Fëdor Petróvich (also called Petríshchev) finally proposes to Lisa. When Praskóvya Fëdorovna goes into Iván Ilych's room the next morning to inform him of the happy news, he seems in terrible pain. When she begins to remind him of his medicines, he looks at her with such hate that she falls silent. He tells her to let him die in peace. Lisa comes in, and gets the same hostile look. He informs his wife and daughter that he will free them of himself soon.
After the two women leave, Lisa complains to her mother. She doesn't like being treated as if her father's illness is her fault. The doctor arrives, and receives the same hostile treatment. Iván Ilych dismisses him, telling the doctor that the doctor knows he can do nothing. The doctor tells Praskóvya Fëdorovna that the only thing to do now is give him opium.
Though the doctor perceives correctly that Iván Ilych is suffering physically, Iván Ilych's mental anguish is far worse. Late at night, when looking at Gerásim's good face, he is forced to ask the question: "What if my whole life has really been wrong?'" (167). He worries that real goodness, which he felt in his childhood, was a great gift that he squandered. He feels that he has wasted his life and can do nothing to get it back.
When he sees his family the next day, his revelation seems confirmed. "In them he saw himself all that for which he had lived and saw clearly that it was not real at all, but a terrible and huge deception which had hidden both life and death" (167-8). These feelings make him hate his family more. He's given opium, but at noon he's in pain again. His wife encourages him to take communion, and with some prodding he agrees. The priest arrives, and taking communion momentarily revives Iván Ilych's hope and desire for life. When his wife comes in afterward, he's struck once again by how much he hates her. He tells her to go away and leave him alone.
Iván Ilych can no longer deny the hypocrisy of his life. And now that the awfulness of his wasted life is unavoidable, he cannot stomach reminders of what he once was himself. His wife and daughter and the doctor are not particularly awful people. They are completely typical. But because he sees his former self in them, their presence is unbearable (167).
He ceases to treat them with any measure of civility. As Tolstoy sees it, courtesy is merely another empty and dishonest ritual. Iván Ilych dismisses his wife, his daughter, and refuses to go along with the doctor's chicanery. He refuses to indulge pretense. He refuses to hide his hatred of his family.
Detachment from life is a great theme of the novel. Refusal to recognize death and detachment from life go hand in hand. Iván Ilych has a terrible revelation in evaluating all that he once prized: ". . . [he] saw clearly that it was not real at all, but a terrible and huge deception which had hidden both life and death" (167-8). Propriety and emulation of his peers and superiors make for a spiritually impoverished life.
After he tells his wife to go away (see end of Chapter Eleven) Iván Ilych begins the screaming that lasts three days, continuing until he dies. During this time, Iván Ilych seems outside of time. He is trapped in the feeling that he is being pushed deeper and deeper into the black, bottomless sack. "He felt that his agony was due to his being thrust into that black hole and still more to his not being able to get right into it. He was hindered from getting into it by his conviction that his life had been a good one" (169).
Suddenly a force seems to strike him in the chest and side, and he falls through the hole and sees a light. The sensation is described as being like the feeling "in a railway carriage when one thinks one is going backwards while one is really going forwards and suddenly becomes aware of the real direction" (169-70). He accepts, once and for all, that his life was not lived rightly, and asks what the right thing would have been. This event occurs on the third day, two hours before his death. His son has come to his bedside, and it is at the moment when the boy catches Iván Ilych's hand, presses it to his lips, and cries, that Iván Ilych sees the light.
Iván Ilych opens his eyes and feels sorry for his son. He sees his wife, and pities her as well. He begins to apologize. He tries to ask for forgiveness, but he lacks the physical strength to say the words, and an attempt to say "Forgive me" becomes "Forego." He is comforted "knowing that He whose understanding mattered would understand" (170).
When he sees them, and realizes that he must let them know of his sorrow and release them from sorrow, the things oppressing him seem to drop away, at all sides. He feels the pain, and yet it seems not what it was. He asks where Death is, and cannot see it. In place of Death, there's light. For Iván Ilych, the last two hours seem a single revelatory instant. For the others watching, his pain seems to be continuing. As he dies, he hears someone by his side saying "It is finished!" (171), and repeats the words to himself: "Death is finished'" (171). He stops in the middle of a sigh, stretches out, and dies.
The death is rife with Christian imagery: the screaming lasts three days, referencing the three days between Christ's death and resurrection. The sudden force that hits Iván Ilych, before he sees the light, is a pain in his chest and his side. According to the Gospel of John, Christ was pierced through the side after being taken down from the cross.
Although Iván Ilych has struggled with revelations about the hypocrisy of his life, he does not irrevocably and definitively accept that he has not lived well until Chapter Twelve. Before, seeing hypocrisy made Iván Ilych nasty and hateful, but here on the last day Iván Ilych finds a truth to replace the lies he has always lived.
The revelation seems to come from both outside and inside. The acceptance of compassion comes after months of pained questioning, and is the final conclusion of a long, internal process. But the realization coincides with the feeling of his son pressing Iván Ilych's hand to his lips, and crying. Vladimir Ivánich's simple and sincere act is the strongest expression of his concisely sketched character. The boy feels genuine pity for his father, and sorrow at his passing. The others are merely waiting for him to die. The physical contact, combined with the internal questioning, come together in Iván Ilych at the moment of realization.
Compassion and living fully can both be done even when there is no time left. And the revelation, even if it cannot be communicated, has a truth that transcends communication between people. When Iván Ilych cannot complete his plea for forgiveness to his wife, he takes comfort knowing that God hears his pleas. Penitence has a value of its own; the internal process leading up to penitence, and the final plea, are what count. If no one hears the penitent man, the truth and value of the repentance are undiminished.
Compassion must flow out without distinction. When Iván Ilych realizes the truth behind life, his compassion is felt not only for his sincere young son, but also for his wife. The experience of this kind of love is like medicine for Iván Ilych: "How good and how simple!'" (170). Goodness and simplicity, as exhibited in Gerásim, can now be experienced by Iván Ilych.
Ironically, his death helps him to escape the barriers that have constrained him for all of his adult life. Tolstoy uses the metaphor of the train, which seems to be moving in one direction but in fact is going the other way. At last, at the sight of the light, Iván Ilych realizes that his pained agonies and questioning have not been a descent into a horrible pit. He has been moving toward a revelation, toward compassion and acceptance. This realization is more substantial than the rest of his life put together. As he dies, Iván Ilych realizes what his life has been missing. For him, there is no more gap between behavior and truth. His whole being is caught up in "an unchanging moment," a blissful spiritual awakening. Those watching him see agony, but Iván Ilych dies at peace.