Revolving around philosophical and social conflicts, this story is set in a provincial mental asylum and explores the interactions occurring between a doctor and the members of his town. Andrey Yefimitch Ragin is the head doctor of a small town and although his position is favorable, he finds himself distressed with the mediocrity surrounding him. His deep desire to be submerged in intellectual conversation is satisfied by one of the patients in the mental ward adjacent to the hospital. This ward consists of five patients, referred to as lunatics, and a behavior enforcing soldier. The doctor seldomly visited the ward, but the one time he did, he became captivated by a paranoid patient who challenged his view on suffering. Ivan Gromov, although in a mental ward, was one of the sane members of the town, an eloquent man capable of engaging in the sort of intellectual conversation that the doctor had long been searching for. Gromov denounces the injustice he sees everywhere, while Dr. Ragin insists on ignoring injustice and other evils; partially as a result of this way of thinking, he neglects to remedy the shoddy conditions of the mental ward.