Dubliners (1914) is a collection of fifteen James Joyce stories, of which “A Painful Case” is the eleventh. It follows “Clay,” with which it shares the theme of lovelessness. Like all the works in the volume, “A Painful Case” dramatizes what Joyce saw as an emotional and moral paralysis afflicting his native city. Duffy’s inability to admit changes into his daily routine or feeling into his life is the centerpiece of the story, which describes two painful cases: a man who denies love and a woman who vainly searches for it. Although Roman Catholicism was pervasive in Irish spiritual and temporal life at the time, its reach does not extend to these characters, and Joyce’s comment that Duffy lives “his spiritual life without any communion with others” signals his rejection of the church. Among Duffy’s books is Friedrich Nietzsche’s Also sprach Zarathustra: Ein Buch für Alle und Keinen (1883-1885; Thus Spake Zarathustra, 1896), an anti-Christian tract about a self-sufficient superman who needs neither social interaction nor romantic love. Also, at one point in their relationship, Mrs. Sinico, with an almost maternal solicitude, becomes Duffy’s confessor. In Catholicism, however, women cannot play this role. Such an ironic or inverted treatment of Ireland’s religion is a recurrent thematic motif in other Dubliners tales.

Like all of these stories, “A Painful Case” progresses toward what the author called an “epiphany,” a sudden realization or rude awakening to the truth about oneself or one’s world. Duffy experiences such an enlightenment, but, as is typical in these stories, it is too late to do him any good. It comes in stages: His first reaction to Mrs. Sinico’s death is disgust; then he experiences pangs of guilt; finally, he reaches the point of self-awareness. A wiser man, he also is infinitely sadder. Except for the brief time with Mrs. Sinico, he has lived alone and seemed suited to a solitary, adventureless existence; but after his epiphany, for the first time he feels alone, and what remains of his life indeed may be intolerable.

The consequences of Duffy’s denial of Mrs. Sinico’s instinctive passionate gesture are beyond his ken. Rather than reestablishing the reasoned order of his life, it sows the slowly nurturing seeds of its destruction. Further, the denial destroys Mrs. Sinico. Seeking love, she finds only temporary intellectual companionship, and when the interlude ends, her physical and emotional decline is aggravated by alcoholism. A normal person, according to an examining surgeon, would not have died of Mrs. Sinico’s injuries; her death, he thought, probably was the result of shock and heart failure. Whether it was accidental or a suicide, she dies of a broken heart.

The last paragraph of the story starts with the rhythm of a freight train reverberating in Duffy’s ears and concludes with utter silence, symbolizing his loneliness. The passage also suggests another theme, the failure of people to communicate, which Joyce develops throughout the story. For example, in the opening paragraph, Duffy is said to be an unpublished author, a closet writer; later, responding to Mrs. Sinico, he explains his reluctance to publish by speaking scornfully of potential audiences. In addition, her interpretation of his words disillusions him. On the night he learns of her death, Duffy goes to a pub, but the proprietor does not talk to him, even while serving him obsequiously. Duffy gazes at other men in the pub, but neither sees nor hears them.

“The Sisters,” the first Dubliners story, begins “There was no hope for him . . . ,” and the young narrator, looking up at a dying priest’s window, says softly to himself the word “paralysis.” Nor is there any hope for Duffy in “A Painful Case”; he suffers from the same emotional and spiritual paralysis that afflicts so many people in Dubliners, which ends with the aptly titled story “The Dead.”