Yet another two weeks pass. During this time, Petrishchev finally proposes to Liza, but when Praskovya enters Ivan’s room to tell him the good news, she discovers that his condition has become even worse overnight, so she doesn’t say what she intended to say. Instead, she talks about his medicine until she catches him glaring at her with hatred. “For Christ’s sake, let me die in peace!” he exclaims. Just as Praskovya about to leave, Liza enters and begins talking about her father’s medicine, but he only gives her the same look and assures her that pretty soon he won’t burden them anymore. When Liza and her mother step out of the room, she asks Praskovya what they’ve done to upset him, saying that she pities Ivan but also doesn’t see why she and her mother have to suffer as a result of his illness.
Again, Ivan resents his family members because they fail to show him the kind of empathy he thinks he deserves. In this exchange, it becomes clear that the family’s tense relational dynamic is related not just to Praskovya and Liza’s insensitivity, but to Ivan’s vehemence. After all, his wife and daughter are only talking about his medicine because they want to help him. At the same time, though, he’s right to pick up on the fact that they are less concerned than they perhaps could be, as made overwhelmingly apparent when Liza admits to her mother that she doesn’t like the strain Ivan’s illness has placed upon her otherwise happy life.
Ivan’s doctor comes, but Ivan tells him to go away, saying that everyone knows there’s nothing that can help him. Outside the bedroom, the doctor tells Praskovya that the only thing he can do is alleviate Ivan’s pain by giving him opium. Meanwhile, Ivan continues to contemplate the way he lived his life, finally admitting that he may not have lived so respectably after all. He realizes that the misgivings he had as a young man in law school were perhaps well-founded, and he senses that he has indeed led a wrongheaded life. As if to illustrate this, he can’t help but see Praskovya and Liza as embodiments of his wasted life when they visit him the following morning. Looking at them, he understands that everything he cared about in life did nothing but distract him from the most important part of existence: the inevitability of death.
Finally, Ivan allows himself to honestly assess his life. In doing so, he comes to see the superficial lifestyle he led as fleeting, unimportant, and inconsequential. Instead of focusing on his career or his status in society, he realizes, he should have thought about the nature of life. He has spent years trying to distract himself from his discontent, but nothing he has done will save him from death. Having grasped this concept, he sees Praskovya and Liza as manifestations of everything he did wrong in life, since they, too, care about the sort of superficial matters he used to obsess over. In turn, he finds a new reason to resent them, thereby estranging himself even further from his loved ones.
As Ivan looks at Praskovya and Liza, he begins to hate them for representing everything negative about the way he’s lived his life. He also begins to groan aloud, so Praskovya urges him to take communion. Too defeated to refuse, he agrees, so Praskovya summons a priest, who hears Ivan’s final confession. Afterward, Ivan feels slightly better. Praskovya notices this and points it out, asking him if he truly feels improved. He tells her that he does, but he looks away while saying it, sensing once again that everything about her—her clothing, facial expression, and tone of voice—is “wrong,” nothing but “a deception that hides life and death.” Thinking this way, his pain returns, though now it’s more intense. “Get out!” he screams. “Go away! Leave me alone!”
That Ivan derives momentary relief from taking communion once more hints that he has certain religious proclivities. It also suggests that Tolstoy sees religion as perhaps the only thing capable of soothing a dying man. And yet, this respite from suffering is short-lived, quickly turning into anger and bitterness. Once again, Ivan lashes out at the people around him, yelling at Praskovya because he doesn’t know how else to express his anguish. In turn, Tolstoy stops just short of sending a blatantly religious message, instead merely alluding to the fact that religion can bring comfort, ultimately refraining from fully presenting such spirituality as something that will invariably bring people peace.