Reading Illness in Leo Tolstoy’s The Death of Ivan Ilych: Perspectives on Literature and Medicine

Abstract

This article seeks to establish the ambiguous nature of Ivan Ilych's illness in Leo Tolstoy's novella The Death of Ivan Ilych (1886), and it then proceeds to offer sociocultural commentary on an incurable illness that results in the death of the title character. Regardless of the exact nature of Ivan Ilych's illness, however, the story suggests that Ivan lived the "wrong" kind of life despite his self-deception and the lies of those around him. Some readers might be intrigued by the mysterious ailment of Ivan Ilych that aggravates into an agonizing death, and some might read the story as a pathography and ponder the doctors' possible diagnoses alluded to in the text like a floating kidney, a vermiform appendix or a chronic catarrh. While others, on the other hand, might argue for alternative illnesses (not mentioned in the text) allowing for a case like cancer. However, reading the story as a parable to be decoded by physicians using medical expertise does not do justice to its symbolic engagement with illness. It is argued that the text seems to favor a reading that connects ailment to the lifestyle one is following and to one's own personality or social class. In this regard, the article works at the intersection between the humanities and "medical theories" as adapted for literary ends. Ivan Ilych led the wrong form of life in his pursuit of wealth and hypocritical relations. Therefore, his terminal illness-read as a form of pancreatic cancer-is a figure for an "unhealthy" upper middle-class life lived at the wrong side emotionally, socially and physically. Within the interdisciplinary approach of this article, the metaphorical significance of illness is more important than specifying the exact illness that eventually causes Ivan Ilych's death because this illness is significantly symbolic beyond its literal sense. Therefore, the symbolic representation/understanding of illness-of cancer in particular-as a social blight or a scourge related to social behavior is insightful for physicians and patients alike.