- In the third month of Ivan Ilych's illness, he becomes aware that everyone else around him is just wondering when he'll put himself out of his own misery.
- Ivan's condition is now bad enough that he takes morphine and opium for the pain (which doesn't really work), and eats specially prepared meals.
- He also needs help from somebody else every time he goes to the bathroom.
- It's the young, hearty Gerasim, who attends to Ivan in that delicate and deeply embarrassing task.
- On one particularly awful occasion, Ivan collapses in a chair after relieving himself, unable even to pull up his pants.
- The mortified Ivan tells Gerasim how sorry he is that he has to put him through this.
- But Gerasim doesn't mind at all. It's simple, he says warmly: Ivan is sick, and he needs help, and that's that.
- After Gerasim has disposed of Ivan's business, he pulls up Ivan's trousers and pulls Ivan out of the chair to set him down on a couch.
- Ivan suddenly realizes that Gerasim's presence is a source of comfort to him.
- Ivan is now desperate that Gerasim not leave, and tries to keep him around by having him do various things.
- Eventually he asks Gerasim to stay with him for a while and support his legs on his shoulders, hoping that having his legs up will ease his pain.
- Gerasim agrees, and they start to talk. Ivan is overjoyed to find another person who is comforting.
- No one else is a comfort to Ivan.
- What Ivan hates in particular is that everyone else refuses to acknowledge that he is really sick and dying.
- Everyone seems to pretend that he isn't dying, and they go on with life as usual, without much care for Ivan.
- Gerasim doesn't pretend, and his kindness to Ivan comes from genuine compassion.
- Ivan thinks of how this contrasts with Shebek in particular, who comes to visit and just wants to talk legal cases with Ivan as if Ivan were still working at the courts.
- Ivan hates behavior because it feels so false.
- In fact, with the exception of Gerasim, everything and everyone around Ivan feels false.