Summary
A wealthy doctor delivers Ilusha's death sentence with clinical coldness, suggesting expensive treatments in Sicily and Paris that the poor family could never afford. When the desperate father asks if anything can save his son, the doctor essentially shrugs and says it's not his problem. Young Kolya explodes at the doctor's callousness, calling him an 'apothecary' and threatening him with his dog Perezvon. Alyosha tries to keep the peace, but Kolya's anger reflects what everyone feels about this privileged man who offers impossible solutions to desperate people. Inside, dying Ilusha shows heartbreaking maturity, telling his father to find another good boy to love after he's gone, and asking to be buried by their special stone where they used to walk together. The scene captures how class differences create cruelty - the doctor can walk away to his comfortable life while this family faces devastating loss with no resources. Kolya promises to return and keep Ilusha company, understanding that sometimes the only thing we can offer is our presence. The father's final breakdown shows how parents would rather keep their broken children than accept any substitute, because love isn't replaceable. This chapter reveals how dignity and loyalty matter more than hope when hope becomes impossible.
Coming Up in Chapter 70
The story shifts to Ivan Karamazov and Grushenka, where intellectual torment meets earthly passion. As one brother grapples with a child's death, another faces his own moral crisis.
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An excerpt from the original text.(~500 words)
Lusha The doctor came out of the room again, muffled in his fur coat and with his cap on his head. His face looked almost angry and disgusted, as though he were afraid of getting dirty. He cast a cursory glance round the passage, looking sternly at Alyosha and Kolya as he did so. Alyosha waved from the door to the coachman, and the carriage that had brought the doctor drove up. The captain darted out after the doctor, and, bowing apologetically, stopped him to get the last word. The poor fellow looked utterly crushed; there was a scared look in his eyes. “Your Excellency, your Excellency ... is it possible?” he began, but could not go on and clasped his hands in despair. Yet he still gazed imploringly at the doctor, as though a word from him might still change the poor boy’s fate. “I can’t help it, I am not God!” the doctor answered offhand, though with the customary impressiveness. “Doctor ... your Excellency ... and will it be soon, soon?” “You must be prepared for anything,” said the doctor in emphatic and incisive tones, and dropping his eyes, he was about to step out to the coach. “Your Excellency, for Christ’s sake!” the terror‐stricken captain stopped him again. “Your Excellency! but can nothing, absolutely nothing save him now?” “It’s not in my hands now,” said the doctor impatiently, “but h’m!...” he stopped suddenly. “If you could, for instance ... send ... your patient ... at once, without delay” (the words “at once, without delay,” the doctor uttered with an almost wrathful sternness that made the captain start) “to Syracuse, the change to the new be‐ne‐ficial climatic conditions might possibly effect—” “To Syracuse!” cried the captain, unable to grasp what was said. “Syracuse is in Sicily,” Kolya jerked out suddenly in explanation. The doctor looked at him. “Sicily! your Excellency,” faltered the captain, “but you’ve seen”—he spread out his hands, indicating his surroundings—“mamma and my family?” “N—no, Sicily is not the place for the family, the family should go to Caucasus in the early spring ... your daughter must go to the Caucasus, and your wife ... after a course of the waters in the Caucasus for her rheumatism ... must be sent straight to Paris to the mental specialist Lepelletier; I could give you a note to him, and then ... there might be a change—” “Doctor, doctor! But you see!” The captain flung wide his hands again despairingly, indicating the bare wooden walls of the passage. “Well, that’s not my business,” grinned the doctor. “I have only told you the answer of medical science to your question as to possible treatment. As for the rest, to my regret—” “Don’t be afraid, apothecary, my dog won’t bite you,” Kolya rapped out loudly, noticing the doctor’s rather uneasy glance at Perezvon, who was standing in the doorway. There was a wrathful note in Kolya’s voice. He used the word apothecary instead of doctor on purpose, and, as he...
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Intelligence Amplifier™ Analysis
The Road of Comfortable Cruelty
When people are insulated from consequences, they become casually cruel without recognizing the harm they cause.
Why This Matters
Connect literature to life
This chapter teaches how to identify when someone's distance from consequences makes them casually indifferent to your suffering.
Practice This Today
This week, notice when professionals deliver bad news without emotion—ask yourself if they face any consequences for the pain they're causing you.
Now let's explore the literary elements.
Terms to Know
Class privilege in medicine
The way wealthy people get better healthcare and more compassionate treatment from doctors. In 19th century Russia, poor families like Ilusha's were treated as charity cases, while rich patients got personal attention and hope.
Modern Usage:
We still see this when wealthy patients get concierge medicine while working-class families wait in emergency rooms or get rushed appointments.
Medical paternalism
When doctors act like all-knowing authorities who don't need to explain themselves or show empathy to patients and families. They deliver harsh news without considering the emotional impact on desperate people.
Modern Usage:
This happens when doctors speak only in medical jargon, refuse to answer questions, or act annoyed when families want more information about a loved one's condition.
Impossible hope
When someone offers solutions that sound helpful but are completely unrealistic for the person's situation. The doctor suggests expensive treatments abroad that this poor family could never afford, making his advice cruel rather than helpful.
Modern Usage:
Like when financial advisors tell minimum-wage workers to 'just invest more' or when people suggest expensive therapies to families already drowning in medical debt.
Dignified poverty
How poor people maintain their self-respect and moral values even when they can't afford what they need. The captain still shows respect to the rude doctor and focuses on his son's emotional needs rather than begging for money.
Modern Usage:
We see this when working families dress their best for parent-teacher conferences or when people facing eviction still help their neighbors.
Child's wisdom
When children facing serious situations show more emotional maturity than the adults around them. Ilusha understands his situation and tries to comfort his father instead of the other way around.
