As time passes, everyone in Ivan’s life understands that the only question regarding his death is how long it will take. He struggles each night to sleep and receives opioid and morphine injections, but none of these remedies make him feel better. He also has to eat specially prepared foods and must go to the bathroom in a chamber pot, which Gerasim empties. Thankfully, though, going to the bathroom also means that he can interact with Gerasim, of whom he has become very fond. Gerasim is a happy and pure young man who has no qualms about cleaning up after Ivan, and he even comes to Ivan’s aid when the dying man is incapable of bringing himself to or from the chamber pot.
In this section, Ivan’s condition only gets worse. It’s important to note that everyone around him has finally accepted this development. However, they continue to avoid acknowledging this in front of Ivan. Indeed, even if it’s obvious to them that he’s nearing the end of his life, they act like his condition isn’t so bad. This, it seems, is most likely because they don’t want to fully engage with his process of dying, finding it easier to mostly ignore what’s happening to him. The only person who is fully involved in Ivan’s demise is Gerasim, who helps him through everyday activities like going to the bathroom. Except for this young man, then, Ivan is alone.
When Gerasim is cleaning up after Ivan one day, Ivan acknowledges that this must not be very pleasant for him. However, Gerasim tells him not to worry, saying, “It’s no trouble. You’re a sick man.” On another occasion, Gerasim lets Ivan rest his legs on his shoulders, putting Ivan’s legs in an elevated position that eases his pain. After a while, Ivan tells Gerasim he can go, but the servant insists upon staying. From this point on, Ivan frequently calls for Gerasim so that he can elevate his legs, and he finds pleasure in talking to the young man and admiring the easy, unbegrudging way in which Gerasim behaves. Although Ivan resents other people’s healthiness, he finds Gerasim’s good health somehow calming and reassuring.
Ivan takes a liking to Gerasim because the young man represents a certain kind of innocence and purity that his own life lacks. This is because Ivan’s life has been corrupted by greed. Throughout his life, Ivan has devoted himself to superficial, materialistic modes of existence, all in an attempt to distract himself from his own discontent. Gerasim, on the other hand, has no problem embracing life’s difficulties, understanding that everyone will die one day. For this reason, he is happy to help Ivan in a way that nobody in Ivan’s social class is willing to do.
What Ivan hates most about his condition is that everyone around him pretends that he’ll recover. Ivan, on the other hand, knows he’s dying, so he thinks of everyone’s optimism as a lie. Even the doctors pretend that they’ll be able to help him, but this just enervates Ivan because he wants them to acknowledge his true condition. And yet, he never tells them to stop lying when they examine him and talk about his prospects.
By this point in the novella, Ivan has accepted his fate but hasn’t yet made peace with it. He knows that he’s dying, which is why he is so offended by everyone’s optimism. And yet, he can’t help but listen to his doctors with hope in his heart, wanting to be reassured of a possible recovery. In this way, he both admits and ignores reality, clearly too afraid of death to embrace his inevitable end.
In addition to thinking that everyone is lying to him, Ivan senses that the people around him see him as a burden. Believing that his doctors and loved ones see his dying as little more than a nuisance, he thinks that everyone blames him for acting in some kind of “indecent” manner. Worse, he knows that this very mindset arises from the standards of decency and social charm to which he has devoted his entire life. Knowing what everyone must be thinking, then, he realizes that nobody empathizes with him because they don’t want to truly understand his predicament. The only person willing to actually do this, he knows, is Gerasim, who tells him one evening, “We’ve all got to die one day. Why shouldn’t I give you a hand?”
As Ivan slowly dies, he recognizes that the life he lived was largely vapid and superficial, as evidenced by the fact that his peers and loved ones can’t be bothered to empathize with him. This, in turn, leads him to the realization that genuine empathy requires a willingness to understand another person’s hardships. To that end, people are hesitant to sympathize with Ivan’s condition because doing so would mean trying to understand what it would feel like to be dying. Only Gerasim, then, is willing and able to show Ivan empathy, since he’s unafraid of acknowledging the inevitability of death.
Privately, Ivan wants people to treat him like a small, ailing child. He knows that this would perhaps embarrass him, but he yearns for this kind of empathy regardless, which is why he takes comfort in his relationship with Gerasim. However, he goes to great lengths to hide this secret wish, as is the case when Shebek comes to visit him and he speaks seriously about a certain court case. It is exactly this kind of lying, though, that plagues Ivan’s final days.
Although Ivan has admitted to himself that he’s dying, he is still very much attached to his former life. That he speaks with Shebek about a court case illustrates his desire to present himself as unchanged. In reality, though, he has undergone a significant transformation, since becoming ill has forced him to reevaluate what he really cares about. Even if he hasn’t yet completely renounced the way he lived his life, it’s clear that he’s begun to question the point of constantly focusing on power, wealth, and status. And yet, he continues to act like these things are still on his mind—a sign that it’s difficult to break free from the lifestyle he’s cultivated.