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At the center of Joyce's “A Painful Case” stands the figure of a seemingly mature man who has never really lived—who has experienced no sensations, passions, impulses, or pleasures. Plot seems less important than the idea of an unlived life embodied in a person who has never really enjoyed—who has lived only for duty, conscience, and propriety. The first element of the ironic narrative pattern, that of circular movement (back and forth in the case of Duffy), reflects the emotional stasis which is his particular case: “He had neither companions nor friends.”
The question of Duffy's consciousness is of paramount interest, for Duffy is at the center of the story from its inception; he informs its development and illuminates its possibilities. The significance of the story lies in Duffy's vision; the “lives” of Mrs. Sinico, the cultural setting, and the incidents have meaning for us only in so far as they are seen by Duffy. For example, it is through Duffy's eyes that we see the meaning of Mrs. Sinico's death. However, Joyce rarely misses a chance for ironic commentary; by standing just outside of Duffy's consciousness he illuminates the irony. The title of the story is a good example: of course, Mrs. Sinico's death is a painful case, but the more painful case is Duffy's. Full dramatic irony comes when we realize that at first Duffy cannot fully see his own loss reflected in Mrs. Sinico's death; it is only at the epiphany that full knowledge comes.
James Duffy's case is that of the alienated man. His pattern of life reflects his spiritual isolation, and we have the image of a medieval monk in his cell. We are told that the lofty walls of his uncarpeted room are free from pictures; his room contains a black iron bedstead, an iron washstand, a fender and irons, and four cane chairs. We also learn that it is he who bought every article of furniture in the room;