Another fortnight passes. Ivan Ilyich spends all day on the sofa suffering “ever the same unceasing agonies” of loneliness, pain, and the knowledge that death is coming (296). He continues to question whether he has lived his life correctly and why he must suffer. He feels a “terrible loneliness” (296) and reflects on childhood memories. Nevertheless, he resists the idea that perhaps he has not lived right, reminding himself of “all the legality, correctitude, and propriety of his life” (298). He concludes that he has lived right, and there is no explanation for the agony accompanying death.

Two more weeks go by and Ivan Ilyich’s family welcomes news of his daughter’s formal engagement. Ivan Ilyich, however, experiences “a change for the worse” and remains on the sofa “groaning and staring fixedly straight in front of him” (298). He treats his wife with animosity, demanding that she let him “die in peace” (298). He is still in pain, but his chief misery is now his own moral suffering. Inwardly, he asks himself, “What if my whole life has been wrong?” (299) and comes to understand an “awful truth” that everything he has valued is false (299). This realization intensifies his suffering, and another dose of opium sends him into unconsciousness.