“A Painful Case” and the other Dubliners stories are written in a realistic style with so much naturalistic detail about Ireland’s capital that some critics consider the city to be the hero of the book. Because Joyce has a definite design in mind, however, the details not only heighten verisimilitude, but also are symbolically and thematically significant.

For example, the name of the Dublin suburb where Duffy lives—Chapelizod—recalls the tragic love story of the Arthurian prince Tristan and Irish princess Iseult. Joyce’s description of Duffy’s unpublished translation of Gerhart Hauptmann’s play Michael Kramer (1900; English translation, 1911) in his desk also is highly suggestive. Joyce probably selected the play, which he himself once had translated, because both Hauptmann’s hero and Duffy are aloof loners who are incapable of love and believe that artists must isolate themselves. The lack of color in Duffy’s room; the brown tint that is both the color of his face and Dublin’s streets; the shallow river and disused distillery near which he lives—all of these details are of a piece, creating a sense of sterility, drabness, and ineffectuality. The method is similar to that which Joyce utilizes at the start of “Araby,” the third Dubliners story: Physical details signify inner qualities.

Joyce’s narrative realism is combined with a simple plot whose few incidents culminate in a crisis leading to a personal revelation or recognition. The enlightenment that comes with this epiphany, something of a confrontation with reality, is illuminating but not rejuvenating, and indeed may reinforce prevailing inadequacies and paralysis. Joyce uses this technique, like his symbols, not only in “A Painful Case” but also elsewhere in Dubliners to give cumulative emphasis to his themes.