"Paul's Case: A Study in Temperament" is, like the title implies, an analysis of a particular individual whose unique nature makes him worthy of exploration.
This is not a story about the life of a young man, but about how his nature is in direct conflict with his reality.
Paul's first conflict is his feeble nature. That is, undeniably, a very real problem. His feebleness entails that he is unable to cope with the typical dynamics of everyday life: He cannot stand the smell of cooking, has a fascination with aesthetics, and his love for artificiality is not a symptom of superficiality, but a sign of rebellion against, what he feels, is the tedious nature of reality.
Perhaps it was because, in Paul's world, the natural nearly always wore the guise of ugliness, that a certain element of artificiality seemed to him necessary in beauty. Perhaps it was because his experience of life elsewhere was so full of Sabbath-school picnics, petty economies, wholesome advice as to how to succeed in life, and the inescapable odors of cooking, that he found this existence so alluring, these smartly clad men and women so attractive, that he was so moved by these starry apple orchards that bloomed perennially under the limelight.
Another conflict is self identity versus status quo: Paul, contrary to the rest of the so-called "everyday people", knows more about himself than many people know about their own life. He is aware of what he likes and dislikes. He clearly does not care for those "role models" his father tries to have him emulate. He simply "is" and wishes to be left alone.
One last important conflict is life and death, in an allegorical way. Paul chooses to embark in the radical trip to New York, after stealing money from his job once his job at Carnegie Hall, his "bone" is taken away. He risks it all because, to him, life has no meaning unless it is lived the way that it should be lived. He wants to be part of the atmosphere of all beautiful people, and all the beautiful things.
Paul has no problem fitting in the society of the Waldorf in New York because, in his eyes, that is the life that he is supposed to have lived. When he is found out, and the possibility of returning to Cordelia Street comes back- A return to all that is ugly and petty- Paul threw himself under the railroad tracks.
When the right moment came, he jumped. As he fell, the folly of his haste occurred to him with merciless clearness, the vastness of what he had left undone. There flashed through his brain, clearer than ever before, the blue of Adriatic water, the yellow of Algerian sands.
However, even then Paul's conflicting life fought his own death:
Then, because the picture-making mechanism was crushed, the disturbing visions flashed into black, and Paul dropped back into the immense design of things.
Hence, Paul's main conflicts arise from his nature, his reality, and how he tries to survive it. When he cannot attain what he feels should be rightfully his, he much rather end life, as he knows it. Why continue, when he cannot live his own life as he feels that he should.