The story opens with a description of a lunatic asylum, ward no. six, in a provincial hospital. The ward has five pitiful inmates—including the "imbecile" Jew Moiseika—and is overseen by a coarse porter named Nikita. The narrator describes how a university-educated inmate named Ivan Gromov drove himself mad with paranoia and was admitted to the asylum. The hospital is run by Dr. Andrei Yefimich Rabin, a "strange man" who became a doctor to humor his father, after actually wanting to become a priest. Rabin begins his career as a highly motivated physician who looks after his patients with the greatest of care. However, he is soon disillusioned by the "uselessness" of his task, neglects to visit the wards, and becomes indifferent to his patients' plight. Rabin eases his conscience with the thought that every man is born to die and concludes that "suffering leads man to perfection."