Paul suffers from an unnamed mental illness for which he is repeatedly hospitalized, paralleling Bernhard's own struggle with a chronic lung disease.

A very sensitive man, unsuitable for the world, obsessed by an exclusive and cruel passion for music as well as for race cars and sailing, Paul Wittgenstein dissipated his whole fortune and ultimately died poor.

Their friendship strengthened whilst both recovered in a hospital - Bernhard from a lung ailment and Paul from a bout of madness.

The latter will die alone in an asylum, a victim of an incurable conflict with the world; whereas the former will succeed in controlling his own madness, emblem of that very conflict[citation needed], and making it a lever for his sense of social living[citation needed].

Through the narration of symptomatic episodes, Bernhard unravels the emptiness of Austrian society[citation needed], its parasitic and vain aspects[citation needed], spending its time to self-congratulate on fake recognitions and futile prizes with the same rhythm used to blather and drink coffee in the best Viennese cafés.