While lying in the hospital wing following the death of Orr, all of Yossarian's dreams and nightmares converged and collided in one diagnosis.
So long had he pretended to be afflicted with his fictitious liver disease, he forgot about the possibility of actually becoming ill.
But they told him this had now come to pass, his kidneys were dead and he would have to start dialysis.
Yossarian considered this turn of events. On the upside, it meant he would no longer be forced to fly any more missions - thus sparing him the possibility of death - but it also unquestionably meant he was now actually dying.
After some time on dialysis, he began to feel atrocious. A feeling that even the sight of his beloved Chaplain could not weaken. The feeling of being run over by a steam roller and of having the life gradually drained out of him.
He went to his superior and asked what could be done about this:
"Well you're dehydrated so you need to drink a lot more and take lighter dialysis for a few days"
"Won't that mean the toxins which should be cleared from my blood will just remain there, making me feel more nauseated, especially in the mornings and last thing at night?"
"Well yes, but that's Catch 22"
"And won't taking more fluid on board increase my risk of a fluid overload which could result in a heart attack?"
"That's Catch 22 also"
"I thought you said the first one was Catch 22?"
"It's a big loophole"
"What if I just don't do dialysis anymore?"
"Well then you'll die. That's the real Catch 22"
Yossarian returned to his sick bed and tried the light dialysis. As expected, he felt less like he had just had an encounter with the big wheel on a steam roller, but more like he wanted to take his insides, shove them in a bin bag and throw them down the garbage shoot.
As he lay there, he thought about dialysis and this Catch 22. He got it into his head that the power of dialysis only lay in the fact that everyone believed in it. Everybody did it, because they thought it was keeping them alive and nobody knew how to stop doing it because of Catch 22.
So he took the brave step of stopping. He felt relieved and released from his burden, he felt alive and for the two days he survived, well those were the happiest two days of his life.
It was actually at this point that he uttered the best quote from Heller's original version of the book.
"I'm not running away from my responsibilites. I'm running to them. There's nothing negative about running away to save my life"
Then he died.
Catch 22 caught up with him.