Ivan Ilych is dying, and everyone in his house has agreed to pretend he isn’t. His wife, his daughter, his acquaintances, and his doctors talk about treatment and recovery. Tolstoy is precise about what hurts most. It isn’t the pain, which is terrible. It’s the deception, the lie everyone keeps up around him. He comes within a hairbreadth of shouting at them: “Stop lying! You know and I know that I am dying.” He never does. Later Tolstoy describes his loneliness as complete, though he lies in a busy household in the middle of a crowded town.

One person won’t play along. Gerasim, the butler’s young assistant, a peasant lad who carries out the sickroom commode, holds his master’s legs up on his shoulders, sometimes all night long, because Ivan feels better while he does. Once, when Ivan is sending him away, Gerasim says straight out, “We shall all of us die, so why should I grudge a little trouble?” Tolstoy tells us that Gerasim alone did not lie, and that Ivan was at ease only with him.

Tolstoy published The Death of Ivan Ilych in 1886. Nothing Gerasim does changes the fact that his master will die, and he doesn’t try. He offers no explanation, no comfort about the afterlife, no change of subject. He stays in the room with the fact.

No one in that house could take Ivan’s death away, and the ones who tried made him lonelier. What Gerasim changed looked small: Ivan wasn’t the only one awake. Death frames every life, and no amount of company removes the isolation of dying. But presence brings a dying person comfort, and something less obvious, a coherence and even a meaning to the experience itself.

A Line Worth Pinning Up

Irvin Yalom put Gerasim’s gift into one sentence. In Staring at the Sun, in a chapter called “Overcoming Death Terror Through Connection,” he writes: “Sheer presence is the greatest gift you can offer anyone facing death (or a physically healthy person in a death panic).”

He didn’t pretend presence closes the distance between two people. Of the four ultimate concerns at the center of his thinking, death, freedom, isolation, and meaninglessness, John Grady and John Viterito read him as ranking death first. Isolation, in his account, never goes away; in Existential Psychotherapy he calls it “an unbridgeable gulf” between oneself and anyone else. A few pages later he says what can be done about it: “No relationship can eliminate isolation. Each of us is alone in existence. Yet aloneness can be shared in such a way that love compensates for the pain of isolation.”

That last sentence is Gerasim, holding a dying man’s legs on his shoulders, sometimes all night long.

Where Yalom Turns to Buber

Then Yalom does something I didn’t expect from the author of the four ultimate concerns. In that same chapter on isolation, he turns several times to the philosopher Martin Buber. He quotes Buber’s line that a great relationship “throws a bridge from self-being to self-being across the abyss of dread of the universe.” He begins his account of “need-free love” with Buber’s I-Thou meeting: to relate truly, you have to listen, drop your stereotypes and expectations of the other, “and allow oneself to be shaped by the other’s response.”

He even retells the story Buber told about himself. A young man came to see Buber, apparently for a chat. Buber was kind and thoughtful, and only later learned that the visitor had come on the edge of a momentous decision. Buber berated himself, Yalom writes, for “not being there in spirit.” In Buber’s own account of that visit, he names what someone in despair is looking for when they go to another person: “a presence by means of which we are told that nevertheless there is meaning.” Gerasim gave Ivan that. Ivan’s family did not.

Yalom is candid that the borrowing is uneasy. In his reading, Buber held that our basic mode of existence is relational and that we are creatures of the between. Yalom admits that Buber “would protest” at his making isolation fundamental, “and even more vigorously would he protest at my citing his work as part of my discussion.” A page later he pushes back, reading one of Buber’s own recurring dreams as beginning with “a solitary, lonely cry, anxiously awaiting a response.” I take up that dream in The Buffer

I don’t think the two are as far apart as Yalom’s concession suggests. In a 1951 essay, “Distance and Relation,” Buber argues that a person can enter into relation only with what has been set at a distance, as something genuinely other. He is careful to add that this isn’t a sequence in time: distance is the precondition of relation, not a stage that comes before it, and the two can also work against each other. To meet someone, I have to know they are not me. That same knowledge, felt from the other side, is what Yalom calls isolation: the awareness of distance and difference that makes meeting possible is also the awareness of being alone. Ivan’s family worked to erase the distance with a lie, as if nothing separated the dying man from the living. Their lie may have protected them as much as him, keeping their own fear of death at arm’s length. Gerasim honored the distance. He named death plainly and stayed. Buber knew a meeting like that can’t last: “every Thou in the world is by its nature fated to become a thing.” My own view goes a step beyond his: what lasts is what the meeting called out in each person. The manuscript this blog grows out of follows that thread, and later posts will too.

