Nearly all fear death, as if it were the greatest of evils. However, while many patients may find their death to be obvious, some do not recognize their situation. When dying, it is not uncommon for people to re-examine their lives: questioning their decisions and purpose and searching for recognition of their lifetime of efforts. Both Tolstoy’s The Death of Ivan Ilyich and Kalanithi’s When Breath Becomes Air highlights the necessary partnership of humanism and medicine lacking persistence both throughout history and in the 21st century; Tolstoy by showing the errors of 19th century Russia, and Kalanithi exemplifying 21st century America.
History serves as the teacher of modern-day’s teachers, allowing for improvements in various fields of study and warning against past mistakes. Tolstoy’s novella, The Death of Ivan Ilyich, is a piece of literature that offers an imitation of life, allowing for the observation of the end of one’s life, as well as the critical points of the dying process where humanistic intervention in medical care becomes the quintessence of medicine.
Tolstoy provides an omniscient perspective of the character Ivan Ilyich in his novella, who undergoes extensive suffering throughout his life; however, through this suffering, Ivan Ilyich not only acts as the reader’s patient but also transcends the novella as the reader.
Through this, Tolstoy provides a multi-perspective depiction of medical staff. In Tolstoy’s 19th century representation of medical staff, Ivan Ilyich is “insisted to go and see a famous doctor”. Upon examining his life, being one modeled synonymously after aristocrats, Tolstoy combines the perception of the indifferent upper class with that of the scientific doctor.
In other words, Tolstoy constructs the perception of doctors and the medical field in general as lacking any form of empathy and being severely flawed due to its focus on the doctor’s “own importance”, rather than the patients. Through Ivan Ilyich’s perspective, the “questions with predetermined and obviously superfluous answers”, and the doctor’s “knowing look of triumph bordering delight” as if to say, “we know what we’re doing” furthers Tolstoy’s impression of the medical field requiring the intervention of the humanities.
Moreover, through Ivan’s suffering, the reader joins the medical staff and develops their own opinions on how Ivan Ilyich should be treated as a patient. Contrasting with the depiction of the doctors in his novella, Tolstoy implores the reader to denounce the doctors’ actions and instead show more concern for Ivan Ilyich as a dying patient. Tolstoy manifests this message in the form of his character Gerasim, whose “strength and vitality gave [Ivan Ilyich] comfort rather than distress” (199), thereby creating the image of an understanding and palliative medical staff that prioritizes a relationship of comfort. This depicts the reader as Tolstoy’s desired medical staff, being both empathetic with their patients as well as knowledgeable in their treatments.