“He was like a pregnant woman, only that the thing inside him was not a baby but a youth. No, it wasn’t a youth, it was a woman, young, and wearing a coat of mail like a knight. It is absurd, you see, to try to tell what was inside the old writer as he lay on his high bed and listened to the fluttering of his heart. The thing to get at is what the writer, or the young thing within the writer, was thinking about.”

In this passage, Sherwood Anderson underlines the book’s thematic interest in The Loneliness of One’s Inner World. Through the old writer, Anderson makes a direct appeal to the reader to look past the absurdity of the characters’ circumstances and idiosyncrasies and focus on the intimate thoughts these details reveal about each character’s unique interiority.

“The story of Wing Biddlebaum’s hands is worth a book in itself. Sympathetically set forth it would tap many strange, beautiful qualities in obscure men. It is a job for a poet. In Winesburg the hands had attracted attention merely because of their activity. With them Wing Biddlebaum had picked as high as a hundred and forty quarts of strawberries in a day. They became his distinguishing feature, the source of his fame. Also they made more grotesque an already grotesque and elusive individuality.”

Anderson describes Wing Biddlebaum as grotesque, evoking his own definition of the word (established in his opening story, “The Book of Grotesque”), referring to the distinguishing traits that set an individual character apart from their community. In doing so, he highlights the concept of Individuality in a Small Town as a major theme in this passage.

“For several weeks the tall dark girl and the doctor were together almost every day. The condition that had brought her to him passed in an illness, but she was like one who has discovered the sweetness of the twisted apples, she could not get her mind fixed again upon the round perfect fruit that is eaten in the city apartments.”

Anderson ends Paper Pills by returning to the extended metaphor of the twisted apple, which not only applies to Doctor Reefy, but to virtually all the subject characters across the book. In this passage, Anderson explains that once people appreciate the loveable traits of grotesque characters, they gain a more nuanced concept of love that makes them unable to love others in common ways again.