In this novella, which takes place in a mental hospital in a provincial town, Chekhov focuses on the philosophical conflict between Ivan Dmitrich, an educated patient, and Doctor Andrey Yefimitch. While Ivan Dmitritch opposes the injustice they are exposed to - the miserable conditions in which they are forced to live - Andrey Yefimitch insists on ignoring them and does not even move a finger to change the situation. When the doctor finally realizes the 'philosophical' mistake he has fallen into, it is too late. The Sixth Ward is the symbol of the 'madness' of the elite Russian intellectuals who prefer to watch Russia and the country's problems from afar rather than dealing with them.