Chapter 1
Unusually, the novel begins with what in most novels would normally be considered as the epilogue, thus all suspense concerning the final outcome of the action of the work is removed and the reader is able to concentrate almost entirely on its psychological and philosophical aspects.
The opening scene of the novel is in the Law Courts in St. Petersburg, where during an interval in a trial one of Ivan Ilyich Golovin's colleagues, a certain Pyotr Ivanovich, remarks upon a notice in the newspaper telling of the death of Ivan Ilyich "which occurred on February the 4th of this year 1882." The following conversation of the men present, whom, we are told, had all been fond of Ivan Ilyich, centres not about their upset at his death, but instead on who will take up his now vacant position and what knock-on effects that this will have for them.
The scene then moves to the home of Pyotr Ivanovich, who had been one of Ivan Ilyich's nearest acquaintances, and we are told how after his dinner he changes and goes to Ivan Ilyich's house in order to pay his respects to the dead. Here he encounters one of his habitual card-playing companions, a man named Schwartz with whom he hopes to join in a game of cards later. Unsure of how to behave, he enters the room where Ivan Ilyich's body is briefly and is then drawn into another room by Ivan' widow, Praskovya Fedorovna, who wishes to find out from him if there is any way she can extract any more money from the government over and above that she will receive from her pension now that her husband is dead. Pyotr Ivanovich tells her that he thinks not, and departs from the house for that of his colleague Fedor Vasilievich, where Schwarz and others are playing cards, and finding that they have only just finished playing the first rubber, joins in.
Chapter 2
In this chapter, we are told of Ivan Ilyich's pre-history. He was the son of a careerist civil servant who had finished up as a Privy Councillor. His younger brother, who was considered a failure, worked in the railways department, and his sister had married a Baron Greff. Ivan, considered to be the best of the Golovin children, had studied at the School of Law, during which time he occasionally succumbed to youthful vices, but graduated successfully nevertheless, thereafter taking a position in the tenth rank of the civil service, working as an official for special service for a provincial governor, a position he enjoyed and found very comfortable. He served in this capacity for five years and was then made examining magistrate in another province, the power of which more elevated position he enjoyed enormously. He performed the job "in the proper way" and efficiently and it was in this new town that he met his wife, the most eligible girl of the area, and believing that marriage was something that a man in his position should do, he did. He then soon found out that married life was not so easy, and with the birth of his first child his wife became to him incomprehensibly more difficult and demanding, with the result that Ivan involved himself more and more in his work. After three years of service as examining magistrate Ivan was made Assistant Public Prosecutor, and then four years later was transferred to another province as Public Prosecutor, where his relationship with his wife continued to be generally strained and he became more and more involved in his work, which consequently gave him increasing pleasure. Things continued thus for another seven years, by which point his eldest daughter was sixteen, and his only other surviving child had been put by his wife into the High School rather than the School of Law in order to spite him.
Chapter 3
We now find Ivan Ilyich seventeen years into his married life, being passed over for promotions and dissatisfied with his salary of three thousand five hundred rubles a year. He therefore, in this summer of 1880 decides to go with his family to his brother-in-law's country home with his family in order to save money, but overcome by ennui he makes a journey to St. Petersburg with the sole intention of finding himself a position, no matter what it may be, which commands a salary of five thousand rubles. In the course of his journey, he chances upon an old acquaintance who informs him of a suitable post in St. Petersburg that is about to be vacated. This he subsequently secures and then transfers himself to the town, where he immerses himself in the preparation of his family's new lodgings in the appropriate fashion. In the course of this he one day knocks his side while trying to show a draper how he wants some curtains hung, an incident that he later blames for bringing on his following illness. His family then arrive and he begins his new job at the law courts, continuing to keep his personal and business affairs totally separate, the latter remaining the more significant for him. The Golovins soon make a circle of new acquaintances "comme il faut" and their daughter Lisa is even courted by a wealthy young examining magistrate named Petrischev.
Chapter 4
In this chapter Ivan Ilyich begins to feel somewhat unwell, feeling occasional discomfort in his left side where he hurt it and tasting a strange and unpleasant taste in his mouth. This discomfort gradually increases, making family quarrels more frequent, and eventually Ivan Ilyich's wife advises him to see a famous doctor, which he does, the doctor telling him nothing concrete, but that it might be a question of "a floating kidney, chronic catarrh, or appendicitis", leaving Ivan unsure as to whether his condition is dangerous or not. Ivan becomes yet more irritable, goes to see another specialist and then a homoeopathist and also the friend of a friend who is a doctor. But when his condition does not improve he even considers seeing an old woman who possesses a supposedly wonder-working icon. He starts to feel that he is becoming an irritation and a burden to others both in his home and work life and by this point the physical pain that he feels has become almost constant.
