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Tolstoi's The Death of Ivan llych: A Source for Understanding Compassion

The desire not only to overcome but also to understand the pain and mystery of loss is a hidden theme in many of the requests for consultation that come to the psychiatric-mental health clinical nurse specialist in the general hospital. Although affected by the spiritual and moral suffering of dying patients and their relatives, health care professionals do not always grasp the underlying reasons for the silence, prudence, confusion, or even apparent uncaring attitudes and actions of relatives and their own colleagues towards dying patients. While literary sources in general and Tolstoi's The Death of Ivan llych in particular, have been used, much that has been written to sensitize them about death and dying has been underutilized. The Death of Ivan llych illustrates the despair and isolation of a dying man in the middle-class society of 19th century Russia, a society not unlike our own today in its honoring of the self before the interests of others. It specifically portrays the deep suffering of a lawyer and bureaucrat. Ivan llych, as he searches in his final illness for the meaning of his life. This literary work has the ability to fortify and enrich clinical nurse specialists in their consultative work guiding health care colleagues in their care of the dying.