From the book:
I am a sick man. ... I am a spiteful man. I am an unattractive man. I believe my liver is diseased. However, I know nothing at all about my disease, and do not know for certain what ails me. I don't consult a doctor for it, and never have, though I have a respect for medicine and doctors. Besides, I am extremely superstitious, sufficiently so to respect medicine, anyway (I am well-educated enough not to be superstitious, but I am superstitious). No, I refuse to consult a doctor from spite. That you probably will not understand. Well, I understand it, though. Of course, I can't explain who it is precisely that I am mortifying in this case by my spite: I am perfectly well aware that I cannot "pay out" the doctors by not consulting them; I know better than anyone that by all this I am only injuring myself and no one else. But still, if I don't consult a doctor it is from spite. My liver is bad, well - let it get worse! I have been going on like that for a long time - twenty years. Now I am forty. I used to be in the government service, but am no longer. I was a spiteful official. I was rude and took pleasure in being so. I did not take bribes, you see, so I was bound to find a recompense in that, at least. (A poor jest, but I will not scratch it out. I wrote it thinking it would sound very witty; but now that I have seen myself that I only wanted to show off in a despicable way, I will not scratch it out on purpose!)