Twelve more days pass and Ivan is no longer able to leave his sofa. He lies facing the wall, pondering Death and questioning the rationale behind his suffering. Since the beginning of his illness, his moods have alternaten between the terror of imminent death and hope for the restoration of his organs' proper function. But as his disease progresses, hope appears less and less real while the terror before death grows increasingly insistent. Although surrounded by a populous town and numerous acquaintances, Ivan experiences a sense of loneliness more profound than if he were "either at the bottom of the sea or under the earth."
Ivan lives wholly in memories. Pictures of his past rise before him starting always with what is nearest in time and going back to his remote childhood. As he examines his life, Ivan realizes that the further back he looks, the more life there is. He finds that just as the pain grows worse and worse, so too does his life grow, like "a stone falling downward with increasing velocity." He comes to the conclusion that, "Life, a series of increasing sufferings, flies further and further towards its end—the most terrible suffering."
He desperately wishes to understand the purpose of his suffering, "what it is all for." He knows that an explanation would be possible if he had not lived rightly, but recalling once again the propriety of his life, he resigns himself to the senselessness of agony and death.
Time, for Ivan, is contracting. The first four chapters of the novel span approximately forty years of Ivan's life, the second four chapters span several months, and the last four cover a time period of no more than four weeks. While Chapter VII mentions that Ivan's illness is in its third month, Chapter X begins with the words, "Another fortnight passed." The steadily decreasing units of time mentioned throughout the text serve to highlight the fact that time is running out for Ivan.
Moreover, along with time, Ivan's spatial dimensions are also shrinking. From his initial migrations between provinces, Ivan comes to settle in a city and acquires an apartment. Before long he is confined to his study inside that apartment, and by Chapter X he can no longer move from his position on the sofa. Tolstoy uses this contraction of time and space both for artistic and practical purposes. The narrative tool not only brilliantly emphasizes Ivan's movement toward death; it also builds tension before the climax at the moment of Ivan's death. Yet Tolstoy also builds tension in another way. For the most part, each chapter in The Death of Ivan Ilych is smaller than the one before it. The size of each successive chapter decreases, and when matched with the contracting temporal and spatial dimensions, the decreasing size lends a gradually accelerating rhythm to the final chapters. Tolstoy draws our attention to this effect with his metaphor of a stone falling downward with increasing velocity.
Tolstoy mentions that Ivan's loneliness is more profound than "either at the bottom of the sea or under the earth." It is not a coincidence that both images supplied in this comparison suggest places of burial. Tolstoy seems to imply that for all practical purposes, Ivan is already dead and buried. Ivan's existence and struggles are shown, once again, to be of a spiritual nature, and he no longer links his recovery to physiological restoration. As Ivan realizes that his illness has pervaded his entire life and that the disease he suffers from is actually the manifestation of a general illness that has been growing with him since childhood, Ivan desires to move back, spiritually, to the moment of his birth. Yet, Ivan cannot find an explanation for that general illness, he cannot understand why he is suffering. His spiritual rebirth is stalled because, as in Chapter IX, Ivan is still unable to admit that he has not lived correctly.