“Ha, ha, ha! Next you’ll be finding pleasure in a toothache!” you will exclaim, laughing.
“And why not? There is also pleasure in a toothache,” I will answer.

This passage, which begins Chapter IV of the “Underground” section, illustrates the extent of the Underground Man’s masochism. In the previous chapter, he has described in great detail the ways in which he takes pleasure in his own humiliation, enjoying the extremity of his indecision and powerlessness. The “you” in the quotation is the Underground Man’s imagined audience, to which the entire novel is addressed. This audience represents the perspective of the rational man, who would certainly scoff at the perverse idea that someone could enjoy something that brings him pain. The statement that the Underground Man will next be finding pleasure in a toothache is sarcastic, a dismissal of the absurdity of the situation. No one in their right mind could take pleasure in a toothache.

Always ready to take an idea to its extreme, and eager to disprove any unshakable assumptions his audience might have about reason and nature, the Underground Man brings the perversity of his idea to the next level: there is indeed pleasure in a toothache. He goes on to describe the aesthetic value of the moans of someone suffering from a toothache. His moans are “conscious” moans, the moans of a “developed” man who has been exposed to European civilization and understands that true art has no purpose besides itself. The developed man will construct elaborate, symphonic moans and groans that will give him the satisfaction of irritating his friends and family.

The reference to European civilization relates the idea of the toothache to the question of the value of European culture’s influence on Russia. Indeed, the Underground Man’s pleasure in his toothache is an indication not only of his masochism and his desire to perplex his audience, but of the artificiality of his existence. His enjoyment of the toothache becomes a parody of his enjoyment of other “developed” pleasures, encouraged by European literature and philosophy. Dostoevsky was extremely critical of the way in which this Europeanized, “developed” way of thinking alienated Russian intellectuals from the real culture and people of Russia, who worked with the soil as members of a community. The refinements that the Underground Man exaggerates in this passage are both a result of and a contributing factor to his isolation from society.