- Two months pass. Right before New Year's, Praskovya Fedorovna's brother stops by to make a visit. Ivan comes home to find him alone in the house. When he sees Ivan he gives him an "Oh my goodness, you look like a walking corpse" stare. But when Ivan asks him if he looks different, he admits only "there has been a change" (5.3).
- Somewhat later, the disturbed Ivan goes to a mirror and compares his current appearance with an old photograph of himself.
- There's definitely been a change.
- As he walks away from the mirror he overhears a conversation between Praskovya Fedorovna and her brother, who is telling her that Ivan already looks like a dead man. She says he's exaggerating.
- Ivan decides he must go to see Peter Ivanovich at once, since he has a doctor friend. His wife – could she be showing signs of a conscience? – gives him an extra-kind and pitying look as he leaves which only succeeds in disgusting him.
- Peter and Ivan go to see a doctor, with the same results as usual: more incomprehensible talk about Ivan's "vermiform appendix" and the assurance that everything could turn out just fine. Ivan just needs to wait for absorption to occur.
- For the rest of the day, Ivan has the absorbing, vermiform appendix lodged in the back of his head.
- He comes home to find Lisa is receiving a visit from her current suitor, Fedor Petrovich. Everyone notices Ivan is in a better mood than usual.
- Ivan goes to bed (he now sleeps alone in his study) and tries to read a Zola novel but can only think about that vermiform appendix of his.
- Ivan is convinced that absorption will occur, and that everything will be OK.
- With a burst of hope Ivan takes his medicine, touches his side, and happily feels that there seems to be no pain. Could it be that absorption is occurring right now?
- Sadly, no: it's only a few seconds before the pain comes back.
- And it now hits Ivan that this isn't really about his appendix at all. It's about life and death. His death.
- His life is ebbing away, and there's nothing he can do to stop it.
- This is a rather terrifying realization, and Ivan becomes panic-stricken. Where will he go when he dies? What does it mean to die? He doesn't know, and he doesn't want to.
- Music that his daughter and her suitor are playing together drifts in, and Ivan is infuriated. No one else realizes or cares that he is facing death, alone.
- Ivan can't believe that all human beings could be sentenced to something so utterly horrible as death.
- Terror seizes him again and he starts desperately feeling around for matches to light the dark room, in the process whacking himself on his nightstand. He attacks it furiously in retaliation and makes such a racket that Praskovya Fedorovna comes into the room.
- Ivan tells Praskovya Fedorovna he's feeling worse, and she proposes to bring in another specialist.
- Ivan is not happy with that idea. She kisses him, managing only to make him hate her more.