| Quote #4
"My God! My God!" he muttered. "Again, again! And it will never cease." And suddenly the matter presented itself in a quite different aspect. "Vermiform appendix! Kidney!" he said to himself. "It's not a question of appendix or kidney, but of life and...death. Yes, life was there and now it is going, going and I cannot stop it. Yes. Why deceive myself? Isn't it obvious to everyone but me that I'm dying, and that it's only a question of weeks, days...it may happen this moment. There was light and now there is darkness. I was here and now I'm going there! Where?" A chill came over him, his breathing ceased, and he felt only the throbbing of his heart. (5.15)
This is the moment where it first hits Ivan fully that he is going to die. Death no longer seems like a mere possibility; it's something that's going to happen to him. Now he's forced to come to terms with what it means. What will become of him? Will he really just cease to be? It's also worth noting that this is the moment when Ivan stops thinking primarily in medical terms.
| Quote #5
In the depth of his heart he knew he was dying, but not only was he not accustomed to the thought, he simply did not and could not grasp it.
This brings out the difference between understanding intellectually that people die, and understanding what death means. Ivan has known that everybody dies since he was a kid, but it's never sunk in that he, Ivan Ilych, with all of his memories, joys, and loves will completely cease to exist at some point. It's significant that he thinks back to his "Vanya" days. This is the first time we get a suggestion that Ivan was once happy as a child. Perhaps he was happy because he was loved by his parents. Their care and love gave him a sense of himself as something unique, important, and valuable. But nothing can save him now from dying.
| Quote #6
But suddenly in the midst of those proceedings the pain in his side, regardless of the stage the proceedings had reached, would begin its own gnawing work. Ivan Ilych would turn his attention to it and try to drive the thought of it away, but without success. It would come and stand before him and look at him, and he would be petrified and the light would die out of his eyes, and he would again begin asking himself whether It alone was true. And his colleagues and subordinates would see with surprise and distress that he, the brilliant and subtle judge, was becoming confused and making mistakes. He would shake himself, try to pull himself together, manage somehow to bring the sitting to a close, and return home with the sorrowful consciousness that his judicial labours could not as formerly hide from him what he wanted them to hide, and could not deliver him from It. And what was worst of all was that It drew his attention to itself not in order to make him take some action but only that he should look at It, look it straight in the face: look at it and without doing anything, suffer inexpressibly. (6.7)
Ivan's death is personified here – and capitalized too – as It. It feels like some kind of active force that follows him wherever he goes. It's also inescapable; nothing Ivan does can make him stop thinking about the fact he's going to die. But what's particularly awful is that even though Ivan is forced to think about it, Ivan can't accomplish anything by thinking about it. He's powerless. All he can do, as the narrator tells us, is suffer.