The illness causes his pain to increase and be more persistent.
His illness also causes him torment because he loses strength and his appetite. The fact that people around him were not understanding his illness and what he is going thru causes him the worst kind of torment, of all. He feels as if they are going thru everyday life as if nothing is wrong. “The pain in his side oppressed him and seemed to grow worse and more incessant, while the taste in his mouth grew stranger and stranger. It seemed to him that his breath had a disgusting smell, and he was conscious of a loss of appetite and strength. There was no deceiving himself: something terrible, new, and more important than anything before in his life, was taking place within him of which he alone was aware. Those about him did not understand or would not understand it, but thought everything in the world was going on as usual. That tormented Ivan Ilych more than anything (IV,
49-51).
He once could solve his problems thru reasoning or by using his job as a distraction. These methods provide relieve for him because he was able to get away from the discomforts and unpleasant things in life. He’s in a tremendous amount of pain and he does not have the power any longer to shield himself from what is happening to him. He cannot overlook his problem nor can he use his job to distract him from his problem. Ivan has to face his problem head on and it seems like there is nothing he can do but suffer. “And his colleagues and subordinates would see with surprise and distress that he, the brilliant and subtle judge, was becoming confused and making mistakes. He would shake himself, try to pull himself together, manage somehow to bring the sitting to a close, and return home with the sorrowful consciousness that his judicial labours could not as formerly hide from him what he wanted them to hide, and could not deliver him from It. And what was worst of all was that It drew his attention to itself not in order to make him take some action but only that he should look at It, look it straight in the face: look at it and without doing anything, suffer inexpressibly” (VI, 16-18).