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!

— Notes from the Underground