Dimmesdale's self loathing is apparent is much of his behavior. The most obvious is his constant heart pain. Even Pearl notices that he always keeps his hand over his heart. This is caused not only by pain, but also because he is trying to hide his feelings of remorse from others. In addition, he carves or burns a letter "A" into his chest. The townspeople do not discover this until the end of the novel, but Dimmesdale has obviously believed he deserved a scarlet letter as well as Hester. Dimmesdale also flogs himself at night and holds all night prayer vigils in hopes of ridding himself of the guilt and self-loathing he feels. In the second scaffold scene, he anguishes over telling the town about his sin, only to leave the scaffold in the middle of the night with Chillingworth, who, unknown to Dimmesdale, is contributing to his feelings of guilt. Finally, when he does confess, his body is so weakened by the constant struggle he feels, that his heart is simply too sick to survive his confession. He dies a confessed but unfulfilled sinner who never gets to watch his daughter grow up.