Viktor Frankl would have recognized Gerasim too. In Man’s Search for Meaning, he places meaning “in the world rather than within man or his own psyche,” and his word for how we come to it is discovery. But he doesn’t mean stumbling on it. Each of us, he writes, is “questioned by life,” and we answer by taking responsibility for our own. One place he says we find meaning is in encountering another person. Another is the attitude we take toward suffering we cannot avoid. He also insists that “the transitoriness of our existence in no way makes it meaningless.” To my mind, the meaning of an encounter is made possible, not erased, by the fact that it will end, and it is something we make as well as find. (An earlier version of this post said Frankl called meaning constructed. His word was discovered; The Buffer takes up where I part company with him.)

Tolstoy shows both at once in the novella’s last pages. Two hours before Ivan dies, still screaming, his hand falls on his schoolboy son’s head, and the boy catches it, presses it to his lips, and begins to cry. Ivan opens his eyes, looks at his son, and feels sorry for him, then for his wife. He wants to spare them. Only after that does he look for his old fear of death and fail to find it. “In place of death there was light,” Tolstoy writes, and he adds that the meaning of that instant did not change. Ivan still dies his own death. But the end comes inside a touch, and it makes sense of his last hours in a way the lie never could. That’s what I mean when I say presence brings coherence as well as comfort.

Yalom’s chapter on connection in Staring at the Sun holds an idea that reaches past the bedside. He calls it rippling: each of us can create, “often without our conscious intent or knowledge,” circles of influence that may affect others for years, even generations. And, he adds, rippling “does not necessarily mean leaving behind your image or your name.” Gerasim is a minor character in a short book. We never learn what became of him. Yet the few hours he gives a dying man have been read for nearly a hundred and forty years, and they still teach people how to sit with someone who is afraid. When clients bring me their anxiety about dying, rippling is often an idea they find helpful. Sometimes it’s as straightforward as recognizing the many small interactions that fill a day: the friendly greeting offered to the overworked clerk at the grocery checkout, or being the person who goes out of their way to greet the student who gets lost in the busyness of the classroom.

“The Total Isolation of Death”

Psychology has studied death anxiety for more than a century, but the founders of terror management theory note that “in the realm of scientific psychology, the problem of death has never garnered much attention.” Their program began in the 1980s, when three young social psychologists came upon Ernest Becker’s The Denial of Death and set out, in their words, “to build on Becker’s claim that people strive for meaningful and significant lives largely to manage the fear of death.” Of everything that program has produced, the piece I find most telling is modest. In 2010, Clay Routledge and Jacob Juhl asked sixty undergraduates how meaningful their lives felt, then split them at random: some wrote briefly about their own death, others about failing an important exam. Afterward, everyone answered questions about how anxious they felt about their own death. Writing about death raised that anxiety only for students whose lives felt thin on meaning. One item on the scale stopped me: it asks how anxious you feel about “the total isolation of death.” Even a questionnaire built to measure fear of one’s own death counts its isolation as part of the fear.

That’s the study’s connection to Gerasim, and also its limit. It measured meaning, not presence; it never asked who was in the room. So it supports half of what I’m arguing, that meaning keeps the thought of death from turning into dread, and leaves the other half to Tolstoy and Yalom. There’s one more reason for care. Routledge and Juhl used terror management theory’s classic method, a brief written reminder of death, and in 2022 a project called Many Labs 4 failed to find one of the theory’s classic effects with that kind of reminder across seventeen labs. The failed effect was a different one, how people defend their worldview after thinking about death, so it doesn’t undo the 2010 result. It does raise the possibility that a few minutes of writing about death move people less reliably than the theory assumed, which is why the study is supporting evidence here, not the foundation.

