James Joyce's "A Painful Case," alongside the other stories in his collection Dubliners, employs a realistic style that meticulously captures the essence of Ireland’s capital. These stories are so deeply rooted in the city's fabric that some critics argue Dublin itself emerges as the collection's central character. However, Joyce's intention goes beyond mere representation; the intricacy of his details serves not only to enhance realism but also to infuse the narrative with symbolic and thematic depth.

One striking example of this symbolic layering is found in the setting where the protagonist, Duffy, resides. The suburb of Chapelizod is a name steeped in literary allusion, conjuring the tragic romance of Tristan and Iseult from Arthurian legend. This allusion is not incidental; it subtly echoes Duffy’s own emotional desolation. Further, Joyce mentions an unpublished translation of Gerhart Hauptmann’s play Michael Kramer hidden in Duffy’s desk—a choice laden with meaning. Both Hauptmann’s protagonist and Duffy are characterized by their isolation and emotional detachment, believing that true artistry requires solitude.

The drabness of Duffy's world is meticulously painted through Joyce's choice of details—his colorless room, the brown-tinged streets of Dublin, and the shallow river flowing past a disused distillery. Each element contributes to a tapestry of sterility and ineffectiveness. This technique mirrors Joyce's approach in "Araby," another story in the collection, where physical descriptions are deeply intertwined with psychological and emotional landscapes.

In "A Painful Case," Joyce couples his narrative realism with a straightforward plot. Few events unfold, yet they build to a climactic crisis that leads to a profound personal revelation for Duffy. This epiphany, however, is a double-edged sword: it offers stark illumination but does not bring rejuvenation. Instead, it often underscores existing inadequacies and paralysis. Joyce masterfully uses this narrative strategy throughout Dubliners, crafting stories that resonate with cumulative thematic power.