“Paul’s Case” is intentionally claustrophobic. Told in close third-person narration, it hardly ever strays outside the confines of Paul’s mind. This extremely focused point of view conveys Paul's intense self-involvement. Paul is so consumed his own depression that he is rendered unable think about others. Not until midway through the story do we learn about the existence of Paul’s sisters. Even then, they are mentioned only in passing and never named. After using one of them to justify a lie to his classmates, Paul never thinks or speaks about them again. He doesn’t consider the feelings of his father, who lost his wife when his children were very young. Instead, he dismisses his father as an annoyance to be avoided and lied to. It doesn’t occur to him that his father worries about his whereabouts only because he loves him. Paul also never thinks about what it means that his father paid back the money he stole and set out for New York to find him. Like the sisters, Paul’s father is never named.
Cather’s tight focus on Paul’s point of view mirrors his self-absorption. His egoism blots out everyone, not just his family. The only people he observes with interest are those he idealizes—and he fails to see them as they really are. The soprano, Charley Edwards, and the Yale student are not real people for Paul but rather figures in a fantasyland of theater and money. He imagines that the soprano is a queen of romance, when in fact she is a middle-aged mother of several kids. He believes that Charley walks through a magic portal into the theater world, when Charley is actually a youngster in an unremarkable local troupe. He views the Yale student as the boy he himself was meant to be, when in reality the two can hardly get along for the space of one night. Whether Paul is ignoring the people who love him or fantasizing about those who hardly know him, he demonstrates his inability to think of anyone but himself. Even in the seconds before he dies, his last thought is for the places he won’t get to see, rather than the family members who will mourn his death.