Chapter 5
Two months later and just before New Year Ivan's brother-in-law, a healthy and vital man, comes to stay, and on first seeing Ivan makes a face that lets him know how much he must have changed. Ivan also overhears him talking to Praskovya Fedorovna and saying how he thinks that Ivan looks like a dead man. Ivan then goes with his friend Pyotr Ivanovich to see his friend the doctor, who tells Ivan that his problem may be to do with his vermiform appendix. He therefore returns home thinking that if he can only stimulate his body in the right way through concentration of his mind he can conquer his problem, but this is not so and the pain returns. He then realises that he is probably dying and feels only anger and fear at the prospect, cursing his family and friends for not realising that they too will be next.
Chapter 6
In this chapter we see how Ivan cannot grasp the idea that he is dying. He can see how man in general must inevitably die but cannot apply this logic to himself as an individual. He tries to stop himself from contemplation of death by immersing himself in his old habits, but whatever he does death is always there, lurking by him in everything he sees and does.
Chapter 7
Now in the third month of his illness, Ivan is consumed by the thought of whether he will soon vacate this world, and everyone that he knows is aware of this. He cannot sleep and has become weakened and unable to look after himself even in the most simple matters such as relieving himself and dressing. It is at this point that the reader is introduced more fully to Gerasim, the healthy young peasant lad who is the butler's assistant and is to prove Ivan's greatest support in his final weeks. Uncomplainingly and even cheerfully, and with the minimum of fuss he looks after his master, who appreciates immeasurably the uncritical fashion in which Gerasim performs his tasks. At this point Ivan is tormented by the falsity of his family and circle of friends who pretend that he is only ill and not dying, something which Gerasim never does. Ivan also feels a great need to be pitied, and feels that Gerasim's genuine attitude towards him comes closer to this than anybody else's.
By this point Ivan has lost all appreciation of the passing of time, and finds that in any case it has no relevance to him anymore. We see Ivan washing and being disgusted by the wasted and emaciated state of his face and body. He is then visited by one of the celebrated physicians who is treating him, who displays just the same capacity for deception and falsity that Ivan has remarked in all the others, and he feels the same hatred for him as he does for his deceitful wife, whom he feels only ever really does anything for her own benefit and not for his. That evening after dinner his wife, daughter and future son-in-law come in to see him before going out to the theatre to see a performance with Sarah Bernhardt, a famous and fashionable actress of the time. Ivan notices the nature of their conversation discussing the theatre, which is so like any other of its type and so senseless. When they leave it seems for a second that the falsity has gone with them and Ivan's pain lessens momentarily, but soon to return.
Chapter 9
That same night after his wife returns from the theatre, Ivan, in a "state of stupefied misery" induced by the opium that he has taken for his pain, feels that he is being thrust into a black sack but that he cannot be pushed all the way in. Eventually he breaks through, wakes up, and having sent Gerasim away starts to bemoan his fate, the cruelty of life and the absence of God, asking why he is thus afflicted. He then realises that the pleasant life to which he had previously imagined he would wish to return has in fact become increasingly false, empty and devoid of joy the further he has distanced himself from childhood. However, no matter how much he tries he cannot imagine what in his proper and correct life he could have possibly done wrong to deserve such agony.
Chapter 10
Two weeks later Ivan can no longer find comfort lying in bed and instead spends his time lying facing the back of the sofa. He has realised that certainly death is approaching and for no reason. By now his hopes of recovery have almost entirely faded and impending death has become increasingly real. He finds himself utterly lonely and spends most of his time in trying to recapture and live in memories of his childhood before the falseness of his life began, and he realises finally the incomprehensible and unreasoning nature of death.
Chapter 11
Two more weeks similar to the preceding two go by. Petrischev formally proposes to Lisa. Ivan has started to worry that perhaps his whole life has in fact been lived wrongly and this thought constantly torments him, as does his hatred of those around him, who he sees living out their own false lives. Praskovya Fedorovna persuades Ivan to take communion and for a short while afterwards he feels hope and an intense desire to live. But he sees in his wife the falsehood of his own life, which flings him back into despair and he screams at her to leave the room.
Chapter 12
From the moment that Ivan shouts at his wife at the end of chapter 11 he begins to scream, and does so incessantly until two hours before his death three days later. For these three days he feels himself struggling into that black sack already mentioned in chapter 9, but feels that it his own justification of his falsely lived life that prevents him from getting right into it. However, finally he realises that in fact his life was not lived right and he feels that he falls entirely into the sack and sees light at the bottom. At this point, asking himself "what is the right thing", he grows quiet and his schoolboy son, Vasya comes up to him and kisses his hand. He feels this and suddenly feels that ineffable love that takes away death, and he forgives and feels sorry for all those people that he had formerly hated. "And there was no fear because there was no death. In place of death there was light". And although for those who witness his death his agony seems to continue for two more hours, for Ivan this moment of blissful realisation is constant and stays with him unchanged to the end.