Central to The Death of Ivan Ilych is the idea of what Tolstoy calls the false. With the exception of one character, everyone in the novella – including Ivan Ilych himself – is false, and lives in a world built on falsehood. The characters' relationships to each other are shallow and fake. Their desires are petty, and they are concerned only with appearances. What they believe to be happiness is illusory. The central lie in their lives, however, is their refusal to admit to their own mortality: that enables them to remain blind to all the other ways in which their lives are false. When Ivan Ilych finds himself faced with death, the falsehood of the world he used to live in and the falsehood in himself are slowly revealed.
Tolstoy uses the first chapter to display the falseness of Ivan's world, in particular by showing how little those people supposedly closest to Ivan care for him.