Ivan begins to experience some discomfort in his left side and an unusual taste in his mouth. The discomfort gradually increases and soon Ivan is both irritable and quarrelsome. As his ill humor begins to mar the easy and agreeable lifestyle he has worked so hard to construct, volatile disputes with his wife occur more and more often. Praskovya, "with characteristic exaggeration," comments that Ivan has always had a dreadful temper. Ivan now starts all the arguments. Realizing that her husband's uncontrollable rages are making her life miserable, Praskovya begins to feel sorry for herself. She hates Ivan and would like to see him die, if only his salary would not cease.

One day Ivan goes to see the doctor. At the doctor's office Ivan is struck by the similarity between his attitude toward the accused in the law courts and the doctors attitude toward him. To Ivan, the only important question is whether or not his case is serious. But ignoring Ivan's concern, the doctor focuses on the strictly medical question of whether Ivan's problem is a floating kidney or appendicitis. This question the doctor answers brilliantly, and as Ivan thinks, in favor of the appendix. Ivan gets the feeling that his case is very serious and he is struck by the doctor's indifference and utter lack of sympathy to a matter of such importance.

Ivan heads home, depressed and fearful. He begins to tell his wife about the examination, but before he can finish, his wife leaves with their daughter to go out. Ivan takes medicine and strictly follows the doctor's orders, but more tests reveal that the doctor's initial prognosis was incorrect. Ivan then attempts to deal with his sickness by forcing himself to think that he has gotten better, but any unpleasantness with his wife, lack of success in work, or bad cards at bridge bring to mind his disease. Ivan goes to see more doctors, including a homeopath, but each doctor diagnoses his illness differently from the others. Ivan becomes annoyed with himself one day when he starts to believe that a wonder-working icon can affect miracles.

Ivan realizes that those around him think everything is normal, and do not understand nor