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The doctor, kneeling on the sofa, is still sounding him when Praskovya Fedorovna’s silk dress rustles at the door and she is heard scolding Peter for not having let her know of the doctor’s arrival.

She comes in, kisses her husband, and at once proceeds to prove that she has been up a long time already, and only owing to a misunderstanding failed to be there when the doctor arrived.

Ivan Ilych looks at her, scans her all over, sets against her the whiteness and plumpness and cleanness of her hands and neck, the gloss of her hair, and the sparkle of her vivacious eyes. He hates her with his whole soul. And the thrill of hatred he feels for her makes him suffer from her touch.

Her attitude towards him and his diseases is still the same. Just as the doctor had adopted a certain relation to his patient which he could not abandon, so had she formed one towards him—that he was not doing something he ought to do and was himself to blame, and that she reproached him lovingly for this—and she could not now change that attitude.

“You see he doesn’t listen to me and doesn’t take his medicine at the proper time. And above all he lies in a position that is no doubt bad for him—with his legs up.”

She described how he made Gerasim hold his legs up.

The doctor smiled with a contemptuous affability that said: “What’s to be done?These sick people do have foolish fancies of that kind, but we must forgive them.”

When the examination was over the doctor looked at his watch, and then Praskovya Fedorovna announced to Ivan Ilych that it was of course as he pleased, but she had sent today for a celebrated specialist who would examine him and have a consultation with Michael Danilovich (their regular doctor).

“Please don’t raise any objections. I am doing this for my own sake,” she said ironically, letting it be felt that she was doing it all for his sake and only said this to leave him no right to refuse. He remained silent, knitting his brows. He felt that he was surrounded and involved in a mesh of falsity that it was hard to unravel anything.

Everything she did for him was entirely for her own sake, and she told him she was doing for herself what she actually was doing for herself, as if that was so incredible that he must understand the opposite.

At half-past eleven the celebrated specialist arrived. Again the sounding began and the significant conversations in his presence and in another room, about the kidneys and the appendix, and the questions and answers, with such an air of importance that again, instead of the real question of life and death which now alone confronted him, the question arose of the kidney and appendix which were not behaving as they ought to and would now be attached by Michael Danilovich and the specialist and forced to amend their ways.

The celebrated specialist took leave of him with a serious though not hopeless look, and in reply to the timid question Ivan Ilych, with eyes glistening with fear and hope, put to him as to whether there was a chance of recovery, said that he could not vouch for it but there was a possibility. The look of hope with which Ivan Ilych watched the doctor out was so pathetic that Praskovya Fedorovna, seeing it, even wept as she left the room to hand the doctor his fee.

The gleam of hope kindled by the doctor’s encouragement did not last long. The same room, the same pictures, curtains, wall- paper, medicine bottles, were all there, and the same aching suffering body, and Ivan Ilych began to moan. They gave him a subcutaneous injection and he sank into oblivion.