Iván Ilych's wife returns late that night; he tells her to go away. She tells him to take some opium, which he does, and then leaves. Until three in the morning, he is in terrible trancelike misery, as if "he and his pain were being thrust into a narrow, deep black sack, but though they were pushed further and further in they could not be pushed to the bottom. . . . He was frightened yet wanted to fall through the sack, he struggled but yet co-operated" (161). He regains consciousness to find Gerásim holding up his legs, but he sends the young man away.
Iván Ilych calls out to God, asking why this has been done, weeping "because there was no answer and could be none" (162). He begins to talk to himself about what he wants, and when he starts to wish for his former life he begins to think about how he lived before.
Suddenly, his former life seems less satisfying than what it was. His childhood memories of simple things are untainted, but when he considers all of his life since then he realizes that his life has been "something trivial and often nasty" (163). Yet when he asks himself if he has lived as he should have, he quickly tells himself that he did everything correctly, according to the laws of decorum and propriety.
The deep searching of Chapter Nine leads to two new developments. First, Iván Ilych, for the first time, wishes unconsciously for death. Second, he questions directly and consciously the way he used to live his life.
The black sack of his opium-induced stupor is part hallucination, and part literary metaphor. The bottomless sack, whose depths are an unfathomable destination, suggests death. In Iván Ilych's terrible pain, his feelings toward the sack are ambivalent: though terrified of it, part of him wishes for the release of death. The sack also might suggest the womb, as Iván Ilych is going to emerge from the sack and experience a rebirth at the end of the novel.
Although Iván Ilych has been disgusted by falsity, here is the first time he seriously wonders if he has lived correctly. He cannot yet make the final step, of realizing that propriety and decorum were hollow excuses for living detached from a deeper life. But on some level he has realized that his previous ideas of proper living created a life that was "trivial and often nasty" (163).
Two more weeks pass, and Iván Ilych eventually can no longer leave his sofa. His agonized questions are always the same now. He asks himself if this is death, and his inner voice answers that it is. He asks himself why such sufferings are, and the inner voice answers that they exist for no reason.
As time passes, his vacillations between hope for recovery and dread of death swing more and more toward continuous contemplation of death. He often thinks of his childhood, but the pleasant memories bring him pain because he is aware of what he has lost. His life's development seems to parallel his illness: as time passes, his life, like the disease, has grown worse and worse with time. He imagines life as a stone, dropping at increasing velocity. Life is a series of increasing sufferings, flying toward a terrible end. He feels that resistance is impossible, and comprehension of death is impossible. And he still cannot admit completely that his life has not been lived properly.
The stone falling with increasing velocity parallels Tolstoy's technique for this novel. The chapters at the start of the book are longer, and cover more time. As the chapters progress, the amount of time covered decreases and the chapters decrease in length. While Chapter Two covers decades, Chapter Nine measures time elapsed as a single fortnight.
Paralleling this development, Iván Ilych's range, intellectually and spatially, decrease. In space, his world shrinks as he is confined to increasingly smaller spaces. By Chapter Ten, he in confined completely to his sofa.. Intellectually, he can only contemplate the same questions, again and again. The questions are unanswerable.