The awful, terrible act of his dying was, he could see, reduced by those about him to the level of a casual, unpleasant, and almost indecorous incident (as if someone entered a drawing room defusing an unpleasant odour) and this was done by that very decorum which he had served all his life long. He saw that no one felt for him, because no one even wished to grasp his position. Only Gerasim recognized it and pitied him. And so Ivan Ilyich felt at ease only with him. He felt comforted when Gerasim supported his legs (sometimes all night long) and refused to go to bed, saying: "Don't you worry, Ivan Ilyich. I'll get sleep enough later on," or when he suddenly became familiar and exclaimed: "If you weren't sick it would be another matter, but as it is, why should I grudge a little trouble?" Gerasim alone did not lie; everything showed that he alone understood the facts of the case and did not consider it necessary to disguise them, but simply felt sorry for his emaciated and enfeebled master. Once when Ivan Ilyich was sending him away he even said straight out: "We shall all of us die, so why should I grudge a little trouble?"—expressing the fact that he did not think his work burdensome, because he was doing it for a dying man and hoped someone would do the same for him when his time came.
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Tolstoy portrays Russian society as unfeeling. The people surrounding Ivan were uncaring and put out by his condition. At this point in the novel, he is nothing more than a burden..... a burden they wished themselves to be free of. Only Gerasim, a servant, cared for him and showed compassion.
The Death of Ivan Ilyich