New York City was historically known as a destination for those seeking adventure and new opportunities, and often described as a center of fine living and society. It was considered at the time of the publication of "Paul's Case" as “the symbol of ultimate glamour and cosmopolitan sophistication”.[3] Indeed, in the story, New York City is described as lavish and extraordinary, in contrast to the descriptions of Paul's home, Pittsburgh, which he despises.[4]
Paul, a high school student from Pittsburgh, is frustrated with his dull middle-class life. This frustration, mixed with a desire for a luxurious lifestyle, causes him to purposely separate himself from everyone else, leading to feelings of isolation.[5] Paul's teachers and father refer to Paul as a "case", representing him at a distance and as an example of someone to be studied, handled, and managed; the term enables Cather to adopt "the voice of medical authority".[6] Paul seems to display some symptoms of a narcissistic personality disorder, but that is still debated.[7]
