He had six brothers (William, Egerton, Albert, Jeyarajan, Arthur and Ellalasingam) and three sisters (Girlie Cooke, Amy Crosette-Thambiah and Tutse Rasaratnam).

[1][2] Paul married his cousin Winifred Hanah Ponmani, daughter of Dr William H. Ponniah Kanagasabai, in 1926.

[1] Ponmani was a sick woman and died in 1944 of cardiac failure caused by rheumatic mitral stenosis.

After Ponmani's death Paul married Irma Maheswari Tampoe Phillips, daughter of Francis Philips.

He applied for the post of Fifth Surgeon at Colombo General Hospital but was rejected due to his "youth and inexperience".

[2] Paul returned to Ceylon after obtaining his MS and took up a position as surgeon at the Civil Hospital in Jaffna in 1930.

[2] Paul was the first Ceylonese to deliver the Hunterian Oration at the Royal College of Surgeons of England on three occasions – The Surgical Anatomy of the Spermatic Cord (1950), Congenital Abnormalities of the Midline Abdominal Wall (1953) and Haemorrhages from Head Injuries (1955).