Bedbound, Ivan now only marks the days according to when Gerasim enters and exits his room. His condition only gets worse, reaching a point where he can barely stomach a cup of tea and some medicine. One morning, Gerasim informs him that Praskovya is still in bed but that his doctor is coming to examine him. When the doctor arrives, Ivan can sense how little the man really cares about him. As he takes a moment to warm his hands from the cold, the doctor asks Ivan how he’s feeling, and Ivan tells him that he’s in constant pain. He then suggests that there must be something the doctor can do, to which the doctor responds, “Yes, it’s normal for patients like you to say that sort of thing.”
Once again, Ivan must face the fact that very few people truly care about his condition. In the same way that he used to indifferently wield his authority as a judge, the doctor takes a cold, unemotional approach to treating him. This is most evident when he indicates that it’s predictable that “patients like [Ivan]” would want to know if there’s anything to be done about their discomfort. This is an especially frustrating comment, since it not only fails to give Ivan any information about his prospects, but is also condescending and apathetic, effectively speaking down to Ivan simply for inquiring about his pain.
Having warmed his hands, the doctor begins to examine Ivan. As he does so, Ivan thinks about how ridiculously futile this process is, knowing that the doctor is just keeping up the lie that there’s anything he can do to help. At this point, Praskovya enters and, pretending to have been awake, admonishes one of the servants for failing to fetch her when the doctor arrived. When she says this, Ivan glares at her and resents everything about her, including her healthy appearance and her touch, which fills him with hatred.
Gerasim has already informed Ivan that Praskovya was asleep, but now Praskovya tells the doctor that she was awake before he arrived. In doing so, she tries to make herself look like a more involved caretaker than she actually is. Regardless of what she says, though, Ivan knows that she couldn’t be bothered to wake up earlier to check on him, and this overall lack of empathy causes him to resent her even more than he already does.
When the doctor finishes his examination, Praskovya tells Ivan that she arranged for yet another doctor to come see him. When he protests, she tells him that she’s only doing this for herself, using sarcasm to suggest that she’s doing everything on his behalf, even though he knows that, in reality, she truly is doing all of this for herself, since she wants to look like a good wife but doesn’t actually care about his health. Either way, the new doctor comes, and when Ivan asks him if there’s any chance that he could get better, the doctor says that anything is possible. When Praskovya notices that this comment fills her husband with hope, she begins to cry.
Praskovya’s comment is interesting because she tries to use sarcasm to indicate that she is a dedicated caretaker who only has Ivan’s best interests in mind. Strangely enough, though, her sarcastic remark fails because she actually is doing everything for herself (to make herself look good), meaning that the comment isn’t actually sarcasm at all. Wanting to seem like a diligent wife who is deeply concerned about her husband’s illness and discomfort, she misrepresents herself, ultimately hiding the fact that she is more focused on how she appears in society than on Ivan’s condition. At the same time, though, it’s worth noting that she does seem to genuinely care about Ivan’s decline, as evidenced by the fact that she cries when she sees the futile hope he derives from the doctor’s altogether unremarkable assessment. In this moment, readers see that she feels sorry for Ivan, even if she is also so concentrated on her own life that she sometimes fails to be a good caretaker.
Ivan’s newfound optimism doesn’t last long, as his pain returns and nothing about his situation seems to improve. That evening, Praskovya dresses for an opera that she and Ivan decided to take the family to before he was sick. When she enters his room in her beautiful clothing, she guiltily tells him that she normally wouldn’t dream of going out under such circumstances, but that they already purchased the tickets. She also says that Petrishchev will be joining them, adding that the young man wants to enter the sickroom. Ivan agrees, so Liza and Petrishchev come in and start talking about the play. Ivan’s young son, Vasya, also comes in, and Ivan thinks about how much he pities the boy, who is forced to watch his father die a painful death. He also feels that Vasya is the only person other Gerasim who really pities him.
In the same way that Ivan appreciates Gerasim’s purity, he idealizes Vasya’s innocence. In both Gerasim and Vasya, he sees something authentic and admirable, something that hasn’t yet been corrupted by the greed or superficiality of bourgeoise society. In contrast, Praskovya, Liza, and Petrishchev are so involved in socializing that they have lost their ability to focus on what really matters in life, as evidenced by the fact that they’re going to an opera while Ivan himself lies on his deathbed.
As Ivan’s family makes small talk about the opera, Ivan hardly participates. At one point, Petrishchev stops talking and looks at him, and everyone else follows his gaze. They then realize that Ivan has been glaring at them with unconcealed contempt. Silently, everyone stands in the room without knowing what to do. Finally, Liza says that they ought to get going, and they leave Ivan on his own, at which point he begins to feel somewhat better, though his pain remains.
Yet again, Ivan’s family’s lack of empathy causes him to resent them. As they discuss the upcoming opera, he hates them for going along as usual in their lives. Of course, this is a somewhat selfish outlook, since it’s unreasonable to expect people to halt their entire lives when a loved one gets sick. However, what Ivan seems to recognize in this moment is that his family is intent upon living the same kind of life that he himself has spent his entire adulthood trying to live. Now that he’s unable to participate in this life, though, he finds it empty of meaning, at least in comparison to his own approaching encounter with death.