Paul and Karl have practically been best friends since they were in the womb since both of their dads worked in politics. "We were like two pieces of the same guy," Karl says. "I got the muscles and the common sense, he got the talent and the face" (1.38). He's always been the voice of reason in Karl's life, going all the way back to third grade when Karl got the idea that Communism would solve all of the problems in Lightsburg. Paul's response was that it was "a real stupid idea" (11.37), and ultimately, he was right.
At least, that's the way it's always been … until now. Karl and Paul both spend a lot of the book trying to alienate each other so they can both achieve normality and get out of therapy. Really, Paul has more of a reason than Karl to want out—being gay in a small town in the early 1970s wasn't exactly the greatest position to be in, and he takes a lot of flak for it both in school and at home.
For one thing, Paul is in the theater and music programs, and his dad would rather he "man up" and be a big athletic star. His dad usually acts out this anger by embarrassing Paul during moments of triumph at plays or choir concerts—"Mr. Knauss catches him afterwards and tells him that he's embarrassed the whole family" (17.29) by being gay, Karl explains to Marti. Gee, thanks, Dad.
As a result, Paul retreats even further into his shame by going up to "the stroll in Toledo" (17.32) to meet other gay men. Usually, the Madman Underground has to come rescue him before he gets beat up.
Ultimately, Paul resolves his desire to be normal and realizes he needs the Madmen more than he thought as a result of the incident with Gratz, Marti, and Huck Finn. "Right then, I realized I couldn't give the Madmen up," he explains. "Couldn't. I mean … been through too much together, love everybody […] Couldn't stop being a Madman, you now?" (21.92). We do know, Paul. We do.