Ivan Ilyich finds himself living in a world of false appearances.  His whole life has been spent doing what's right in the eyes of society.  His house, his wife and his family only care about this front of propriety.  Only a few moments before his death does Ilyich finally realize that he is empty inside, that his whole life has been spent achieving the wrong aims.  Every notion of rightness ultimately proves to be wrong for him.  Only through the laborious suffering of his illness does Tolstoy's protagonist finally discover truth.  Though he's physically alive throughout the work, he only becomes spiritually alive in his last moments.