For Ilyich, it is all torture, and he simmers and rages at his situation. None of them can agree on a diagnosis, and the remedies they give him accomplish nothing. His wife calls in a series of ever more expensive doctors.
Formerly an "intelligent, polished, lively and agreeable man," he grows depressed and enfeebled. Instead of abating, the pain gets worse, and he becomes unable to work. One day, he falls off a stepladder and develops a pain in his side. In the story, Ivan Ilyich is forty-five years old, a midlevel Saint Petersburg magistrate whose life revolves mostly around petty concerns of social status. And one afternoon we contemplated the suffering of Ivan Ilyich as he lay ill and worsening from some unnamed, untreatable disease. Some weeks we would practice our physical examination etiquette other weeks we'd learn about the effects of socioeconomics and race on health. It was in a weekly seminar called Patient-Doctor-part of the school's effort to make us more rounded and humane physicians. The one time I remember discussing mortality was during an hour we spent on The Death of Ivan Ilyich, Tolstoy's classic novella. The way we saw it, and the way our professors saw it, the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.
How the process unfolds, how people experience the end of their lives, and how it affects those around them seemed beside the point. Our textbooks had almost nothing on aging or frailty or dying. Although I was given a dry, leathery corpse to dissect in my first term, that was solely a way to learn about human anatomy. I learned about a lot of things in medical school, but mortality wasn't one of them.
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