if you are tired. Take a rest." Lie down? No, he was not at all tired, and he finished the rubber. All were gloomy and silent. Ivan Ilych felt that he had diffused this gloom over them and could not dispel it. They had supper and went away, and Ivan Ilych was left alone with the consciousness that his life was poisoned and was poisoning the lives of others, and that this poison did not weaken but penetrated more and more deeply into his whole being.

With this consciousness, and with physical pain besides the terror, he must go to bed, often to lie awake the greater part of the night. Next morning he had to get up again, dress, go to the law courts, speak, and write; or if he did not go out, spend at home those twenty-four hours a day each of which was a torture. And he had to live thus all alone on the brink of an abyss, with no one who understood or pitied him.