The Death of Ivan Ilyich
Author : Leo Tolstoy
This masterpiece by the renowned Russian writer is a profound study in human nature, charting as it does the gradual decrepitude and eventual demise of an unremarkable man. The book not only portrays the author’s perceptive understanding of the inner torment that accompanies the contemplation of imminent death, it also demonstrates his grasp of how these emotions are shaped by human relationships. In painstakingly depicting the innermost thoughts and turbulent emotions of the contemplation of imminent mortality, the book demonstrates how the terror and helplessness of dying often reflect the perception of how one has lived. The book is therefore as much about what gives this life value, as it is about what gives its ending meaning. Beyond that, it is also a critique of society as a whole, the author contrasting its fragile social fabric to its rigid bureaucratic institutions.
In describing the manifestly banal and conventional life of the protagonist of the book, the fictional Ivan Ilyich, the author sketched the portrait of ‘a capable man, cheerful and kind, sociable and convinced of the need to follow the path of duty‘ who ‘did his work, pursued his career and at the same time discreetly enjoyed himself’. The narrative also counterpoised his attitude to work, ‘exceedingly conservative, bureaucratic and even forbidding‘, with his social persona, ‘often amusing and witty, and always pleasantly polite‘. The book however attributed to him a very capricious nature, his manner fluctuating widely depending on his fortunes – he was content when they were favourable, but when his luck turned sour, he ‘saw himself as the victim of an outrageously cruel injustice‘ and resented how ‘everyone else thought it was just the way things went’. The author also characterised his social ties as weak and superficial, expressing this through the selfish thoughts of his friends and colleagues who, on learning of his death, expressed relief ‘that he had died and they hadn’t’, and who worried only about how his death would affect their prospects ‘for transfer or promotion’. Perhaps even worse, the author conveyed their unease about having ‘to fulfil some tedious social obligations such as attending the funeral and calling on the widow to express their condolences‘ (pages 15-17, 26-27, 36-37 and 2-3).
One of the most compelling features of the book its most intuitive portrayal of the illness that eventually consumed Ivan Ilyich – a poorly defined malady that emerged innocuously after he fell and bumped his side on a window frame knob. The book painted a menacing picture of the progression of the disease through its agonisingly slow course, noting for example how the occasional ‘funny feeling in his left side’ developed into ‘a constant dragging sensation…which put him in a bad mood‘. The narrative also graphically conveyed the harrowing self-pity and ‘constant despair‘ that dominated his thoughts; these emanated from ‘the depths of his soul’ and endured because ‘he could not get used to the idea’ that he was dying. The book portrayed his futile attempts to avoid thinking about death, describing his awareness that ‘everything that once had protected him by hiding and eliminating any awareness of death was unable to perform that function now’. To symbolise the utter hopelessness of the situation, the author depicted Ilyich’s anguishing realisation that ‘whatever was done, nothing would emerge but more and more agony, suffering and death‘ (pages 32, 37-38, 48-59 and 64).
A key theme of the book relates to the troubling deathbed ruminations of Ivan Ilyich, reflections which the author chronicled in their most distressing manifestations. It is perhaps understandable that many of his cogitations expressed self-pitying notions of unfairness, for example when he questioned the reason for ‘all this horror‘, incredulous that ‘life could have been as senseless and sickening as this’. The book also projected the self-blaming thoughts that ‘did most to poison the last days in the life of Ivan Ilyich’; these were thoughts of having lived a life of pretence which left him remorseful that ‘maybe I didn’t live as I should have done’. The memories of his fading life also haunted him, the author writing that ‘in his last days of solitude‘, Ilyich ‘lived only by recreating the past’, a pastime that was dominated by how ‘images of his past life came back to him one after another’. It is therefore illuminating when the author pointed out that, ‘more dreadful than the physical pain’, it was the ‘suffering in spirit‘ that was Ilyich’s ‘greatest agony‘, and this reached its terrifyingly dramatic denouement when he recognised that, despite all his fighting and struggling, he was getting nearer and nearer to the thing that terrified him’. It is indeed this feeling of being ‘crammed by an invisible, unstoppable force’ that caused his insufferable screams which ‘went on unbroken for three days’ (pages 80-89 and 66).
In his insightful depiction of Ivan Ilyich’s encounters with his doctors, the author most astutely explored the way healthcare focuses on physical illness and glosses over psychological suffering. This was evident for example in Ilyich’s first unhappy consultation during which he became irritated by the doctor’s ‘knowing look’ and sense of ‘self-importance‘. The author also portrayed Ilyich’s frustrations with the doctor’s questions which had ‘predetermined and obviously superfluous answers’, and with how the doctor dismissed his concerns about whether his illness was life-threatening. Concluding from this that he was ‘in a bad way’ but ‘the doctor didn’t care’, Ilyich became consumed ‘with self-pity and great animosity towards the doctor who showed so much indifference‘. Indeed, the author added, because of the doctor’s confusing pronouncements, Ilyich’s pain took on ‘a new and more serious significance’. Symbolic of the limits of healthcare, the author went on to narrate how Ilyich consulted several doctors, who sadly ‘gave him conflicting diagnoses (pages 44-45).
Just as the author portrayed the effect of illness on emotions, he also provided a discerning depiction of how illness affects relationships. In this regard, the author described how Ilyich became irritable when he sensed that his family was unconcerned about his suffering, and that they ‘thought that everything in the world was going on as before’; this made him rage at them on the least provocation, a situation that tipped an already brittle matrimony into full marital discord. In representing the fallout of this, the author described how his resentful wife, Praskoya Fyodorovna, ‘began to wish he was dead’ but cautioned herself when she considered the loss of income his death would imply. Perhaps as a reflection of his family’s unsympathetic attitude to his condition, Ilyich’s dying wishes were for empathy – ‘for someone to take pity on him as of he was a sick child‘, and ‘to be kissed and cuddled and have a few tears shed over him’. It was particularly poignant therefore that it was Gerasim, ‘the peasant servant who waited on them at table’, who best understood his situation, and who provided him with the comfort that neither his family or friends could (pages 22, 37-39, 43-45 and 60-66).
In a uniquely perceptive writing style, the author of this book depicts the evolution of an unstated illness and describes its impact on the victim, his family, and his friends. Particularly enlightening is the book’s characterisation of the emotional turmoil that accompanies a progressive and incurable disease, and the way this is exacerbated by the unsympathetic attitudes of family members, and the lack of empathy from health practitioners. In many ways, the book is also an exploration of the darker side of human sentiments, reflecting the self-centred considerations of those privy to the misfortune of others, and expressing their uncomfortable hidden thoughts. Despite the gloom of the topic however, the author’s prose, simple but elegant, is a pleasure to read.
This book is an observation of human nature that serves as a mirror for the reader. Revealing the true nature of most lives, and the deepest secrets of most minds, the book teaches the importance of ordering our lives in anticipation of its ending, and emphasising what really matters when life approaches its end. The book portrays the thoughts and deep wishes of the dying, and emphasises the sensitivity and courtesy by which everyone should treat the sick. For highlighting these lessons, central to healthcare, I recommend the book to all doctors.
Publisher, Place, Year: Penguin Books, London, 1882
Number of chapters: 8
Number of pages: 114
Star rating: 5