Modern Usage:
This happens when kids in difficult family situations become caregivers, or when children with serious illnesses comfort their parents.
Righteous anger
Anger that comes from seeing injustice, especially when someone with power treats vulnerable people badly. Kolya's fury at the doctor represents what everyone feels but can't express due to social position.
Modern Usage:
Like when someone finally speaks up to a boss who's been mistreating workers, or when people get angry at politicians who ignore working-class struggles.
Characters in This Chapter
The doctor
Antagonist representing class privilege
He delivers Ilusha's death sentence with cold professionalism, suggesting expensive treatments he knows the family can't afford. His dismissive attitude shows how wealth creates callousness toward the poor.
Modern Equivalent:
The specialist who spends two minutes with you, talks over your head, and suggests treatments your insurance won't cover
Captain Snegiryov
Desperate father
Ilusha's father begs the doctor for any hope while maintaining his dignity. His terror and helplessness show how parents suffer when they can't save their children, regardless of social class.
Modern Equivalent:
The parent in the hospital hallway, asking every nurse if there's anything else that can be done
Kolya
Voice of moral outrage
He explodes at the doctor's callousness, calling him names and threatening him with his dog. His anger represents what everyone feels but can't express due to social position.
Modern Equivalent:
The teenager who calls out adults for their hypocrisy when everyone else stays silent
Ilusha
Dying child showing wisdom
Despite being mortally ill, he comforts his father and makes practical requests about his burial. His maturity in facing death shows how suffering can create unexpected strength.
Modern Equivalent:
The kid with a serious illness who ends up taking care of everyone else's feelings
Alyosha
Peacekeeper and witness
He tries to maintain peace between Kolya and the doctor while witnessing the family's suffering. His presence provides stability in an emotionally chaotic situation.
Modern Equivalent:
The family friend who shows up during a crisis and just stays present without trying to fix everything
Key Quotes & Analysis
"I can't help it, I am not God!"
Context: When the desperate father begs him to save Ilusha's life
This reveals the doctor's coldness and refusal to take responsibility for his lack of compassion. He hides behind professional distance to avoid dealing with human suffering.
In Today's Words:
Not my problem, I just work here
"Your Excellency, for Christ's sake!"
Context: Desperately trying to get the doctor to offer any hope for his dying son
Shows how desperation makes people beg from those with power, even when those people have already shown their indifference. The religious reference emphasizes his complete helplessness.
In Today's Words:
Please, I'm begging you, there has to be something you can do
"Find another boy, a good boy, and love him instead of me"
Context: Trying to comfort his father about life after his death
This shows heartbreaking maturity and selflessness. A dying child is trying to solve his father's future grief, demonstrating how love makes us think of others even in our darkest moments.
In Today's Words:
Dad, when I'm gone, you need to find someone else to care about
Thematic Threads
Class
In This Chapter
The wealthy doctor offers impossible treatments while dismissing the family's poverty
Development
Continues exploring how economic inequality creates different realities and moral blind spots
In Your Life:
You might see this when dealing with professionals who can't understand why their expensive solutions aren't options for you
Dignity
In This Chapter
Kolya defends the family's dignity by confronting the doctor's callousness
Development
Shows how dignity must sometimes be actively protected against those who would strip it away
In Your Life:
You might need to speak up when someone treats you or your loved ones as less than human
Love
In This Chapter
The father's refusal to consider replacing Ilusha shows love's irreplaceable nature
Development
Deepens the exploration of parental love as something beyond reason or substitution
In Your Life:
You might recognize that some relationships can't be replaced, only grieved and honored
Powerlessness
In This Chapter
The family faces medical authority with no resources to challenge or change their situation
Development
Explores how systemic inequalities leave people vulnerable to institutional indifference
In Your Life:
You might feel this when dealing with bureaucracies that hold power over your essential needs
Presence
In This Chapter
Kolya promises to return and stay with Ilusha, offering companionship over false hope
Development
Introduces the theme of showing up as the most honest form of support
In Your Life:
You might find that simply being there matters more than having solutions when someone is suffering
You now have the context. Time to form your own thoughts.
Discussion Questions
- 1
What specific behaviors made the doctor's delivery of bad news so cruel, beyond just the medical facts he shared?
analysis • surface - 2
Why does the doctor suggest expensive treatments he knows the family can't afford - what does this reveal about how he sees his role?
analysis • medium - 3
Where do you see this same pattern of 'comfortable cruelty' in modern institutions - healthcare, insurance, customer service, or government agencies?
application • medium - 4
When you're dealing with someone who has power over your situation but won't face consequences for their decisions, what strategies protect you?
application • deep - 5
What does Ilusha's mature response to his own death sentence teach us about dignity in impossible situations?
reflection • deep
Critical Thinking Exercise
Map Your Power Dynamics
Think of a recent frustrating interaction with customer service, insurance, medical billing, or any institution. Draw or describe the power dynamic: Who had consequences to face? Who could walk away? Who had to live with the results? Then identify three specific strategies that could have protected you or gotten better results.
Consider:
- •Look for the buffer zones - what protects them from seeing your pain?
- •Consider documentation - what evidence do you need when someone can deny they said something?
- •Think about allies - who else has skin in the game and might advocate for you?
Journaling Prompt
Write about a time when someone in power treated you as a problem rather than a person. How did their distance from consequences affect their behavior? What would you do differently now?
Coming Up Next...
Chapter 70: Grushenka's Desperate Plea
In the next chapter, you'll discover jealousy can mask deeper fears about abandonment and self-worth, and learn people in crisis often push away those they need most. These insights reveal timeless patterns that resonate in our own lives and relationships.