A second line of work comes at the same question from the other side. In a 2002 series of studies led by Mario Mikulincer, people who merely imagined a long or final separation from a partner had thoughts of death come more readily to mind, mainly if they already worried about being left.

A study from the same year as Routledge and Juhl’s, led by Jacob Juhl, found the same pattern regarding nostalgia. A death reminder raised fear of dying in people who rarely think back fondly on their past, but not in people who often do. The authors point out that in nostalgic memories the self is often surrounded by close others, though they’re careful to say no one yet knows which part of nostalgia does the protecting. I’d put my money on the people populating those memories.

My Take

When someone we love is frightened of dying, the instinct is to reassure: you have years yet, the scan will be fine, try not to dwell on it. Ivan’s family did a version of exactly that, and it made the house the loneliest place he could be. What Gerasim did is harder. He said the true thing out loud and then stayed put.

Meaning helps too, as the 2010 study suggests. But presence is the one thing any of us can offer tonight, without a theory of death or the right words. I’ve watched it do more in a therapy room than anything I could have said.

If you want to take a look at the research underneath this, including another angle this post leaves out, I’ve written a longer companion essay, The Buffer.

Go Deeper

  • The Death of Ivan Ilych by Leo Tolstoy. Short enough to read in an evening, free online in the public-domain Maude translation, and still the most honest portrait I know of dying alone in a crowded house.
  • Staring at the Sun: Overcoming the Terror of Death by Irvin D. Yalom. Yalom’s book on mortality for general readers; the chapter on connection is where the line about presence lives.
  • With the End in Mind: Dying, Death, and Wisdom in an Age of Denial by Kathryn Mannix. A palliative-care physician’s stories from her practice, arguing that honesty and preparation can make dying less frightening; longlisted for the Wellcome Book Prize.

References

  • Becker, E. (1973). The Denial of Death. Free Press.
  • Buber, M. (2002). Between Man and Man (R. G. Smith, Trans.). Routledge Classics.
  • Buber, M. (2000). I and Thou (R. G. Smith, Trans.). Scribner Classics.
  • Buber, M. (1988). The Knowledge of Man: Selected Essays (M. Friedman, Ed.; M. Friedman & R. G. Smith, Trans.). Humanities Press International. (Original work published 1965)
  • Frankl, V. E. (1984). Man’s Search for Meaning (3rd ed.). Simon & Schuster.
  • Grady, J., & Viterito, J. (2026). The evolution of Irvin Yalom’s existential views on death anxiety. The Humanistic Psychologist, 54(1), 27–44. https://doi.org/10.1037/hum0000381
  • Juhl, J., Routledge, C., Arndt, J., Sedikides, C., & Wildschut, T. (2010). Fighting the future with the past: Nostalgia buffers existential threat. Journal of Research in Personality, 44, 309–314.
  • Klein, R. A., et al. (2022). Many Labs 4: Failure to replicate mortality salience effect with and without original author involvement. Collabra: Psychology, 8(1), 35271. https://doi.org/10.1525/collabra.35271
  • Mikulincer, M., Florian, V., Birnbaum, G., & Malishkevich, S. (2002). The death-anxiety buffering function of close relationships. Personality and Social Psychology Bulletin, 28(3), 287–299.
  • Routledge, C., & Juhl, J. (2010). When death thoughts lead to death fears. Cognition and Emotion, 24(5), 848–854.
  • Solomon, S., Greenberg, J., & Pyszczynski, T. (2015). The Worm at the Core. Random House.
  • Tolstoy, L. (1886). The Death of Ivan Ilych (L. & A. Maude, Trans.).
  • Yalom, I. D. (1980). Existential Psychotherapy. Basic Books.
  • Yalom, I. D. (2008). Staring at the Sun: Overcoming the Terror of Death. Jossey-Bass.

Revised October 2026. This version reframes the argument and corrects several attributions in the original post.