Praskovya Fedorovna returns late at night to find Ivan still awake with Gerasim keeping him company.
She tells Ivan to take some opium for the pain, and he does, mostly just to get rid of her.
Until 3am or so, Ivan is miserable and in some kind of opium-induced haze.
He feels as if he's being shoved into a deep, narrow black sack, but can't break through to the bottom of it. He's afraid of what's there, and yet he wants to reach the bottom.
Finally Ivan breaks through to the bottom, and at that point he regains consciousness. Gerasim is still with him, asleep in a sitting position with Ivan's legs on his shoulders. Ivan tells Gerasim to go away.
Once Gerasim is gone, Ivan bursts into tears, crying like a child. He starts talking to God, wanting to know where God is and why God is doing this to him.
What did he do to deserve it?
God doesn't answer.
Then, at once, Ivan falls silent.
He has started to hear something like a voice within himself, and focuses all of his attention on listening.
It's his voice, the voice of his soul...
Ivan asks himself what he wants. "To live and not to suffer" (9.16), the voice says.
Ivan asks himself how he wants to live. Just like before, when everything was pleasant and comfortable, the voice says.
Ivan starts to think of just what his pleasant life was like before the illness, and finds that now none of it seems that pleasant at all.
Instead, it seems pointless and rather nasty, except for his earliest happy memories from childhood.
And as he surveys his life, Ivan realizes that the further he moves away from his childhood, the more pointless and nasty it gets.
All the while he had imagined his life was getting better, it was getting worse.
Ivan can't believe life would be so horrible and senseless. "There is something wrong" (9.24), he exclaims to himself.
It then occurs to Ivan for the first time that maybe he didn't live as he should have lived. Could he have screwed it all up? The thought is so scary and seemingly impossible that he immediately disregards it.
So Ivan keeps wondering how he could have deserved anything so horrible and senseless.
He doesn't know what he could have done.
The thought that his life was wrong keeps coming up, but Ivan keeps dismissing it.
His life was so very proper. How could anything be wrong with it?